Development of a Novel Diagnostic Support Tool for Degenerative Cervical Myelopathy Combining 10-s Grip and Release Test and Grip Strength: A Pilot Study

Diagnostics, 2022 · DOI: 10.3390/diagnostics12092108 · Published: August 31, 2022

Simple Explanation

This study aimed to create a straightforward diagnostic tool for degenerative cervical myelopathy (DCM) by combining the grip and release test (GRT) and grip strength measurements. The diagnostic performance of GRT and grip strength varies depending on the patient's sex and age. To address this, the study developed a diagnostic support tool to determine abnormal results in these tests based on sex- and age-specific cutoff values. The study found that using this novel diagnostic support tool, which combines GRT and grip strength, is more effective for the early diagnosis of DCM than using either test alone.

Study Duration

May 2005 and April 2017

Participants

247 DCM patients and 721 controls aged 40–89 years

Evidence Level

Not specified

Key Findings

1
The diagnostic support tool, combining GRT and grip strength, showed an overall sensitivity of 88.2% and a specificity of 78.1% in diagnosing DCM.
2
The calculated cutoff values for GRT varied by sex and age group. For example, for men aged 40-59, the cutoff was 21, while for women in the same age group, it was 18.
3
Similarly, the cutoff values for grip strength also varied by sex and age group, with men aged 40-59 having a cutoff of 32 and women in the same age group having a cutoff of 20.

Research Summary

The study developed a diagnostic support tool for DCM using grip strength and GRT measurements from DCM surgery patients and healthy controls. GRT and grip strength showed good diagnostic accuracy individually, with AUCs ≥0.70 for all sex and age groups. Cutoff values were determined using the Youden index. The diagnostic support tool improved test sensitivity in all sex and age groups, making it valuable and easy to use. It defines a positive result when either GRT or grip strength is abnormal.

Practical Implications

Early DCM Diagnosis

The diagnostic support tool can aid in the early diagnosis of DCM, potentially leading to earlier surgical intervention and improved patient outcomes.

Primary Care Screening

The tool is simple and noninvasive, making it suitable for use in primary care settings for initial DCM screening.

Objective Follow-up

The tool can be used to objectively track the progression of DCM and assess the effectiveness of interventions.

Study Limitations

1
The study population had an imbalance in sex distribution, with more males in the DCM group and more females in the control group.
2
All DCM patients included in the study were surgical patients, potentially limiting the generalizability of the findings to non-surgical DCM cases.
3
Racial differences and body size variations were not accounted for, potentially limiting the applicability of the results to other populations.

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