#CSM-019

[monchiropracteur]

The Gait Deviation Index as an indicator of gait abnormality among degenerative spinal pathologies

http://monchiropracteur.com/ monchiropracteur.com Abstract Introduction The Gait Deviation Index (GDI) is a composite measure of gait abnormality derived from lower-limb joint range-of-motion which is increasingly being reported for clinical gait analysis among neurologic and orthopedic patients. A GDI score of 100 is representative of healthy individuals and decreasing scores represent a greater abnormality. Preliminary data is needed to help assess the utility of GDI as a measure of compromised gait among spine patients and to provide reference values for commonly treated pathologies. Methods GDI scores were obtained from healthy adults and four symptomatic degeneration groups: cervical spondylotic myelopathy (CSM), adult degenerative scoliosis (ADS), and single-level lumbar degeneration (LD). Clinical gait analysis was done using a three-dimensional motion tracking system. Evaluations were done 1 week prior to surgical intervention for degeneration groups. Two-sample t-tests were used to compare degenerative cohorts to healthy controls and for inter-cohort comparisons. Pearson correlations were used to test for significant relationships between GDI and walking speed. Results Degenerative cohorts all showed significantly lower (worse) GDI scores compared to healthy (all p  http://link.springer.com/10.1007/s00586-019-06252-2?utm_source=dlvr.it&utm_medium=tumblr http://monchiropracteur.com/

[monchiropracteur]

Effects of decompressive operation on cardiac autonomic regulation in patients with cervical spondylotic myelopathy: analysis of blood pressure, heart rate, and heart rate variability

http://monchiropracteur.com/ monchiropracteur.com Abstract Purpose To investigate the effects of cervical decompression operation on cardiac autonomic regulation and its relationship to recovery of somatic neurological function in cervical spondylotic myelopathy (CSM) patients. Methods One hundred and thirty-two consecutive patients were enrolled in this study, in which 73 patients received decompression operation and the remaining 59 were treated non-operatively. The follow-up period was 6 months. Baseline and follow-up evaluation included Japanese Orthopaedic Association (JOA) score, office-based blood pressure (BP) measurement, heart rate (HR), and 24-h heart rate variability (HRV) assessment. Relationship between achieved JOA score (final JOA score–baseline score) and changes of BP, HR, and HRV parameters in both operative and non-operative groups was analyzed. Results In operative group, patients’ JOA score and markers of parasympathetic activity in HRV assessment were significantly higher than baseline level 6 months later. Blood pressure, especially systolic blood pressure (SBP), was significantly downregulated in both hypertension and non-hypertension patients. Mean heart rate was also significantly decreased. Furthermore, achieved JOA score was significantly negatively correlated with changes of SBP, minimal HR, mean HR, maximum HR, but significantly positively correlated with changes of HRV parameters reflecting parasympathetic activity. However, changes of JOA score, BP, HR, and HRV parameters in non-operative group were not significant. Conclusions Cervical decompression operation could improve both somatic neurological function and cardiac autonomic regulation in CSM patients, and achieved JOA score was significantly positively correlated with improvement in HRV and cardiac parasympathetic activity. Graphical abstract These slides can be retrieved under Electronic Supplementary Material. http://link.springer.com/10.1007/s00586-019-05972-9?utm_source=dlvr.it&utm_medium=tumblr http://monchiropracteur.com/