Kinematic alteration in three-dimensional reaching movement in C3-4 level cervical myelopathy

PLoS ONE, 2023 · DOI: https://doi.org/10.1371/journal.pone.0295156 · Published: November 30, 2023

Simple Explanation

This study investigates how spinal cord compression at different levels in the neck affects reaching movements. Researchers compared patients with compression at the C3-4 level to those with compression at the C4-7 level, assessing their three-dimensional reaching motions before and after surgery. The study used a 'whack-a-mole' type task to isolate reaching movements, measuring the time and distance taken to reach targets. By comparing these measurements between the two groups, the study aimed to understand how the location of spinal cord compression influences upper limb function. The findings suggest that compression at the C3-4 level has a more significant negative impact on reaching movements compared to compression at the C4-7 level. This information can help improve the understanding and treatment of cervical myelopathy.

Study Duration

From April 7, 2018 to November 29, 2020

Participants

Nine CM patients with maximal cord compression at the C3-4 level (C3-4 group) and 15 CM patients with maximal cord compression at the C4-7 level (C4-7 group)

Evidence Level

Not specified

Key Findings

1
The 3D reaching trajectories of the C3-4 group was unstable with higher variability.
2
The C3-4 group showed longer MT (p < 0.05) and MD (p < 0.01) compared with the C4-7 group both before and after surgery.
3
MT was negatively correlated with the Japanese Orthopedic Association score only in the C3-4 group (r = - 0.48).

Research Summary

This study aimed to compare the reaching movement between two different spinal cord compression level groups in cervical myelopathy (CM) patients. We found that spinal cord compression at the C3-4 level had a negative effect on 3D reaching movement and the kinematic alteration influenced the upper extremity performance. This new knowledge may increase our understanding of kinematic alteration in patients with CM.

Practical Implications

Targeted Rehabilitation Strategies

Rehabilitation programs can be tailored to address the specific kinematic deficits associated with different levels of cervical myelopathy, particularly focusing on improving stability and efficiency of reaching movements in C3-4 compression.

Improved Diagnostic Accuracy

Using kinematic analysis of reaching movements can aid in more accurately diagnosing and assessing the severity of cervical myelopathy, especially in differentiating between C3-4 and C4-7 compression.

Enhanced Surgical Planning

Surgeons can use the information about the differential impact of compression levels on reaching kinematics to inform surgical planning and optimize decompression strategies for better functional outcomes.

Study Limitations

1
Only the total time and distance required reaching movement between targets were analyzed.
2
The study did not consider a capability of static standing balance during the reaching task.
3
Additional kinetic parameters analyzing more detailed temporal/spatial changes need be considered

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