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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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Abstract

Purpose

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

Methods

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.

Results

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).

Conclusions

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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Abbreviations

DCM:

Degenerative cervical myelopathy

ICD:

International Classification of Diseases

BFP:

Body fat percentage

BMI:

Body mass index

References

  1. Fehlings MG, Tetreault LA, Wilson JR, Skelly AC (2013) Cervical spondylotic myelopathy: current state of the art and future directions. Spine 38. https://doi.org/10.1097/BRS.0b013e3182a7e9e0. S1-8

  2. Theodore N (2020) Degenerative cervical spondylosis. N Engl J Med 383:159–168. https://doi.org/10.1056/NEJMra2003558

    Article  CAS  PubMed  Google Scholar 

  3. Hurwitz EL, Randhawa K, Yu H et al (2018) The Global Spine Care Initiative: a summary of the global burden of low back and neck pain studies. Eur Spine J 27:796–801. https://doi.org/10.1007/s00586-017-5432-9

    Article  PubMed  Google Scholar 

  4. GBofDS2013C (2015) Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the global burden of Disease Study 2013. Lancet 386(743–800). https://doi.org/10.1016/S0140-6736(15)60692-4

  5. Wu J-C, Ko C-C, Yen Y-S et al (2013) Epidemiology of cervical spondylotic myelopathy and its risk of causing spinal cord injury: a national cohort study. Neurosurg Focus 35:E10. https://doi.org/10.3171/2013.4.FOCUS13122

    Article  PubMed  Google Scholar 

  6. Fehlings MG, Wilson JR, Kopjar B et al (2013) Efficacy and safety of surgical decompression in patients with cervical spondylotic myelopathy: results of the AOSpine North America prospective multi-center study. J Bone Joint Surg Am 95:1651–1658. https://doi.org/10.2106/JBJS.L.00589

    Article  PubMed  Google Scholar 

  7. Fehlings MG, Ibrahim A, Tetreault L et al (2015) A global perspective on the outcomes of surgical decompression in patients with cervical spondylotic myelopathy: results from the prospective multicenter AOSpine international study on 479 patients. Spine (Phila Pa 1976) 40:1322–1328. https://doi.org/10.1097/BRS.0000000000000988

    Article  PubMed  Google Scholar 

  8. Cooper R, Kuh D, Hardy R et al (2010) Objectively measured physical capability levels and mortality: systematic review and meta-analysis. BMJ 341:c4467. https://doi.org/10.1136/bmj.c4467

    Article  PubMed  PubMed Central  Google Scholar 

  9. Dumurgier J, Artaud F, Touraine C et al (2017) Gait speed and decline in Gait Speed as predictors of Incident Dementia. J Gerontol Biol Sci Med Sci 72:655–661. https://doi.org/10.1093/gerona/glw110

    Article  Google Scholar 

  10. Kobayashi H, Otani K, Nikaido T et al (2021) Grip Strength as a screening index for severe degenerative cervical myelopathy in primary care: development of cutoff values using receiver operating curve analysis. Int J Gen Med 14:9863–9872. https://doi.org/10.2147/IJGM.S336541

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kadanka Z, Kadanka Z, Skutil T et al (2021) Walk and run Test in patients with degenerative Compression of the cervical spinal cord. J Clin Med 10:927. https://doi.org/10.3390/jcm10050927

    Article  PubMed  PubMed Central  Google Scholar 

  12. Paul AJ, Amritanand R, Margabandhu P et al (2021) Composite grip strength as a marker of outcome in patients surgically treated for degenerative cervical myelopathy. Asian Spine J 15:664–672. https://doi.org/10.31616/asj.2020.0253

    Article  PubMed  Google Scholar 

  13. Singh A, Choi D, Crockard A (2009) Use of walking data in assessing operative results for cervical spondylotic myelopathy: long-term follow-up and comparison with controls. Spine (Phila Pa 1976) 34:1296–1300. https://doi.org/10.1097/BRS.0b013e3181a09796

    Article  PubMed  Google Scholar 

  14. Collins R (2012) What makes UK Biobank special? Lancet 379:1173–1174. https://doi.org/10.1016/S0140-6736(12)60404-8

    Article  PubMed  Google Scholar 

  15. Sudlow C, Gallacher J, Allen N et al (2015) UK biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age. PLoS Med 12:e1001779. https://doi.org/10.1371/journal.pmed.1001779

    Article  PubMed  PubMed Central  Google Scholar 

  16. Palmer LJ (2007) UK Biobank: bank on it. Lancet 369:1980–1982. https://doi.org/10.1016/S0140-6736(07)60924-6

    Article  PubMed  Google Scholar 

  17. Cruz-Jentoft AJ, Bahat G, Bauer J et al (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48:601. https://doi.org/10.1093/ageing/afz046

