Research

Will a home-based rehabilitation program improve hand function in cervical myelopathy patients?

Current Research

Loss of fine motor control is a symptom frequently experienced by patients with cervical myelopathy, manifesting as difficulty using buttons or necklace clasps, or picking up small items. Decreased hand function has a significant impact on quality of life, providing the motivation to design a clinical trial* testing a take-home rehabilitation kit. The kit was specifically created for patients with cervical myelopathy, to be used as a post-surgical therapy tool . It focuses on intense repetition of day-to-day tasks, a type of exercise called massed practice, that has been shown to improve function. Below are videos demonstrating a patient’s hand function before and after treatment:

Before Treatment

We are actively screening for moderately to severely impaired cervical myelopathy patients (30-75 years old) with dexterity symptoms. Consider the following questions:

  • Does your patient have clumsy hands or difficulty with fine motor tasks?

  • Does your patient have balance problems or difficulty walking?

  • Does your patient have urinary frequency, incomplete emptying and/or incontinence not due to other medical condition?

  • Is your patient’s examination consistent with myelopathy?

  • Does the MRI cervical spine report indicate cervical stenosis or signal change in the spinal cord?

If you think your patient may qualify for the study, please see the Referrals section for more information about referring your patient.

After Treatment

*This study is being run in collaboration with Western University and the London Health Sciences Centre, and is funded with a grant from the Canadian Institutes of Health Research.

Previous Research

Imaging-related studies

  1. Cronin A, Detombe S, Duggal C, Duggal N, Bartha R. Spinal cord compression is associated with brain plasticity in degenerative cervical myelopathy. Brain Commun., 2021 Jun 22; 3(3): fcab131

  2. Ryan K, Schranz AL, Duggal N, Bartha R. Differential effects of transcranial direct current stimulation on antiphase and inphase motor tasks: A pilot study. Behav Brain Res, 2019 Jul 2; 366: 13-18

  3. Ryan K, Goncalves S, Bartha R, Duggal N. Motor network recovery in patients with chronic spinal cord compression: a longitudinal study following decompression surgery. J Neurosurg Spine, 2018 Apr 1; 28 (4): 379-388

  4. Ryan K, Wawrzyn K, Gati JS, Chronik BA, Wong D, Duggal N, Bartha R. 1H MR spectroscopy of the motor cortex immediately following transcranial direct current stimulation at 7 Tesla. PLoS One, 2018 Jan 1; 13 (8): e0198053

  5. Aleksanderek I, McGregor SM, Stevens TK, Goncalves S, Bartha R, Duggal N. Cervical Spondylotic Myelopathy: Metabolite Changes in the Primary Motor Cortex after Surgery. Radiology, 2017 Mar 1; 282 (3): 817-825

  6. Aleksanderek I, Stevens TK, Goncalves S, Bartha R, Duggal N. Metabolite and functional profile of patients with cervical spondylotic myelopathy. J Neurosurg Spine, 2017 Feb 3: 1-7

  7. Goncalves S, Stevens TK, Doyle-Pettypiece P, Bartha R, Duggal N. N-acetylaspartate in the motor and sensory cortices following functional recovery after surgery for cervical spondylotic myelopathy. J Neurosurg Spine, 2016 Oct 1; 25 (4): 436-443

  8. Kowalczyk I, Duggal N, Bartha R. Proton magnetic resonance spectroscopy of the motor cortex in cervical myelopathy. Brain. 2012 Feb; 135 (Pt 2): 461-8

  9. Duggal N, Rabin D, Bartha R, Barry RL, Gati JS, Kowalczyk I, Fink M. Brain reorganization in patients with spinal cord compression evaluated using fMRI. Neurology. 2010 Mar 30; 74 (13): 1048-54

Clinically-related research

  1. McGregor SMK, Detombe SA, Goncalves S, Doyle-Pettypiece P, Bartha R, Duggal N. Does the Neurological Examination Correlate with Patient-Perceived Outcomes in Degenerative Cervical Myelopathy? World Neurosurg, 2019 Dec 1; 132: e885-e890

  2. Staudt MD, Rabin D, Baaj AA, Crawford NR, Duggal N. Biomechanical evaluation of the ProDisc-C stability following graded posterior cervical injury. J Neurosurg Spine, 2018 Nov 1; 29 (5): 515-524

  3. Kemal Yucesoy, Kasim Z Yuksel, Murvet Yuksel, Orhan Kalemci, Idiris Altun and Neil Duggal. Changes in Sagittal Alignment after Cervical Disc Arthroplasty: Results of a Pilot Study. Journal of Spine, 2016 Mar 5; 5 (1): 288-

  4. Kowalczyk I, Ryu WHA, Rabin D, Arango M, Duggal N. Reduced endotracheal tube cuff pressure to assess dysphagia after anterior cervical spine surgery. Accepted to The Journal of Spinal Disorders & Techniques September 28, 2013. The Journal of Spinal Disorders & Techniques, 2014 Aug; 18

  5. Ryu WH, Kowalczyk I, Duggal N. Long-term kinematic analysis of cervical spine after single-level implantation of Bryan cervical disc prosthesis. Spine J, 2013 Jun 1; 13 (6): 628-34

  6. Crawford NR, Baek S, Sawa A, Safavi-Abbasi S, Sonntag VKH, Duggal N. Biomechanics of a Fixed–Center of Rotation Cervical Intervertebral Disc Prosthesis. International Journal of Spine Surgery 6 (2012) 34–42

  7. Kowalczyk, I, Lazaro, B, Duggal, N. Analysis of in vivo kinematics of cervical devices: Bryan Disc, ProDisc-C and Prestige LP. J Neurosurg Spine, 2011 Aug 9 (2011 Sep).

  8. Duggal N, Bertagnoli R, Rabin D, Wharton N, Kowalczyk I. ProDisc-C: an in vivo kinematic study. J Spinal Disord Tech. 2011 Jul; 24 (5): 334-9

  9. Duggal N, Bertagnoli R, Rabin D, Wharton N, Kowalczyk I. ProDisc-C: An In vivo kinematic study. J Spinal Disord Tech. 2010 Dec 8; 2010 Dec 8

*Select publications