Priority 23 from the Degenerative Cervical Myelopathy PSP

UNCERTAINTY: What lifestyle modifications (such as physical activity or exercise) are required or should be recommended to patients with DCM to support recovery, avoid deterioration and improve quality of life? (JLA PSP Priority 23)
Overall ranking	23
JLA question ID	0097/23
Explanatory note	Patients with DCM are interested in what lifestyle modifications they should make in order to support recovery, avoid deterioration and improve quality of life. Some recommendations include avoiding forward bending and rotation of the neck, prolonged extension of the neck and prolonged sitting or standing. Furthermore, workplace modifications and ergonomics may be valuable in reducing strenuous neck positions during work. It is unclear whether these suggestions are based on scientific evidence. Further research is require to evaluate what lifestyle modifications, such as physical activity or exercise, should be recommended to patients with DCM to support recovery, avoid deterioration and improve quality of life.
Evidence	No systematic reviews, scoping reviews or guidelines identified
Health Research Classification System category	Neurological

Extra information provided by this PSP
Original uncertainty examples	What job changes should be advised to patients with DCM? ~ Is there any diet that helps with DCM? ~ When should activity restrictions be placed on the patient? ~ Are there lifestyle factors than can accelerate/slow down the progression of DCM? ~ Is there a chance for return to sport after cervical myelopathy surgery? ~ List of do's and don'ts (physically) and a timeline of when certain physical activities can be resumed.~ What activities could further aggravate and/or accelerate the condition and therefore best avoided?
Submitted by	Spinal Surgeons x 35, Other healthcare professionals x 24, People with DCM and their supporters x 29

Extra information provided by this PSP

Original uncertainty examples

What job changes should be advised to patients with DCM? ~ Is there any diet that helps with DCM? ~ When should activity restrictions be placed on the patient? ~ Are there lifestyle factors than can accelerate/slow down the progression of DCM? ~ Is there a chance for return to sport after cervical myelopathy surgery? ~ List of do's and don'ts (physically) and a timeline of when certain physical activities can be resumed.~ What activities could further aggravate and/or accelerate the condition and therefore best avoided?

Submitted by

Spinal Surgeons x 35, Other healthcare professionals x 24, People with DCM and their supporters x 29

PSP information
PSP unique ID	0097
PSP name	Degenerative Cervical Myelopathy
Total number of uncertainties identified by this PSP.	76 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	20 November 2019