    Article  PubMed  PubMed Central  Google Scholar 

  18. Beattie PTP, Phillimore A (2023) Health and Deprivation: Inequality and the North. Routledge, London

    Google Scholar 

  19. Sabia S, Fayosse A, Dumurgier J et al (2021) Association of sleep duration in middle and old age with incidence of dementia. Nat Commun 12:2289. https://doi.org/10.1038/s41467-021-22354-2

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Guo W, Bradbury KE, Reeves GK, Key TJ (2015) Physical activity in relation to body size and composition in women in UK Biobank. Ann Epidemiol 25:406–413e6. https://doi.org/10.1016/j.annepidem.2015.01.015

    Article  PubMed  Google Scholar 

  21. Huang S-Y, Li Y-Z, Zhang Y-R et al (2022) Sleep, physical activity, sedentary behavior, and risk of incident dementia: a prospective cohort study of 431,924 UK Biobank participants. Mol Psychiatry 27:4343–4354. https://doi.org/10.1038/s41380-022-01655-y

    Article  PubMed  Google Scholar 

  22. Celis-Morales CA, Welsh P, Lyall DM et al (2018) Associations of grip strength with cardiovascular, respiratory, and cancer outcomes and all cause mortality: prospective cohort study of half a million UK Biobank participants. BMJ 361:k1651. https://doi.org/10.1136/bmj.k1651

    Article  PubMed  PubMed Central  Google Scholar 

  23. Bradbury KE, Young HJ, Guo W, Key TJ (2018) Dietary assessment in UK Biobank: an evaluation of the performance of the touchscreen dietary questionnaire. J Nutr Sci 7:e6. https://doi.org/10.1017/jns.2017.66

    Article  PubMed  PubMed Central  Google Scholar 

  24. Wong TM, Leung HB, Wong WC (2004) Correlation between magnetic resonance imaging and radiographic measurement of cervical spine in cervical myelopathic patients. J Orthop Surg (Hong Kong) 12:239–242. https://doi.org/10.1177/230949900401200220

    Article  CAS  PubMed  Google Scholar 

  25. Sung RD, Wang JC (2001) Correlation between a positive Hoffmann’s reflex and cervical pathology in asymptomatic individuals. Spine (Phila Pa 1976) 26:67–70. https://doi.org/10.1097/00007632-200101010-00013

    Article  CAS  PubMed  Google Scholar 

  26. Findlay GFG, Balain B, Trivedi JM, Jaffray DC (2009) Does walking change the Romberg sign? Eur Spine J 18:1528–1531. https://doi.org/10.1007/s00586-009-1008-7

    Article  PubMed  PubMed Central  Google Scholar 

  27. Cook C, Brown C, Isaacs R et al (2010) Clustered clinical findings for diagnosis of cervical spine myelopathy. J Man Manip Ther 18:175–180. https://doi.org/10.1179/106698110X12804993427045

    Article  PubMed  PubMed Central  Google Scholar 

  28. Kobayashi H, Otani K, Nikaido T et al (2022) Development of a Novel Diagnostic Support Tool for degenerative cervical myelopathy combining 10-s grip and release test and grip strength: a pilot study. Diagnostics (Basel) 12:2108. https://doi.org/10.3390/diagnostics12092108

    Article  PubMed  Google Scholar 

  29. Kalsi-Ryan S, Rienmueller AC, Riehm L et al (2020) Quantitative Assessment of Gait characteristics in degenerative cervical myelopathy: a prospective clinical study. J Clin Med 9:752. https://doi.org/10.3390/jcm9030752

    Article  PubMed  PubMed Central  Google Scholar 

  30. Singh A, Crockard HA (1999) Quantitative assessment of cervical spondylotic myelopathy by a simple walking test. Lancet 354:370–373. https://doi.org/10.1016/S0140-6736(98)10199-X

    Article  CAS  PubMed  Google Scholar 

  31. Tetreault L, Goldstein CL, Arnold P et al (2015) Degenerative cervical myelopathy: a spectrum of related disorders affecting the aging spine. Neurosurg 77 Suppl 4S51–67. https://doi.org/10.1227/NEU.0000000000000951

  32. Fry A, Littlejohns TJ, Sudlow C et al (2017) Comparison of Sociodemographic and Health-related characteristics of UK Biobank participants with those of the General Population. Am J Epidemiol 186:1026–1034. https://doi.org/10.1093/aje/kwx246

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

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.

Funding

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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The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

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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). https://doi.org/10.1007/s00586-024-08374-8

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