Postoperative improvement in the index finger center of pressure trajectory during precision grip in patients with degenerative cervical myelopathy.

Abstract

The aim of this study was to kinetically evaluate the changes in precision grip in patients with degenerative cervical myelopathy before and after decompressive surgery. Twenty-nine patients with degenerative cervical myelopathy participated in the study. Participants performed a grip-and-lift task by pulp pinch using their thumb and index finger before and after surgery. We monitored individual finger grip force (GF) and center of pressure (COP) trajectory in total five seconds and during the first second while lifting and holding an object. Correlations between the pre-operative COP trajectory and other hand clinical outcomes were analyzed. A multiple regression analysis was used to identify the predictive value of the pre-operative COP trajectory to the severity of sensorimotor dysfunction. There was a significant improvement in the 1-second COP trajectory in the index finger after surgery, but not the GF. Moreover, pre-operative COP trajectory was associated with the post-operative severity of clinical symptoms. The multiple regression analysis concerning the severity of upper extremity symptoms indicated that the model incorporating pre-operative COP trajectory exhibited the highest adjusted R2 compared to GF or conventional clinical tests. These results suggested that patients with degenerative cervical myelopathy could improve their COP trajectory in the index finger after surgery, and the finger kinetic measure could provide an important index for predicting neurological improvement.