Abstract
Background Context
Cervical spondylotic myelopathy (CSM) is a degenerative disease caused by cervical
cord compression and can lead to the significant impairment of motor function including
gait and balance disturbances and changes in lower extremity muscle activity.
Purpose
This study aimed to characterize gait, balance and lower extremity muscle activity
in patients with CSM compared to age-matched healthy controls (HCs) using wearable
sensors in the clinical setting.
Study Design
Nonrandomized, prospective cohort study.
Patient Sample
Ten CSM patients and 10 age-matched HCs were recruited for this study.
Outcome Measures
Gait and balance function parameters contained spatial temporal parameters, step regularity (SR1), stride regularity (SR2) and harmonic ratio (HR). EMG muscle activity parameters included time to peak and peak value during loading, stance, and swing phase.
Methods
In this study, parameters of gait and balance function were extracted using triaxial
accelerometer attached to the spinous processes of Lumbar 5 while participants performed
an overground walking at a self-preferred speed. Moreover, muscular activity was simultaneously
recorded via sEMG sensors attached to tibialis anterior (TA), rectus femoris (RF),
bicep femoris (BF), and gastrocnemius lateral (GL). Independent sample t test was used to find the differences between CSM patients and HCs.
Results
Gait analysis showed cadence, step length and walking speed were statistically significantly
lower in CSM patients than HCs. Stride time was significantly higher for CSM patients
in comparison to HCs. Lower root mean square ratio (RMSR) of acceleration in the mediolateral
(ML) direction, HR in the anteroposterior (AP) direction, SR1 in the AP direction
and SR2 in all three directions were observed in CSM patients. For muscle activity
analysis, EMG RMS for TA and RF during loading phase and RMS for GL during midstance
phase was significantly lower for CSM patients, while significantly higher value was
observed for RF RMS during midstance phase and GL RMS during swing phase in CSM patients.
Conclusion
Our pilot study shows that wearable sensors are able to detect the changes of gait,
balance and lower extremity muscle activities of CSM patients in the clinical setting.
This pilot study sets the stage for future researches on the diagnosis and monitor
progression of CSM disease using wearable technology.
Keywords
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Article info
Publication history
Published online: March 16, 2023
Accepted:
March 10,
2023
Received in revised form:
February 28,
2023
Received:
October 31,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
FDA device/drug status: approved (Tri-acclerometers, Surface EMG sensor; Delsys, Inc, Natick, M.A, U.S.A)
Author disclosures: ZK: Nonfinancial. XJ: Nonfinancial. TH: Nonfinancial. QS: Nonfinancial. XS: Nonfinancial. XZ: Nonfinancial. DG: Nonfinancial.
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