Faculty Collaboration Database

Degenerative cervical myelopathy delays responses to lateral balance perturbations regardless of predictability. J Neurophysiol 2022 Mar 01;127(3):673-688

Date

01/27/2022

Pubmed ID

35080466

Pubmed Central ID

PMC8897012

DOI

10.1152/jn.00159.2021

Scopus ID

2-s2.0-85125553776 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

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.

Author List

Boerger TF, McGinn L, Wang MC, Schmit BD, Hyngstrom AS

Authors

Timothy F. Boerger LAT Postdoctoral Fellow in the Neurosurgery department at Medical College of Wisconsin
Allison Hyngstrom PhD Associate Professor in the Physical Therapy department at Marquette University
Brian Schmit PhD Professor in the Biomedical Engineering department at Marquette University
Marjorie Wang MD Clinical Transformation Officer, Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Electromyography
Humans
Muscle Contraction
Muscle, Skeletal
Postural Balance
Spinal Cord Diseases