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. 2024 May;62(5):200-206.
doi: 10.1038/s41393-024-00965-y. Epub 2024 Mar 4.

The role of comprehensive rehabilitation in the care of degenerative cervical myelopathy

Amiram Catz  1   2 , Yaron Watts  3 , Hagay Amir  4 , Lilach Front  3 , Ilana Gelernter  5 , Dianne Michaeli  3 , Vadim Bluvshtein  3   6 , Elena Aidinoff  6   7
Affiliations

The role of comprehensive rehabilitation in the care of degenerative cervical myelopathy

Amiram Catz et al. Spinal Cord. 2024 May.

Abstract

Study design: Retrospective cohort study.

Objective: To find out if comprehensive rehabilitation itself can improve daily performance in persons with DCM.

Setting: The spinal department of a rehabilitation hospital.

Methods: Data from 116 DCM inpatients who underwent comprehensive rehabilitation after spinal surgery were retrospectively analyzed. The definitions of the calculated outcome variables made possible analyses that distinguished the effect of rehabilitation from that of spinal surgery. Paired t-tests were used to compare admission with discharge outcomes and functional gains. Spearman's correlations were used to assess relationships between performance gain during rehabilitation and between time from surgery to rehabilitation.

Results: The Spinal Cord Injury Ability Realization Measurement Index (SCI-ARMI) increased during rehabilitation from 57 (24) to 78 (19) (p < 0.001). The Spinal Cord Independence Measure 3rd version (SCIM III) gain attributed to neurological improvement (dSCIM-IIIn) was 6.3 (9.2), and that attributed to rehabilitation (dSCIM-IIIr) 16 (18.5) (p < 0.001). dSCIM-IIIr showed a rather weak negative correlation with time from spinal surgery to rehabilitation (r = -0.42, p < 0.001).

Conclusions: The study showed, for the first time, that comprehensive rehabilitation can achieve considerable functional improvement for persons with DCM of any degree, beyond that of spinal surgery. Combined with previously published evidence, this indicates that comprehensive rehabilitation can be considered for persons with DCM of any functional degree, before surgery.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Relationship between the portion of performance gain during rehabilitation, which was independent of neurological improvement during rehabilitation, and the time from spinal surgery to admission to rehabilitation.
The majority of the patients entered into the study were within 70 days of spinal surgery. For these, the time from surgery to rehabilitation did not affect the portion of the gain in performance during rehabilitation, which was independent of the neurological improvement during rehabilitation.
See this image and copyright information in PMC

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