Effects of acute postoperative gait rehabilitation for gait disability in compressive cervical myelopathy

This study compared the enhancement of walking ability via gait rehabilitation during acute rehabilitation for compressive cervical myelopathy with conventional physiotherapy.

This retrospective cohort study included 45 patients who underwent surgery for compressive cervical myelopathy between April 2019 and August 2024; they all presented with gait impairments scoring between one and two on the Japanese Orthopaedic Association score for lower limb motor function. After introducing gait rehabilitation, 24 patients were assigned to the gait rehabilitation group, whereas 21 patients treated pre-introduction formed the control group. Gait rehabilitation primarily involved recumbent ergometer and treadmill walking, whereas the control group engaged mainly in muscle-strengthening exercises, balance training, and walking exercises on the ground. The assessment measures were 10 m maximum gait speed (gait speed) and the Timed Up and Go (TUG) test, with adverse events also monitored. A multiple regression analysis model, adjusted for confounding factors, was employed to examine the difference in changes (Δ) in gait speed and TUG two weeks postoperatively, with statistical significance set at 5%.

Patient background comparisons revealed no significant differences between the groups. The ΔGait speed was 0.29 m/s (95% confidence interval (CI): 0.18–0.42) in the gait rehabilitation group and -0.01 m/s (95% CI: - 0.14–0.12) in the control group. The gait rehabilitation group demonstrated a significant improvement. The ΔTUG was - 2.37 s (95% CI: - 4.00–0.75) in the gait rehabilitation group and 0.66 s (95% CI: - 1.10–2.40) in the control group, indicating a significant enhancement in the gait rehabilitation group (p 0.05). No adverse events were reported.

Gait rehabilitation in the acute phase of postoperative compressive cervical myelopathy significantly improved gait speed and dynamic balance two weeks postoperatively, demonstrating clinically meaningful advantages over usual care. No adverse events were observed throughout the intervention.

Early postoperative gait rehabilitation presents a potentially effective physiotherapy intervention, capable of improving gait speed and dynamic balance within the short two-week postoperative period.