Grip strength, walking pace, and hospital-record-defined incident degenerative cervical myelopathy: a UK Biobank cohort study.
5 affiliations
- 1Neurosurgery Center, National Key Clinical Specialty, Engineering Research Center of Diagnostic and Therapeutic Technology and Devices for Cerebrovascular Diseases in Ministry of Education, Guangdong Provincial Key Laboratory On Brain Function Repair and Regeneration, Zhujiang Hospital Institute of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China. [email protected].
- 2Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
- 3Neurosurgery Center, National Key Clinical Specialty, Engineering Research Center of Diagnostic and Therapeutic Technology and Devices for Cerebrovascular Diseases in Ministry of Education, Guangdong Provincial Key Laboratory On Brain Function Repair and Regeneration, Zhujiang Hospital Institute of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
- 4Department of Spinal Surgery, Orthopedic Medical Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
- 5Department of Spinal Surgery, Orthopedic Medical Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China. [email protected].
Abstract
Background
Previous UK Biobank work associated grip strength and usual walking pace with degenerative cervical myelopathy (DCM). We evaluated whether these associations were robust to more specific hospital-record definitions, competing mortality, alternative exposure modeling, and internally validated incremental discrimination.Methods
We analyzed 501,936 UK Biobank participants. Grip strength was instrumentally measured, and usual walking pace was self-reported. The primary outcome was any-position hospital-record-defined incident DCM; primary-position DCM and paired hospital diagnosis and cervical procedure records were confirmatory outcomes. Cause-specific Cox models adjusted for age, sex, ethnicity, smoking, body mass index, alcohol intake, diabetes, and hypertension. Grip strength was examined continuously and with restricted cubic splines; walking pace was modeled categorically. Fine-Gray competing-risk models, lagged analyses, interaction tests, and 200-resample bootstrap internal validation were performed.Results
During a median 16.43 years (interquartile range 15.58-17.16; 7,945,865 person-years), 978 participants developed hospital-record-defined DCM (12.31 per 100,000 person-years). The main complete-case analysis included 489,344 participants and 923 events. Each 5-kg higher grip strength was associated with a lower hazard (hazard ratio [HR] 0.859, 95% confidence interval [CI] 0.823-0.896). Relative to brisk pace, steady/average pace (HR 1.274, 95% CI 1.087-1.495) and slow pace (HR 2.543, 95% CI 2.049-3.156) were associated with higher hazards. The grip-strength association was approximately linear (P for nonlinearity = 0.724), and no interaction was evident by sex or age. Primary-position, strict 0-90-day surgery, lagged, and Fine-Gray analyses were directionally consistent. In exploratory internal validation, adding both markers increased the optimism-corrected C-index from 0.650 to 0.680 and the censoring-adjusted 10-year AUC from 0.642 to 0.679; the 10-year Brier-score improvement was numerically very small.Conclusions
Instrumentally measured grip strength and self-reported walking pace were associated with subsequent hospital-record-defined DCM. The results extend previous UK Biobank findings by applying more specific hospital-record definitions, competing-risk methods, evaluation of functional form, and bootstrap internal validation. These nonspecific functional measures may inform future prospective diagnostic research but should not be used as stand-alone screening or triage tests.
Related
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BibTeX
@article{yang2026grip,
title = {{Grip strength, walking pace, and hospital-record-defined incident degenerative cervical myelopathy: a UK Biobank cohort study.}},
author = {Simin Yang and Le Kang and Yuqian Yang and Jiahao Du and Zhenhui Wang and Shengxuan Ding and Xiangwei He and Shuizhong Cen},
journal = {BMC neurology},
year = {2026},
month = sep,
doi = {10.1186/s12883-026-05305-6},
url = {https://europepmc.org/article/MED/42958083},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Grip strength, walking pace, and hospital-record-defined incident degenerative cervical myelopathy: a UK Biobank cohort study.
AU - Simin Yang
AU - Le Kang
AU - Yuqian Yang
AU - Jiahao Du
AU - Zhenhui Wang
AU - Shengxuan Ding
AU - Xiangwei He
AU - Shuizhong Cen
PY - 2026
DA - 2026/09/12
JO - BMC neurology
DO - 10.1186/s12883-026-05305-6
UR - https://europepmc.org/article/MED/42958083
AB - Background Previous UK Biobank work associated grip strength and usual walking pace with degenerative cervical myelopathy (DCM). We evaluated whether these associations were robust to more specific hospital-record definitions, competing mortality, alternative exposure modeling, and internally validated incremental discrimination.Methods We analyzed 501,936 UK Biobank participants. Grip strength was instrumentally measured, and usual walking pace was self-reported. The primary outcome was any-position hospital-record-defined incident DCM; primary-position DCM and paired hospital diagnosis and cervical procedure records were confirmatory outcomes. Cause-specific Cox models adjusted for age, sex, ethnicity, smoking, body mass index, alcohol intake, diabetes, and hypertension. Grip strength was examined continuously and with restricted cubic splines; walking pace was modeled categorically. Fine-Gray competing-risk models, lagged analyses, interaction tests, and 200-resample bootstrap internal validation were performed.Results During a median 16.43 years (interquartile range 15.58-17.16; 7,945,865 person-years), 978 participants developed hospital-record-defined DCM (12.31 per 100,000 person-years). The main complete-case analysis included 489,344 participants and 923 events. Each 5-kg higher grip strength was associated with a lower hazard (hazard ratio [HR] 0.859, 95% confidence interval [CI] 0.823-0.896). Relative to brisk pace, steady/average pace (HR 1.274, 95% CI 1.087-1.495) and slow pace (HR 2.543, 95% CI 2.049-3.156) were associated with higher hazards. The grip-strength association was approximately linear (P for nonlinearity = 0.724), and no interaction was evident by sex or age. Primary-position, strict 0-90-day surgery, lagged, and Fine-Gray analyses were directionally consistent. In exploratory internal validation, adding both markers increased the optimism-corrected C-index from 0.650 to 0.680 and the censoring-adjusted 10-year AUC from 0.642 to 0.679; the 10-year Brier-score improvement was numerically very small.Conclusions Instrumentally measured grip strength and self-reported walking pace were associated with subsequent hospital-record-defined DCM. The results extend previous UK Biobank findings by applying more specific hospital-record definitions, competing-risk methods, evaluation of functional form, and bootstrap internal validation. These nonspecific functional measures may inform future prospective diagnostic research but should not be used as stand-alone screening or triage tests.
SN - 1471-2377
ER -