BACKGROUND
Cervical spondylotic myelopathy (CSM) is a degenerative disease affecting cervical spinal cord function and becoming more prevalent in the aging population. Exercise intervention has shown to be beneficial, but adherence to conventional programs can be poor.
OBJECTIVE
This study aimed to compare the effects of conventional intervention and home-based intervention using a head-mounted device on patients with CSM.
METHODS
This quasi-experimental retrospective study was conducted from 2014 to 2018. The head control performance of 75 subjects with CSM, 36 of whom received a conventional exercise intervention and 39 of whom received a home-based exercise intervention, was evaluated before surgery, three months after surgery, and after completing an eight-week exercise intervention. The two-way mixed ANOVA was used to explore the main effects and interactions between two groups and three time points, with statistical significance at P≤.05.
RESULTS
Both groups showed improvements in the numerical rating scale (P=.003), neck disability index (P=.001), and range of motion (ROM) in neck flexion (P<.001) and extension (P<.001) after exercise, but the home-based group exhibited significantly greater ROM in left and right rotation (P<.001 and P=.011) and greater muscle strength in neck flexors (P<.001) and extensors (P<.001) compared to the conventional group. Both groups had lower muscle activation in the sternocleidomastoid (P<.05) and splenius capitis (P<.05) muscles during movements after exercise, while the home-based group exhibited lower reposition errors (P<0.001 for variable error during flexion and P=0.003 for root mean square error during right rotation) after exercise.
CONCLUSIONS
The home-based exercise group demonstrated better outcomes in cervical mobility, neck muscular strength, and proprioception after exercise intervention, even surpassing pre-surgery levels, compared to the conventional group. These findings suggest that home-based exercise intervention using head-mounted device may offer advantages over conventional intervention for individuals with CSM.
CLINICALTRIAL
The research ethics committee of Chang Gung Memorial Hospital (approval No. 201701040A3C101).