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Easy Ten-Second Step Test Can Help Assess Severity of Cervical Myelopathy

Posted on: 01/22/2009
Cervical myelopathy is a condition where the neck is being compressed, causing pain and disability. It's considered to be one of the most common neurologic, or nerve, disorders that is occurring more commonly in the older - or geriatric - population. Usually, the best treatment is surgery, to decompress the area and relieve the pressure on the nerves, but before surgery is decided upon, the surgeon and patient have to take a few things into consideration, including how successful they feel the surgery will be.

In order to judge the severity of cervical myelopathy, physicians have been using various tests and systems. Some ways of grading the severity included measuring clumsiness of the hands, walking and gait ability, and if there are any problems with urinating. The problem with grading those issues is that there is such a huge variety in what people consider as normal and as abnormal, and many other issues may also affect these things.

The authors of this article developed a 10-second step test to measure and to quantify the severity of cervical myelopathy. They then tested their design on a group of 163 patients with cervical compressive myelopathy who were going to have surgery to alleviate the problem. The mean age was about 63 age and 99 of the patients were men. Over one thousand volunteers without cervical myelopathy or any type of neck pain were tested as controls.

The study subjects were asked to take high steps by bending their knee at 90 degrees, making their thighs parallel, or in line with, the floor. They were asked to make these steps in the same place, without holding on to anything for balance, for as many steps as they could do in 10 seconds. If the patients seemed like they were at risk of falling, the test was done close to a hand bar that could be grabbed for balance. A hand test that involved gripping and releasing for 10 seconds was also done.

In gathering the results together, the researchers found that the average number of steps in 10 seconds for the patients was 10.7, give or take 5.3 before they had surgery. They were able to do an average of 16.4 grips, give or take 6.1, in the right hand, and 15.5, give or take 6.2, in the left hand. Seventy-nine patients did the step test twice and the average score was 11.2 steps the first time (give or take 5.1) and 11.5 the second time (give or take 5.5). The researchers noticed a connection between the number of steps that the patients could do and the number of grips they could do.

The healthy volunteers did an average of 19.6 steps, give or take 3.5, and there was a big difference between men and women and changed with age too. As the subjects were older, their number of steps dropped.

Twelve months after surgery, 123 patients were retested. They scored an average of 10.4 steps, give or take 5.9 before surgery, and 14, give or take 5.4 after surgery. Their grips were on average 15.2, give or take 6.2, before surgery and 18.4, give or take 5, after surgery.

The authors concluded that although this type of test wasn't always easy to do and would require a separate area to do, it was more quantifiable and objective that previous tests for cervical myelopathy severity. The authors also pointed out that the test couldn't be done by everyone, including people who already have trouble walking or can't stand on their own without aid.

Yasutsuga Yukawa, MD, et al. "Ten Second Step Test" as a New Quantifiable Parameter of Cervical Myelopathy. In Spine. January 2009. Vol. 34. Pp. 82 to 86.

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