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Association between grip strength and walking pace with incidence of degenerative cervical myelopathy: a UK biobank observational study

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This study investigates the association between handgrip strength, walking pace, and the incidence of degenerative cervical myelopathy (DCM) using the UK Biobank dataset.


We analyzed data from 364,716 UK Biobank participants without prior neurological conditions. Handgrip strength was measured with a dynamometer, and walking pace was self-reported. Cox proportional hazards models assessed hazard ratios (HRs) and 95% confidence intervals (CIs) for DCM development.


The cohort, with an average age of 56.2 years (SD, 8.1) and 47.4% male, was followed for a median of 12.6 years. During this period, 3,993 participants (1.1%) developed DCM. A significant inverse correlation was found between handgrip strength and DCM incidence (P for trend < 0.001), with decreasing HRs for DCM across quartiles of increasing grip strength: HRs were 0.70 (95% CI: 0.64–0.76), 0.62 (95% CI: 0.57–0.68), and 0.59 (95% CI: 0.54–0.66) for the second, third, and fourth quartiles, respectively. Participants with average or brisk walking paces had a lower DCM risk (HR, 0.55; 95% CI: 0.50–0.61 and HR, 0.48; 95% CI: 0.43–0.54) compared to slow walkers. The greatest risk reduction was in those with both higher handgrip strength and faster pace (HR, 0.39; 95% CI: 0.34–0.44).


Handgrip strength and walking pace are inversely associated with DCM incidence, suggesting their potential as cost-effective screening tools for identifying individuals at risk for DCM.

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Degenerative cervical myelopathy


International Classification of Diseases


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This research has been conducted using the UK Biobank Resource under Application Number 89289. We especially thank all the participants of UK Biobank and all the people involved in building the UK Biobank study.


This study was supported by the Sanming Project of Medicine in Shenzhen (No. SZSM201911002), the Sun Yat-sen University Clinical Research 5010 Program (No. 2019009), and the Shenzhen Key Laboratory of Bone Tissue Repair and Translational Research (No. ZDSYS20230626091402006).

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Correspondence to Wei Fuxin, Zhou Zhiyu or Shaoyu Liu.

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Ethical approval

The UK Biobank study obtained approval from the Northwest Research Ethics Committee (Ref 21/NW/0157). Prior to study enrollment, all participants provided written informed consent, and the research adhered to the principles outlined in the Helsinki Declaration.

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Chengkai Lin and Li Junhong contributed equally to this work.

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Chengkai, L., Junhong, L., Zhengya, Z. et al. Association between grip strength and walking pace with incidence of degenerative cervical myelopathy: a UK biobank observational study. Eur Spine J (2024).

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