Clinical Evaluation and Rehabilitation System for Dynamic Balance Control in Cervical Myelopathy Patients
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 16
- 试验地点
- 1
- 主要终点
- Kinetic(Ground reaction force)
研究概览
简要总结
Cervical myelopathy is common among the aging population.One of the complications of cervical myelopathy is balance impairment.In this study, the patients with cervical myelopathy undergo biomechanical, imaging, neurophysiological and functional assessment. Besides, the dynamic balance training is introduced to the patients with cervical decompression surgery.This study is expected to provide important empirical evidence to evaluate the prognosis of the surgery, to further guide the postoperative rehabilitation of myelopathy patients and to improve patients' long-term quality of life.
详细描述
Taiwan is quickly becoming a nation of the aging population with myelopathy reporting to be one of the most common spinal cord disorders associated with spinal degeneration. Given the high prevalence rate of the condition, current project aims to investigate the impact of myelopathy on motor control from a biomechanical perspective with the overall aim to develop an interactive balance perturbation rehabilitation program targeting individual patients and identified the deficiency. The efficacy of the individual rehabilitation program will be assessed and determined to utilize a prospective longitudinal study design. A break down of the proposed three-year project are as follows:
Year 1: Myelopathy patients prepared to receive cervical decompression surgery as well as age-matched asymptomatic controls will be recruited and subjected to the following clinical evaluations: 3-dimensional biomechanical motion analysis, diagnostic Magnetic Resonance Imaging, pain and disability questionnaires, motor performance assessment, spinal curvature, muscle strength assessment as well as transcranial magnetic stimulation examination. Motor control and coordination of functional movements will also be evaluated.
Year 2: Continue to recruit potential participants and further develop the use of the interactive split-belt balance perturbation treadmill as modalities for gait and balance therapy.
Year 3: Physical Therapy rehabilitation programs at 3-month post surgery, one group will participate in a specific and personalized interactive balance perturbation training program targeting balance and gait retraining, while the other group receives the routine Physical Therapy program. Both treatment groups will be assessed pre-operatively, at 3, 6 and 12 months postoperatively. Patients will be classified based on their severity and grade of the spinal cord compression before being compared for any difference in treatment responses.
Year 4: Follow-up monitoring and documenting the number of falls experienced by patients at one year postoperatively as an outcome of effectiveness.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 40 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Aged 40-80 years old
- •Diagnosed cervical myelopathy according MRI imaging
- •Able to stand more than 30 seconds
排除标准
- •With rheumatoid arthritis, ankylosing spondylitis,multiple sclerosis and other systemic disorders
- •With musculoskeletal or neurological disorders,which can impair balance
- •With previous spinal surgery
- •Unable to communicate or follow instruction
- •Not suit to cervical decompressive surgery or physical therapy due to other medical condition
研究组 & 干预措施
Dynamic balance exercise group
balance perturbation training
干预措施: balance perturbation training (Other)
Control group
No intervention
结局指标
主要结局
Kinetic(Ground reaction force)
时间窗: 1 years
Ground reaction force
Transcranial magnetic stimulation (TMS)
时间窗: 1 years
Kinematics (joint range of motion)
时间窗: 1 year
joint range of motion
Electromyography(EMG)
时间窗: 1 years
EMG of lower extremity
Muscle Strength Assessment by Dynamometer
时间窗: 1 years
Muscle strength of upper and lower extremity
次要结局
- Visual Analog Scale (VAS)(3 years)
- Japanese Orthopaedic Association Myelopathy Evaluation Questionnaire(JOACMEQ)(3 years)
- Neck Disability Index (NDI)(3 years)
- Five Times Sit to Stand Test(3 years)
- Nurick Classification(3 years)
- Timed Up & Go test (TUG)(3 years)
- Dynamic Gait Index (DGI)(3 years)