Abstract
Background Degenerative cervical myelopathy (DCM) includes neuropathies such as gait and hand dexterity caused by progressive compression of the spinal cord within the cervical canal. Handgrip strength is not just an indicator of muscle weakness, but is used for a variety of indicators, including length of hospital stay and prognosis. This study was aimed to evaluate whether handgrip strength affects frailty, gait status, and dexterity in patients with DCM.
Methods This cross-sectional observational study included 94 patients (29 females, 65 males; mean age 66.9 years) who underwent surgery for DCM. Preoperatively, handgrip strength, lower leg extension power (LEP), pinch strength, 10-m walk test, counter test, height, weight, body mass index (BMI), the Japanese Orthopaedic Association (JOA) score, the geriatric nutritional risk index (GNRI), and the 5-item modified frailty index (mFI-5) were measured (mFI-5: 0 points = healthy group, 1 point = prefrail group, ≥2 points = frail group).
Results Handgrip strength was significantly correlated with age (r=−0.468, p<0.001), height (r=0.601, p<0.001), weight (r=0.459, p<0.001), LEP (r=0.675, p<0.001), walking speed (r=0.617, p<0.001), counter test (r=0.659, p<0.001), pinch strength (r=0.723, p<0.001), total JOA score (r=0.468, p=0.001), upper extremity motor function (r=0.616, p<0.001), lower extremity motor function (r=0.658, p<0.001), mFI-5 (r=−0.369, p=0.001), and GNRI (r=0.207, p=0.046), but not with BMI, upper extremity sensory function, lower extremity sensory function, trunk sensory function, or bladder function. There were 40 patients in the frail group (19.5±9.7 kg), 32 in the prefrail group (25.2±7.1 kg), and 22 in the healthy group (30.0±7.5 kg). Frail patients had significantly lower handgrip strength than prefrail and healthy patients.
Conclusion In DCM patients, handgrip strength was positively correlated with height, weight, LEP, walking speed, pinch strength, and counter test, and negatively correlated with age. In DCM patients before surgery, handgrip strength affected walking speed, dexterity, and frailty.