Clinical Evaluation and Rehabilitation System for Dynamic Balance Control in Cervical Myelopathy Patients
Condition: Cervical Myelopathy
MeSH terms: Spinal Cord Diseases; Bone Marrow Diseases
Study type: Interventional

Summary: 
      Cervical myelopathy is common among the aging population.One of the complications of cervical
      myelopathy is balance impairment.In this study, the patients with cervical myelopathy undergo
      biomechanical, imaging, neurophysiological and functional assessment. Besides, the dynamic
      balance training is introduced to the patients with cervical decompression surgery.This study
      is expected to provide important empirical evidence to evaluate the prognosis of the surgery,
      to further guide the postoperative rehabilitation of myelopathy patients and to improve
      patients' long-term quality of life.
    

Detailed description: 
      Taiwan is quickly becoming a nation of the aging population with myelopathy reporting to be
      one of the most common spinal cord disorders associated with spinal degeneration. Given the
      high prevalence rate of the condition, current project aims to investigate the impact of
      myelopathy on motor control from a biomechanical perspective with the overall aim to develop
      an interactive balance perturbation rehabilitation program targeting individual patients and
      identified the deficiency. The efficacy of the individual rehabilitation program will be
      assessed and determined to utilize a prospective longitudinal study design. A break down of
      the proposed three-year project are as follows:

      Year 1: Myelopathy patients prepared to receive cervical decompression surgery as well as
      age-matched asymptomatic controls will be recruited and subjected to the following clinical
      evaluations: 3-dimensional biomechanical motion analysis, diagnostic Magnetic Resonance
      Imaging, pain and disability questionnaires, motor performance assessment, spinal curvature,
      muscle strength assessment as well as transcranial magnetic stimulation examination. Motor
      control and coordination of functional movements will also be evaluated.

      Year 2: Continue to recruit potential participants and further develop the use of the
      interactive split-belt balance perturbation treadmill as modalities for gait and balance
      therapy.

      Year 3: Physical Therapy rehabilitation programs at 3-month post surgery, one group will
      participate in a specific and personalized interactive balance perturbation training program
      targeting balance and gait retraining, while the other group receives the routine Physical
      Therapy program. Both treatment groups will be assessed pre-operatively, at 3, 6 and 12
      months postoperatively. Patients will be classified based on their severity and grade of the
      spinal cord compression before being compared for any difference in treatment responses.

      Year 4: Follow-up monitoring and documenting the number of falls experienced by patients at
      one year postoperatively as an outcome of effectiveness.

      Expected outcome and significance The findings from the current project will provide
      important empirical evidence to guide the postoperative rehabilitation of myelopathy
      patients. Through detailed biomechanical motion analysis, it is anticipated that this project
      will provide an in-depth understanding of the influence of decompression surgery on motor
      control and spinal stability. The tailored and innovative rehabilitation program will also
      improve patients' long-term quality of life.
    

Intervention name(s): balance perturbation training
Intervention type(s): Other
Intervention description(s): perturbation training on the split-belt balance perturbance treadmill,
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: rehabilitation