Application Of Portable Gait Analysis In Cervical Spondylotic Myelopathy

Background:Today,the evaluation system of cervical spondylotic myelopathy(CSM)is still not objective under the leadership of precision medicine.Previous studies have identified that gait analysis is benefiting for the early diagnosis of patients with cervical spondylotic myelopathy and making an objective assessment to its severity and efficacy.Compared with the traditional three-dimensional gait laboratory analysis system,the portable gait analysis system has the merit of simple operation and convenient carrying,which is easier to be applied in clinical.The future is promising in the treatment of cervical spondylotic myelopathy.Objective:The aim of this study was to explore the feasibility of portable gait analyzer in clinical application of cervical spondylotic myelopathy.And analyze the gait characteristic of patients with cervical spondylotic myelopathy by the portable gait analyzer system,to identify whether the change of gait parameters can be used as a quantitative evaluation index which reflected the disease,as a reference for similar research.Methods:Under the premise of strict standard,we collected 30 cases,which included 15 patients with cervical spondylotic myelopathy in the First Affiliated Hospital of Dalian Medical University from September to November in 2016 and 15 healthy people.We used the portable gait analyzer which designed by Dalian University of Technology to gait detection and analysis in the Spine Surgery of the First Affiliated Hospital of Dalian Medical University.The statistical analysis of the data was performed by SPSS 18.0.We used the t-test to compare the gait parameters differences between patients with cervical spondylotic myelopathy and healthy subjects.We analyzed the correlation between gait parameters and mJOA-Score of patients with cervical spondylotic myelopathy by spearman correlation analysis.All tests in this paper are bilateral inspection.With P<0.05 was considered statistically significant.Results:In this test,there was no statistic difference in gender ratio,age,height,body weight and body mass index between the patient group and the control group.There was significant difference between the patient group and the control group on velocity,step length,stride length,foot clearance,foot dorsiflexion angle,foot dorsal extension angle,stance duration ratio and swing duration ratio(P<0.05).Stance duration ratio was significantly increased in the control group,and velocity,step length,stride length,foot clearance,foot dorsiflexion angle,foot dorsal extension angle and swing duration ratio were significantly decreased.In the patient group,mJOA-Score was significantly correlated with foot dorsal extension angle,stance duration ratio and swing duration ratio,and was highly correlated with velocity,stance duration,stride length and foot clearance.In the patient group,the lower limb function score of modified Japanese Orthopedic Society was significantly correlated with velocity,highly correlated with stance duration,stride length,foot clearance,stance duration ratio and swing duration ratio,gait cycle and step length.Conclusions:(1)Compared with the healthy people,the patients with cervical spondylotic myelopathy had lower velocity,step length,stride length,maximum foot clearance,foot dorsal extension angle and foot dorsiflexion angle in equal distance.The stance duration ratio was increased significantly and the swing duration ratio was significantly shortened.(2)When the patient's MJOA score was decreased,patients' velocity,stride length,foot clearance,foot dorsal extension angle and swing duration ratio would decrease.When the lower limb MJOA score was decreased,their velocity,step length,stride length,swing duration ratio and foot clearance would decrease,and their gait cycle,stance duration and stance duration ratio would increase.(3)The portable gait analysis is convenient and quick,and it can make objective and quantitative evaluation to cervical spondylotic myelopathy.The future is promising in the treatment of cervical spondylotic myelopathy.