Developing Peri-Operative Rehabilitation in Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 6]: An Unexplored Opportunity?

Global Spine Journal, 2022 · DOI: 10.1177/21925682211050925 · Published: January 1, 2022

Spinal Cord Injury Spinal Disorders Rehabilitation

Simple Explanation

Degenerative cervical myelopathy (DCM) is a common spinal cord problem in adults. Surgery helps, but not everyone fully recovers. This review looks at how rehabilitation can be better used before and after surgery for DCM. Rehabilitation is important for other neurological conditions like stroke and spinal cord injury. The review explores if similar rehabilitation methods could help people with DCM recover better after surgery. The review suggests that exercises like locomotor training and hand therapy, along with technologies like body weight support and virtual reality, might be helpful for DCM patients.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Narrative review

Key Findings

1
The current research on rehabilitation for DCM is limited, with a lack of randomized controlled trials.
2
Locomotor training and arm/hand therapy may benefit PwCM, and technologies like body weight support and virtual reality could enhance these therapies.
3
Rehabilitation strategies from stroke and SCI, focusing on pain management, walking, balance, and hand function, could be adapted for DCM.

Research Summary

This review highlights the need for more research into peri-operative rehabilitation for DCM, drawing parallels with rehabilitation strategies used in stroke and SCI. It suggests that locomotor training, arm/hand therapy, and technological adjuncts like robotic assistance and virtual reality may improve outcomes for PwCM. The review emphasizes the importance of addressing mental health and quality of life in DCM rehabilitation, alongside physical and functional improvements.

Practical Implications

Enhanced Rehabilitation Protocols

Develop comprehensive peri-operative rehabilitation programs for DCM patients, incorporating locomotor training, hand therapy, and advanced technologies.

Targeted Therapy Approaches

Adapt rehabilitation strategies from stroke and SCI to address specific impairments in DCM, such as pain, walking difficulties, balance issues, and hand dysfunction.

Improved Patient Outcomes

By implementing effective rehabilitation programs, improve functional recovery, mental health, quality of life, and reduce healthcare costs for individuals with DCM.

Study Limitations

1
Sparse direct evidence on the benefits of peri-operative rehabilitation for DCM.
2
Lack of randomized controlled trials specifically focused on DCM rehabilitation.
3
Need for high-quality research to determine the optimal timing, intensity, and type of therapies for DCM.

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