{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:07:12Z","timestamp":1789020432869,"version":"build-2803163510"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to compare the discriminative performance of different force platform testing methods for distinguishing patients with cervical spondylotic myelopathy (CSM) from asymptomatic controls and to evaluate the effects of arm position and test duration on individual balance parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross sectional study, 56 patients with CSM and 50 asymptomatic volunteers were enrolled between March to December 2025. Balance function was measured with the eMat 500 force platform under two standing postures, arms hanging down and arms extended forward, both performed with the feet together and the eyes closed, and each posture was tested at durations of 15, 30, and 60s. Receiver operating characteristic (ROC) curve analysis was used to compare the diagnostic value of the different posture and duration combinations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The diagnostic efficiencies of the six test protocols were all different for the four balance parameters. The center of pressure (COP) trajectory length and the mediolateral centre of gravity velocity performed best at 15\u202fs with arms hanging down, the anteroposterior centre of gravity velocity performed best at 60s with arms extended forward, and the area of the 95% confidence ellipse performed best at 30s with arms extended forward. Combined ROC analysis ranked the overall diagnostic performance of the six protocols from best to worst as follows: 30s with arms hanging down (AUC\u202f=\u202f0.897), 15\u202fs with arms hanging down (AUC\u202f=\u202f0.890), 30s with arms extended forward (AUC\u202f=\u202f0.878), 60s with arms extended forward (AUC\u202f=\u202f0.869), 60s with arms hanging down (AUC\u202f=\u202f0.855), and 15\u202fs with arms extended forward (AUC\u202f=\u202f0.840).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The research results indicate that the 30s both arms hanging down test has the highest diagnostic value. This testing approach has the potential to improve the efficiency of outpatient assessment for patients with CSM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnins.2026.1905226","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:31:32Z","timestamp":1789018292000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Standardization and optimization of force platform testing for balance assessment in cervical spondylotic myelopathy"],"prefix":"10.3389","volume":"20","author":[{"given":"Zheng","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital","place":["Beijing, China"]},{"name":"Medical School of Chinese PLA","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaige","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengfei","family":"Chi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junyao","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaohan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taoxu","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianheng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"271","DOI":"10.3389\/fnagi.2014.00271","article-title":"Influence of age on postural sway during different dual-task conditions","volume":"6","author":"Bergamin","year":"2014","journal-title":"Front. Aging Neurosci."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2696","DOI":"10.3390\/ijerph18052696","article-title":"Review of the upright balance assessment based on the force plate","volume":"18","author":"Chen","year":"2021","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref3","first-page":"304","article-title":"Effects of external perturbation on postural adjustments of limbs in healthy individuals: a surface electro-myography study","volume":"33","author":"Chen","year":"","journal-title":"Chin. J. Rehabil. Med."},{"key":"ref4","first-page":"114","article-title":"Research progress on the relationship between human balance function and upper limb activity","volume":"33","author":"Chen","year":"","journal-title":"Chin. J. Rehabil. Med."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1038\/s41582-020-00436-x","article-title":"The neuroanatomical\u2013functional paradox in spinal cord injury","volume":"17","author":"Fouad","year":"2021","journal-title":"Nat Rev Neurol."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2504","DOI":"10.1007\/s00586-021-06836-x","article-title":"Assessing the cone of economy in patients with spinal disease using only a force plate: an observational retrospective cohort study","volume":"30","author":"Haddas","year":"2021","journal-title":"Eur. Spine J."