Research Article

Hand Dexterity Impairment in Patients with Cervical Myelopathy: A New Quantitative Assessment Using a Natural Prehension Movement

Table 1

Japanese Orthopedic Association score for cervical compressive myelopathy.

Dysfunction score

A. Motor function
 I. Fingers
  0 = unable to feed oneself with any tableware, including chopsticks, a spoon, or fork, and/or unable to fasten buttons of any size
  1 = can manage to feed oneself with a spoon and/or a fork but not with chopsticks
  2 = either chopstick feeding or writing is possible but not practical, and/or large buttons can be fastened
  3 = either chopstick feeding or writing is clumsy but practical, and/or cuff buttons can be fastened
  4 = normal
 II. Shoulder and elbow (evaluated by MMT score of the deltoid or biceps muscles, whichever is weaker)
  −2 = MMT ≤ 2
  −1 = MMT 3
  −0.5 = MMT 4
  0 = MMT 5
 III. Lower extremity
  0 = unable to stand up and walk by any means
  0.5 = able to stand up but unable to walk
  1 = unable to walk without a cane or other support on a level
  1.5 = able to walk without a support but with a clumsy gait
  2 = walks independently on a level but needs support on stairs
  2.5 = walks independently when going upstairs but needs support when going downstairs
  3 = capable of fast walking but clumsily
  4 = normal
B. Sensory function
 I. Upper extremity
  0 = complete loss of touch and pain sensation
  0.5 = 50% or below of normal sensation and/or severe pain or numbness
  1 = over 60% of normal sensation and/or moderate pain or numbness
  1.5 = subjective numbness of a slight degree without any objective sensory deficit
  2 = normal
 II. Lower extremity (same as I)
 III. Trunk (same as I)
C. Bladder function
 0 = urinary retention and/or incontinence
 1 = sense of retention and/or dribbling and/or thin stream and/or incomplete continence
 2 = urinary retardation and/or pollakiuria
 3 = normal

MMT: manual muscle testing.