A novel smartphone-based tool to quantify dual-task gait performance for concussion assessment

一种基于智能手机的新型工具，用于量化脑震荡评估的双任务步态表现

• 批准号: 9906556
• 负责人: Vipul Lugade
• 金额: $ 15万
• 依托单位: CONTROL ONE, LLC
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9906556
• 关键词: Accelerometer; Address; Adolescent; Annual Reports; Athletic; Brain Concussion; Cellular Phone; Clinical; Cognitive; Complex; Computer software; Consensus; Data; Decision Making; Development; Disease Progression; Electrophysiology (science); Environment; Equilibrium; Equipment; Equipment and supply inventories; Evaluation; Feedback; Financial Hardship; Functional disorder; Future; Gait; Geography; Goals; Guidelines; Hand; Health Personnel; Health Promotion; Health Status; Healthcare; Hour; Human Resources; Impaired cognition; Impairment; Individual; Injury; Investigation; Laboratories; Length; Life; Measurement; Measures; Medical; Medical Device; Memory Loss; Methods; Monitor; Motor; Movement; Nature; Nervous System Physiology; Neurologic Examination; Outcome Measure; Participant; Patient Self-Report; Pattern; Performance; Phase; Physical Performance; Play; Public Health; Quality of life; Reaction Time; Readiness; Recovery; Reporting; Research Personnel; Risk; Schools; Services; Small Business Innovation Research Grant; Speed; Sports; Sports Medicine; Stimulus; Symptoms; System; Tablets; Techniques; Technology; Telephone; Testing; Time; Training; Traumatic Brain Injury; Treatment Effectiveness; United States; Validity and Reliability; Visit; Walking; Youth; base; cognitive function; cognitive performance; cognitive task; cohort; computerized; cost; experience; gait examination; high school; individualized feedback; injury burden; innovation; instrument; neurocognitive test; novel; oculomotor; outcome forecast; point of care; real time monitoring; research clinical testing; return to sport; sensor; smartphone Application; spatiotemporal; tool; treatment as usual

Project Summary Sport-related concussions are a serious public health concern in the United States, with 1.6 to 3.8 million concussions reported annually. Young athletes who suffer a concussion experience quality of life alterations, with cognitive impairment, reduction in balance or coordination, and memory loss. Unfortunately, several factors limit the ability to accurately and feasibly evaluate the deleterious effects resulting from a concussion. First, current concussion assessment guidelines are consensus, not evidence based, resulting in variable practice patterns that often rely on subjective measurements. Second, impairments in neurological function are difficult to quantify using currently available testing techniques, leading to potential misdiagnosis or early clearance for return to play or school. Finally, though gait evaluations are recommended as part of a thorough neurological examination following a concussion, financial, time, and personnel limitations prohibit the use of instrumented gait testing in most sports medicine and athletic training clinical environments. Therefore, the long-term objective of this project is to address these limitations related to routine concussion evaluations through the use of smartphone-based cognitive and gait assessments to facilitate efficient concussion management. Gait analysis can not only be used to reveal overall health status, but is also beneficial in assessing abnormal ambulation, quantifying disease progression and prognosis, measuring treatment effectiveness, predicting injury risk, and informing return-to-play. Furthermore, investigating dual-task gait function highlights the demanding nature of sports, where athletes must quickly react to stimuli by balancing gait and cognitive demands. With the ubiquity of smartphones, and the availability of numerous embedded sensors, walking performance metrics can be easily and accurately measured. Recently, we have demonstrated the reliability and validity of a smartphone-based accelerometer in quantifying spatiotemporal gait parameters (gait velocity, cadence, step length, step time) when attached to the body or in a bag, belt, hand, or pocket during comfortable, slow, and fast speeds. In addition, we have validated smartphone-based gait measures among healthy athletes in single- and dual-task conditions. Therefore, this Phase I SBIR will result in the development of a novel smartphone application that can assess concurrent cognitive and gait performance in the free-living environment. The aims of this proposal are to 1) Develop a clinical tool to evaluate single- and dual-task gait and cognitive function in an automated fashion among high school athletes using a smartphone; and 2) Determine the reliability and sensitivity of this tool across time in a cohort of concussed and uninjured high school athletes. The ultimate goal of this project is to establish an objective, easy-to-use, low-cost instrument for evaluating concussed athletes in order to monitor recovery, guide return-to play decisions, and reduce future injury.

项目摘要 在美国，与运动有关的脑震荡是一个严重的公共卫生问题， 每年都有脑震荡报告。遭受脑震荡的年轻运动员体验生活质量 改变，伴有认知障碍、平衡或协调能力下降和记忆丧失。 不幸的是，有几个因素限制了准确和可行地评估有害影响的能力 是脑震荡造成的首先，目前的脑震荡评估指南是共识，而不是 基于证据，导致经常依赖于主观测量的可变实践模式。 第二，神经功能的损伤很难用现有的测试来量化 技术，导致潜在的误诊或早期清除返回游戏或学校。最后， 虽然步态评估被推荐作为一个彻底的神经系统检查的一部分， 脑震荡、经济、时间和人员限制禁止在大多数情况下使用仪器步态测试。 运动医学和运动训练临床环境。因此，这一长期目标 该项目旨在通过使用 基于智能手机的认知和步态评估，以促进有效的脑震荡管理。 步态分析不仅可以用来揭示整体健康状况，而且还有助于评估 异常振幅，量化疾病进展和预后，测量治疗 有效性，预测受伤风险，并通知返回发挥。此外，研究双任务步态 功能强调了运动的要求，运动员必须迅速对刺激做出反应， 平衡步态和认知需求。随着智能手机的普及， 通过嵌入式传感器，可以轻松准确地测量步行性能指标。最近我们 已经证明了基于智能手机的加速度计在量化方面的可靠性和有效性 附着在身体上时的时空步态参数（步态速度、节奏、步长、步行时间） 或在舒适、慢速和快速的情况下放在包、皮带、手或口袋中。此外，我们还验证了 在单任务和双任务条件下，健康运动员基于智能手机的步态测量。 因此，第一阶段SBIR将导致开发一种新的智能手机应用程序， 评估在自由生活环境中的认知和步态表现。其目的是 建议是：1）开发一种临床工具来评估单任务和双任务步态和认知功能， 使用智能手机的高中运动员之间的自动化时尚;以及2）确定可靠性 在一组脑震荡和未受伤的高中运动员中，该工具随时间推移的敏感性。的 本项目的最终目标是建立一个客观、易用、低成本的评价工具 脑震荡的运动员，以监测恢复，指导返回到发挥决定，并减少未来的伤害。