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

客观的

基本信息

批准号：
8909153
负责人：
Laurie King
金额：
$ 18.77万
依托单位：
OREGON HEALTH & SCIENCE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-08-08 至 2017-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8909153
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 Health Heterogeneity Hour Injury Laboratory Study Measurable Measurement Measures Medical 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 rehabilitation management sensor sensorimotor system tool

项目摘要

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.

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主诉之一，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，姿势控制的客观措施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障碍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大脑受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天窗口内没有恢复的人。目标1。纵向描述大学运动员脑震荡后的姿势摇摆特征。我们假设，一个子集的参与者谁持续脑震荡将有一个可测量的和显着增加的姿势摇摆受伤后立即和这种异常的姿势控制将持续一个多星期。目标二。确定脑震荡后最敏感的步态指标。我们假设，将具有挑战性的步态条件（快速行走，头部转动和次要任务）添加到仪器化的2分钟步行测试中将增加后检测的灵敏度和特异性。脑震荡评估为了评估静态和动态平衡的恢复，将在受伤后对25名脑震荡后的运动员进行8周的随访（在受伤后的第一周进行两次测试，然后每周进行一次，持续7周，总共进行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，以进行比较。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指标。这些拟议中的研究有可能改变运动员脑震荡后的监测方式，并将该领域推向急需的客观方向。到目前为止，还没有一个实际和客观的措施，脑震荡后的姿势控制缺陷，我们相信，一个子集的运动员返回发挥之前，他们有最佳的控制他们的复杂的平衡系统，进一步诱发他们的第二次有害的脑震荡。如果我们能够识别出在这个经常被忽视的领域中没有恢复的人，我们就可以更自信地建议休息，康复或在适当的时候重返赛场。此外，这项技术还可以用于其他高危人群，包括退伍军人和遭受头部创伤的年幼儿童。这是第一项应用有前途的新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的研究。