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

项目摘要 在美国，与运动相关的脑震荡是一个严重的公共卫生问题，有160万到380万人 每年都有脑震荡的报道。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，以及记忆力丧失。 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。 由脑震荡引起的。首先，目前的脑震荡评估指南是共识，而不是 以证据为基础，导致经常依赖于主观衡量的不同实践模式。 其次，神经功能的损害很难用目前可用的测试来量化 技术，导致潜在的误诊或过早清除返回游戏或学校。最后， 尽管建议将步态评估作为彻底的神经学检查的一部分， 脑震荡、经济、时间和人员的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，这一行动的长期目标是 项目旨在解决与常规脑震荡评估相关的这些限制，方法是使用 基于智能手机的认知和步态评估，以促进有效的脑震荡治疗。 步态分析不仅可以用来揭示整体的健康状况，而且还有助于评估 异常行走，量化疾病进展和预后，衡量治疗 有效性，预测受伤风险，并通知重返赛场。此外，还研究了双任务步态 功能突出了体育运动的要求，运动员必须通过以下方式对刺激做出快速反应 平衡步态和认知需求。随着智能手机的普及，以及大量 通过嵌入传感器，可以轻松、准确地测量步行性能指标。最近，我们 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 与身体相连时的时空步态参数(步速、步频、步长、步长) 或者在舒适的、慢的和快的速度下放在包、腰带、手或口袋里。此外，我们已经验证了 基于智能手机的步态测量了健康运动员在单任务和双任务条件下的步态。 因此，这一阶段的SBIR将导致开发一种新型的智能手机应用程序，该应用程序可以 评估在自由生活环境中的同时认知和步态表现。这样做的目的是 建议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 在高中运动员中使用智能手机的自动化时尚；以及2)确定可靠性 在一群脑震荡和未受伤的高中运动员中，这种工具的敏感性随着时间的推移而变化。这个 该项目的最终目标是建立一个客观、易用、低成本的评估工具 脑震荡的运动员，以监测恢复，指导回归比赛的决定，并减少未来的伤害。

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.