Clinical Prediction Rule for Cervical Myelopathy

1. What are the Clinical Prediction rule variables for Cervical Myelopathy.

Cluster test for cervical myelopathy
1. gait deviation/ataxia or unsteadiness
2. (+) Hoffman’s sign
3. (+) Inverted supinator sign
4. (+) Babinski
5. over the age of 45

If three of five or four of five of these signs are present, the probability of the diagnosis is 94-99%.

Do you know your Clinical Prediction Rules

Clinical prediction rules (CPR) are a mathematical, statistical guideline which incorporates multiple predictors such as; medical signs, symptoms, and other findings, into a combination that will assist in predicting a diagnosis or treatment outcome. It is an evidence-based tool which can help diagnose certain conditions as well as help to select the most appropriate method of treatment for that diagnosis. It assists the Therapist in making the wisest decision on the appropriate treatment.


There are three types of CPR; Prognostic, diagnostic and prescriptive or interventional. Studies related to predictive factors dealing with the diagnosis are considered diagnostic CPR. Prognostic CPR deals with predicting outcomes of a specific treatment or procedure. CPR’s that deal with finding the most effective interventions or procedures is called prescriptive or interventional. In the field of rehabilitation, CPR’s are mainly prescriptive.