New Assessment Method for Upper Limb Function in Patients with Cervical Spondylotic Myelopathy

Study Design. Retrospective cohort study. Objective. Although there are several methods available to assess upper limb function in patients with cervical spondylotic myelopathy, few methods can evaluate the degree of upper limb functional impairment in activities of daily living. Summary of Background Data. We devised and evaluated the utility of a new assessment method called the 10 Coins Test, which is based on daily movements. Methods. The study included 39 patients who underwent spinal surgery for cervical spondylotic myelopathy and who were followed up for 1 year postoperatively. The mean age was 65.2±11.5 years, with 31 (79.5%) male and 8 (20.5%) female patients. The 10 Coins Test is a simple examination that measures the time it takes to pick up and move 10 coins forward. Patient satisfaction with surgery was evaluated on a 5-point scale. We compared the 10 Coins Test results, patient satisfaction, and Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) results before and after surgery. Results. The mean time to perform the 10 Coins Test was 27.4 seconds for the dominant hand and 24.5 seconds for the non-dominant hand preoperatively. In control group, the average time was 14.6 seconds for the dominant hand and 15.0 seconds for the non-dominant hand. The cut-off value was 16.2 seconds. There was a significant difference in the 10 Coins Test time and satisfaction for both hands at 1 week postoperatively compared with preoperatively. The JOACMEQ upper limb motor function showed a significant improvement 3 months postoperatively compared with preoperatively. The 10 Coins Test result was correlated with satisfaction and the JOACMEQ upper limb motor function. Conclusion. The 10 Coins Test allows for the quantitative evaluation of complex movements. It is convenient and highly useful for assessing upper limb function in patients with cervical spondylotic myelopathy.