Abstract
Cervical spondylotic myelopathy (CSM) is rising in the aging population. This study evaluated conventional versus home-based exercise interventions with a head-mounted device in 75 patients. Participants were divided into conventional (N = 36) and home-based (N = 39) groups, assessed pre-surgery, 3-months post-surgery, and after an eight-week intervention. Outcomes included numeric pain rating scale (NRS), neck disability index (NDI), cervical spine range of motion (ROM), neck muscle strength, muscle activation during movement, and cervical proprioception. A two-way mixed ANOVA was used to explore the main effects and interactions between groups and time points. ANCOVA adjusted for potential baseline differences. Both groups improved in NRS (P = 0.003), NDI (P = 0.001), and ROM in flexion (P < 0.001) and extension (P < 0.001) after exercise, while the home-based group showed significantly greater ROM in rotation (left, P = 0.026; right, P = 0.006), greater muscle strength (flexors, P < 0.001; extensors, P < 0.001), and lower sternocleidomastoid muscle activation (P < 0.001). The home-based group exhibited lower reposition errors post-exercise than the conventional group (Variable error during extension, P < 0.001; root mean square error during flexion, left and right rotation, P < 0.001 for all). The home-based intervention with a head-mounted device showed superior outcomes in mobility, muscle strength, proprioception, and muscle activation, surpassing pre-surgery levels and enhancing quality of life for CSM patients.