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Prospective Comparison of Age- and Sex-related Differences in Quantifiable 10-S Grip and Release and 10-S Step Test Results for Diagnosis of Cervical Spondylotic Myelopathy in 454 Patients With Cervical Spondylotic Myelopathy and 818 Asymptomatic Subjects

Machino, Masaaki MD; Imagama, Shiro MD, PhD; Ando, Kei MD, PhD; Kobayashi, Kazuyoshi MD, PhD; Hida, Tetsuro MD; Ito, Kenyu MD; Tsushima, Mikito MD; Matsumoto, Akiyuki MD; Tanaka, Satoshi MD; Morozumi, Masayoshi MD; Ito, Keigo MD, PhD; Kato, Fumihiko MD, PhD; Nishida, Yoshihiro MD, PhD; Ishiguro, Naoki MD, PhD

doi: 10.1097/BRS.0000000000001849

Study Design. A prospective comparison.

Objective. The purpose of this prospective study was to verify the clinical effectiveness of the 10-s grip and release (G&R) and 10-s step quantitative tests for assessing the severity of cervical spondylotic myelopathy (CSM) and to compare age- and sex-related differences in the results between large cohorts of CSM patients and asymptomatic subjects.

Summary of Background Data. To determine the severity of CSM, objective and reproducible means of measuring patient disability are essential. No studies have evaluated differences in quantitative test results between a large series of CSM patients and healthy subjects.

Methods. Four hundred fifty-four CSM patients and 818 asymptomatic subjects were included. The Japanese subjects were in their 40s to 70s and were divided according to their age by decade. The 10-s G&R and 10-s step tests were used to quantitatively assess performance. The severity of myelopathy before surgery was evaluated according to a scoring system proposed by the Japanese Orthopaedic Association for cervical myelopathy (JOA score) in the CSM patients.

Results. In the CSM patients, the 10-s G&R and step test results significantly correlated with the JOA score (P < 0.0001). The number of the 10-s G&R and step tests significantly decreased with age in both groups. There was a difference in the 10-s G&R and step test results between males and females. In the asymptomatic subjects, the number of the 10-s G&R and step tests in the females was less than that in the males. The numbers in the 10-s G&R and step tests were significantly lower in CSM patients than those in asymptomatic subjects in each decade (P < 0.01).

Conclusion. The 10-s G&R and 10-s step tests were useful for quantitatively assessing CSM severity, and age and sex differences in results should be considered in screening.

Level of Evidence: 2

Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine

Department of Orthopedic Surgery, Chubu Rosai Hospital, Japan Labor Health and Welfare Organization, Nagoya, Japan.

Address correspondence and reprint requests to Shiro Imagama, MD, PhD, Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine 65, Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, Japan; E-mail:

Received 29 June, 2016

Revised 18 July, 2016

Accepted 25 July, 2016

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work.

No relevant financial activities outside the submitted work.

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved