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Degenerative cervical myelopathy delays responses to lateral balance perturbations regardless of predictability.
Boerger, T F; McGinn, L; Wang, M C; Schmit, B D; Hyngstrom, A S.
Affiliation
  • Boerger TF; Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
  • McGinn L; Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin.
  • Wang MC; Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
  • Schmit BD; Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin.
  • Hyngstrom AS; Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin.
J Neurophysiol ; 127(3): 673-688, 2022 03 01.
Article in En | MEDLINE | ID: mdl-35080466
The aim of this study was to quantify balance impairments in standing in people with degenerative cervical myelopathy (PwDCM) in response to external perturbations. PwDCM have damage to their spinal cord due to degeneration of the cervical vertebral column, but little is known about balance. Balance was quantified by capturing kinetics, kinematic, and electromyographic data during standing in response to lateral waist pulls. Participants received pulls during predictable and unpredictable contexts in three stance widths at two magnitudes. In response to lateral waist pulls, PwDCM had larger center of mass excursion (P < 0.001) and delayed gluteus medius electromyography onset (P < 0.001) and peak (P < 0.001) timing. These main effects of history of myelopathy were consistent across predictability, stance width, and magnitude. A multilinear regression determined that gluteus medius peak timing + tibialis anterior peak timing most strongly predicted center of mass excursion (R2 = 0.50, P < 0.001). These data suggest that PwDCM have delays in generating voluntary and reactive motor commands, contributing to balance impairments. Future rehabilitation strategies should focus on generating rapid muscular contractions. Additionally, frontal plane postural control is regulated by the gluteus medius and the tibialis anterior, whereas other muscles (e.g. gluteus minimus, ankle invertors/evertors) not studied here may also contribute.NEW & NOTEWORTHY Frontal plane reactive postural control is impaired in persons with degenerative cervical myelopathy because of delayed muscle responses. Additionally, postural control varies across stance width, predictability, and perturbation magnitude.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Spinal Cord Diseases / Postural Balance Type of study: Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: J Neurophysiol Year: 2022 Document type: Article Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Spinal Cord Diseases / Postural Balance Type of study: Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: J Neurophysiol Year: 2022 Document type: Article Country of publication: