Rehab in Mild Stable DCM: Feasibility RCT Comparing Structured Rehabilitation to Clinical Surveillance

Launched by ROYAL COLLEGE OF SURGEONS, IRELAND · Jan 13, 2025

Keywords

ClinConnect Summary

This clinical trial is investigating a new rehabilitation program for patients with mild stable Degenerative Cervical Myelopathy (DCM), a condition that affects the neck and can cause physical disabilities. The main goal is to see if a structured rehabilitation approach, which includes exercises for the neck and upper body, education about physical activity, and training for hand function, can help improve the lives of patients. Researchers want to find out how common mild stable DCM is in neurosurgical clinics, how many eligible patients choose to participate, and whether both patients and doctors find the program acceptable.

To be eligible for the study, participants must have a confirmed diagnosis of mild DCM, which is assessed using a specific scoring system (mJOA) that measures the severity of their condition. They should also be able to understand English well enough to give informed consent. However, those who need immediate surgical treatment for their condition or have other serious health issues will not be included. Participants can expect to follow a 12-week program that includes up to 10 supervised rehabilitation sessions, along with a home exercise plan. This study is currently not recruiting participants, but it aims to pave the way for future research on effective treatments for DCM.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • • Diagnosis of DCM (Clinical symptom of DCM +/- Upper motor neuron sign + imaging evidence of cervical cord compression). Diagnosis will be confirmed by a consultant neurosurgeon (19).
• • Modified Japanese Orthopaedic assessment (mJOA) score of 15-17, indicating mild DCM. The mJOA is a clinician administered validated measure of DCM severity (20)
• • Adequate comprehension of English to understand the purpose of the study and give written informed consent
• Exclusion Criteria:
• • Patient or surgeon preference for urgent surgical decompression for progressive DCM, motor radiculopathy or severe unrelenting radicular arm pain or significant risk factors for progression including co-existing cervical radiculopathy and circumferential cord compression.
• • Diagnosis of other neurological condition that could confound assessment.
• • Involvement in another clinical study or trial
• • Pregnancy
• • If the participant is unable to commit to a 12-week programme of up to 10 sessions of supervised rehabilitation and participating in a regular home exercise programme for the duration of the study.