Objective & Portable Balance& Gait Measures to Document Recovery after Concussion

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• 批准号: 8662064
• 负责人: Laurie King
• 金额: $ 22.86万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-08 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8662064
• 关键词: Acute; Affect; Age; Ankle; Athletic; Behavioral; Brain; Brain Concussion; Child; Chronic; Clinic; Complex; Consensus; Craniocerebral Trauma; Data; Development; Devices; Environment; Equilibrium; Fostering; Gait; Goals; Head; Heterogeneity; Hour; Injury; Laboratory Study; Measurable; Measurement; Measures; Medical; Metric; Mission; Monitor; Musculoskeletal Equilibrium; Neuraxis; Outcome Measure; Participant; Patients; Pattern; Physicians; Play; Population; Process; Property; Psychometrics; Public Health; Recovery; Rehabilitation therapy; Reporting; Rest; Risk; Sensitivity and Specificity; Solutions; Specificity; Speed; Sports; System; Techniques; Technology; Testing; Time; Traumatic Brain Injury; United States; Veterans; Visit; Walking; balance testing; clinical decision-making; college; equilibration disorder; high risk; improved; instrument; kinematics; mind control; premature; prevent; primary outcome; public health relevance; rehabilitation management; sensor; sensorimotor system; tool

PROJECT SUMMARY Although postural instability is one of the most common and devastating complaints after concussion, there are currently no sensitive, objective or easy measurements for this complex problem involving multiple components of the central nervous system. Therefore, objective measures of postural control are not commonly used in clinical decision-making. Our long-term goal is to improve the management and rehabilitation of concussion, through improved quantification of balance impairment in athletes. The objective of this proposal is to use inertial sensors to quantify and determine patterns of recovery for both static and dynamic balance after an injury to the brain, and to determine the most sensitive metrics to help identify those who do not recover in the expected 5-day window. Aim 1.To longitudinally characterize postural sway in college athletes after a concussion. We hypothesize that a subset of participants who sustain a concussion will have a measurable and significant increase in postural sway immediately post-injury and this abnormal postural control will persist for more than one week. Aim 2. To determine the most sensitive gait metrics after concussion. We hypothesize that adding challenging gait conditions (fast walking, head turns and secondary task) to the instrumented 2 minute walk test will increase the sensitivity and specificity of post- concussion assessment. To assess recovery of static and dynamic balance, 25 athletes post-concussion will be followed for 8 weeks after injury (tested twice in the first week after injury and then weekly for 7 more weeks, for a total of 9 study visits). Healthy control participants will be tested along the same time-points for comparison. Inertial sensors will provide data on postural sway and gait variability as primary outcome measures. These proposed studies have the potential to change the way in which athletes are monitored post- concussion and move the field in a much-needed, objective direction. Until now, there has not been both a practical and objective measure of postural control deficit after concussion and we believe that a subset of athletes are returning to play before they have optimal control of their complex balance system, further predisposing them to a second detrimental concussion. If we can identify people who have not recovered in this, often overlooked, domain we could more confidently advise rest, rehabilitation, or return to play when appropriate. Furthermore, this technique could be used in other high-risk populations, including Veterans and younger children who suffer head trauma. This is the first study to apply promising, new inertial sensor technology to determine how a concussion affects static and dynamic postural control.

项目摘要 虽然姿势不稳定是脑震荡后最常见和最具破坏性的投诉之一， 目前没有敏感的，客观的或容易的测量这个复杂的问题，涉及多个 中枢神经系统的组成部分。因此，姿势控制的客观措施 通常用于临床决策。我们的长期目标是改善管理， 通过改善运动员平衡障碍的量化，促进脑震荡的康复。客观 该建议的一个重要方面是使用惯性传感器来量化和确定静态和 动态平衡后，受伤的大脑，并确定最敏感的指标，以帮助确定那些 在预期的5天窗口期内无法康复的患者。目的1.纵向描述 大学运动员脑震荡后我们假设一部分受试者在脑震荡后 在受伤后立即会有可测量的和显著的姿势摇摆增加， 姿势控制将持续一周以上。目标2. 确定最敏感的步态指标 脑震荡后我们假设，增加具有挑战性的步态条件（快速行走，头部转动和 第二任务）的仪器2分钟步行试验将增加的敏感性和特异性后， 脑震荡评估为了评估静态和动态平衡的恢复，25名脑震荡后的运动员将 受伤后8周进行随访（受伤后第一周测试两次，然后每周测试7次 共9次研究访视）。健康对照受试者将在相同的时间点接受沿着检测， 对比惯性传感器将提供姿势摇摆和步态变异性数据作为主要结局 措施这些拟议中的研究有可能改变运动员赛后监测的方式， 冲击和移动领域在一个急需的，客观的方向。到目前为止，还没有一个 实际和客观的测量脑震荡后的姿势控制缺陷，我们相信， 运动员在对他们复杂的平衡系统进行最佳控制之前就开始比赛， 使他们容易遭受第二次有害的脑震荡 如果我们能找出那些没有康复的人， 这个经常被忽视的领域，我们可以更自信地建议休息，康复，或者在 适当此外，这项技术还可以用于其他高风险人群，包括退伍军人和 遭受头部创伤的年幼儿童这是第一次研究应用有前途的，新的惯性传感器 技术来确定脑震荡如何影响静态和动态姿势控制。