Timing of Rehabilitation Following Cervical Spinal Surgery in Degenerative Myelopathy

Feasibility of Early Post-operative Rehabilitation Following Cervical Spinal Surgery in Degenerative Myelopathy

The goal of this clinical trial is to learn whether starting rehabilitation earlier after surgery can improve recovery and is feasible and acceptable for adults with degenerative cervical myelopathy (DCM) undergoing cervical spine surgery. The main question it aims to answer is:

Does starting rehabilitation earlier improve walking, balance, physical activity, quality of life, and nervous system function after surgery?

Researchers will compare participants who begin rehabilitation two weeks after surgery with participants who begin rehabilitation six weeks after surgery to see if earlier rehabilitation leads to better recovery outcomes and participation.

Participants will:

Be randomly assigned to begin rehabilitation either two weeks or six weeks after surgery.

Attend physical therapy sessions twice per week for eight weeks focused on strength, balance, and walking.

Complete assessments of walking ability, balance, physical activity, quality of life, and nervous system function over several months after surgery.

Provide feedback about their experience with the rehabilitation program, including satisfaction and any side effects or challenges related to participation.

Study Overview

• Status: Not yet recruiting
• Conditions: Cervical Myelopathy
• Intervention / Treatment: Behavioral: Physical Therapy

• Study Type: Interventional
• Enrollment (Estimated): 20
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• adult (>18 years of age) with diagnosis of degenerative cervical myelopathy, within 2 weeks of spinal decompression surgery
• plan to be discharged home from acute care (i.e., not admitted to another facility for post-operative rehabilitation)
• able to stand with a maximum of one-person assist (+/- use of gait aid)
• persistent functional impairment in lower extremity strength, balance, coordination, and/or gait
• ability to attend an 8-week in-person rehabilitation program in Edmonton, Alberta

Exclusion Criteria:

• discharge from acute care facility > 2 weeks post-operative
• intra-operative or early post-operative complication delaying discharge or precluding participation in early rehabilitation

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Usual Care Rehabilitation; Participants will begin post-operative rehabilitation 6 weeks following their cervical spine surgery	Behavioral: Physical Therapy; Active, task-specific physical therapy to enhance balance, walking, and strength
Experimental: Early Rehabilitation; Participants will begin post-operative rehabilitation 2 weeks following their cervical spine surgery	Behavioral: Physical Therapy; Active, task-specific physical therapy to enhance balance, walking, and strength

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from Baseline in the Ten Metre Walk Test	Time to walk ten metres; lower times indicate faster walking speed	Baseline and End Rehabilitation (8 weeks following Baseline)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from Baseline in the Six Minute Walk Test	Distance walked in six minutes; longer distances indicate greater walking endurance	Baseline and End Rehabilitation (8 weeks following Baseline)
Change from Baseline in the Timed Up and Go	Time taken to stand, walk 3 metres and return to sitting position; longer time indicates balance and mobility impairments	Baseline and End Rehabilitation (8 weeks following Baseline)
Change from Baseline in the Berg Balance Scale	Standardized test that includes 14 balance tasks, with scores ranging from 0 to 56; lower scores indicate balance impairment	Baseline and End Rehabilitation (8 weeks following Baseline)
Change from Baseline on the 36-item Short Form Survey	Survey measuring health-related quality of life, with scores ranging from 0 to 100; higher scores indicate better health status	Baseline and End Rehabilitation (8 weeks following Baseline)
Change from Admission to Study on the modified Japanese Orthopaedic Association Scale	Score to evaluate the severity of degenerative cervical myelopathy, with scores ranging from 0 to 18; higher scores indicate more mild myelopathy	Study Admission and End of Study (12 weeks)
Change from Baseline in Motor-Evoked Potentials	Transcranial Magnetic Stimulation (TMS) will be used and electromyography (EMG) will be recorded in lower extremity muscles; size of motor-evoked potentials will be measured	Baseline and End Rehabilitation (8 weeks following Baseline)
Change from Baseline in Hoffman Reflexes	Hoffman reflexes will be elicited in the soleus muscle and electromyography (EMG) will be recorded; H:M ratios and rate-dependent depression will be measured.	Baseline and End Rehabilitation (8 weeks following Baseline)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility (Participant Recruitment and Retention)	The recruitment and drop out rates will be recorded	From Study Admission to the End of Study (12 weeks)
Acceptability	Participants will describe their satisfaction with the intervention (including content and timing) through a custom survey following the intervention	Immediately following rehabilitation (Week 8 for Intervention Group, Week 12 for Usual Care Control)
Safety (Adverse Events)	Details and timing of any adverse events will be documented for all participants	From Study Admission to the End of Study (12 weeks)
Change from Baseline in Daily Activity	Activity monitors will be used to measure daily activity levels (including step counts). Average activity over 4-7 days of monitoring will be calculated.	Baseline and End Rehabilitation (8 weeks following Baseline)

Collaborators and Investigators

• Sponsor: University of Alberta
• Collaborators: Alberta Spine Foundation

Study record dates

Study Major Dates

• Study Start (Estimated): June 15, 2026
• Primary Completion (Estimated): October 31, 2027
• Study Completion (Estimated): December 31, 2027

Study Registration Dates

• First Submitted: May 27, 2026
• First Submitted That Met QC Criteria: June 4, 2026
• First Posted (Actual): June 9, 2026

Study Record Updates

• Last Update Posted (Actual): June 9, 2026
• Last Update Submitted That Met QC Criteria: June 4, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: walking; physical therapy; spinal cord injury; post-operative rehabilitation; degenerative cervical myelopathy
• Additional Relevant MeSH Terms: Central Nervous System Diseases; Nervous System Diseases; Wounds and Injuries; Trauma, Nervous System; Spinal Cord Diseases; Spinal Cord Injuries; Therapeutics; Rehabilitation; Physical Therapy Modalities
• Other Study ID Numbers: Pro00161798

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No