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

描述（由申请人提供）：虽然姿势不稳定是脑震荡后最常见和最具破坏性的症状之一，但目前还没有敏感、客观或简单的测量方法来解决这个涉及中枢神经系统多个组成部分的复杂问题。因此，客观的体位控制指标在临床决策中并不常用。我们的长期目标是通过改善运动员平衡损伤的量化来改善脑震荡的管理和康复。该提案的目的是使用惯性传感器来量化和确定脑损伤后静态和动态平衡的恢复模式，并确定最敏感的指标，以帮助识别那些在预期的5天窗口内无法恢复的人。目的1。纵向表征大学运动员脑震荡后的姿势摇摆。我们假设，一部分遭受脑震荡的参与者会在受伤后立即出现可测量的、显著的姿势摇摆增加，这种异常的姿势控制将持续一周以上。目标2。确定脑震荡后最敏感的步态指标。我们假设，在仪器化的2分钟步行测试中加入具有挑战性的步态条件（快速行走、头部转动和次要任务）将增加后-的敏感性和特异性

DESCRIPTION (provided by applicant): 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.