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"337","DOI":"10.22603\/ssrr.2022-0038","article-title":"Cone of economy with the chain of balance-historical perspective and proof of concept","volume":"6","author":"Hasegawa","year":"2022","journal-title":"Spine Surgery and Related Research"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1097\/BRS.0000000000004235","article-title":"Evaluation of gait and functional stability in preoperative cervical Spondylotic myelopathy patients","volume":"47","author":"Hassanzadeh","year":"2022","journal-title":"Spine"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1098","DOI":"10.1097\/BRS.0000000000004814","article-title":"Quantitative Romberg on a force plate: objective assessment before and after surgery for cervical Spondylotic myelopathy","volume":"49","author":"Kesler","year":"2024","journal-title":"Spine"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/978-3-319-73585-6_6","volume-title":"Myasthenia Gravis and Related Disorders","author":"Kuks","year":"2018"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1007\/s00586-011-1981-5","article-title":"Postural balance in low back pain patients: criterion-related validity of Centre of pressure assessed on a portable force platform","volume":"21","author":"Maribo","year":"2012","journal-title":"Eur. Spine J."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"S175","DOI":"10.1016\/j.spinee.2006.03.015","article-title":"Does nonoperative management play a role in the treatment of cervical spondylotic myelopathy?","volume":"6","author":"Matz","year":"2006","journal-title":"Spine J."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1016\/j.spinee.2021.10.001","article-title":"Quantitative Romberg using a force plate: an objective measure for cervical myelopathy","volume":"22","author":"Mkorombindo","year":"2022","journal-title":"Spine J."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.2106\/00004623-200706000-00026","article-title":"Degenerative cervical spondylosis: clinical syndromes, pathogenesis, and management","volume":"89","author":"Rao","year":"2007","journal-title":"J Bone Joint Surg Am"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/j.wneu.2017.01.122","article-title":"The role of gait analysis in the evaluation of patients with cervical myelopathy: a literature review study","volume":"101","author":"Siasios","year":"2017","journal-title":"World Neurosurg."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"64S","DOI":"10.1177\/21925682211063854","article-title":"Improving assessment of disease severity and strategies for monitoring progression in degenerative cervical myelopathy [AO spine RECODE-DCM research priority number 4]","volume":"12","author":"Tetreault","year":"2022","journal-title":"Glob. Spine J."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1056\/NEJMra2003558","article-title":"Degenerative cervical spondylosis","volume":"383","author":"Theodore","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"E792","DOI":"10.1097\/BRS.0000000000003411","article-title":"A diagnostic approach to myelopathy based on prognostic factors in patients with lower extremity symptoms","volume":"45","author":"Tsukamoto","year":"2020","journal-title":"Spine"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"100023","DOI":"10.1016\/j.xnsj.2020.100023","article-title":"Assessment of standing balance in normal versus cervical spondylotic myelopathy patients","volume":"3","author":"Ver","year":"2020","journal-title":"N. Am. Spine Soc. J"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"E466","DOI":"10.1097\/BSD.0000000000000972","article-title":"Surgical outcomes of postural instability in patients with cervical myelopathy","volume":"33","author":"Yano","year":"2020","journal-title":"Clinical Spine Surgery: A Spine Publication"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"E298","DOI":"10.1097\/BSD.0000000000001195","article-title":"The effects of surgery on postural instability in patients with cervical compressive myelopathy: evaluating subjective perceptions and objective measurements","volume":"35","author":"Yano","year":"2022","journal-title":"Clinical Spine Surgery"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"E460","DOI":"10.1097\/BRS.0b013e318178e666","article-title":"Impaired postural stability in patients with cervical myelopathy: evaluation by computerized static Stabilometry","volume":"33","author":"Yoshikawa","year":"2008","journal-title":"Spine"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1186\/s40001-025-02722-0","article-title":"A cross-sectional study of evaluating cervical spondylotic myelopathy based on gait and plantar pressures","volume":"30","author":"Zhang","year":"2025","journal-title":"Eur. J. Med. Res."}],"container-title":["Frontiers in Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnins.2026.1905226\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:31:33Z","timestamp":1789018293000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnins.2026.1905226\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":23,"alternative-id":["10.3389\/fnins.2026.1905226"],"URL":"https:\/\/doi.org\/10.3389\/fnins.2026.1905226","relation":{},"ISSN":["1662-453X"],"issn-type":[{"value":"1662-453X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]},"article-number":"1905226"}}