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

项目总结 虽然姿势不稳是脑震荡后最常见和最具破坏性的症状之一，但有 目前还没有针对这一复杂问题的敏感、客观或简单的测量方法 中枢神经系统的组成部分。因此，客观的姿势控制措施并不是 通常用于临床决策。我们的长远目标是改善管理和 通过改进对运动员平衡损害的量化，脑震荡的康复。目标是 这一建议的目的是使用惯性传感器来量化和确定静态和静态的恢复模式 脑损伤后的动态平衡，并确定最敏感的指标来帮助识别 在预期的5天窗口内不能恢复的患者。目的：1.纵向刻画体位摆动 大学生运动员脑震荡后。我们假设一部分脑震荡的参与者 会在受伤后立即有可测量的和显著的姿势摇摆增加，这是异常的 姿势控制将持续一周以上。目的2.确定最敏感的步态指标 在脑震荡之后。我们假设，增加具有挑战性的步态条件(快走、转头和 辅助任务)将增加后2分钟步行试验的敏感性和特异性。 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 受伤后跟踪观察8周(受伤后第一周测试两次，然后每周测试7次 每周，共进行9次考察访问)。健康对照参与者将在相同的时间点进行测试- 比较一下。惯性传感器将提供有关姿势摆动和步态可变性的数据作为主要结果 措施。这些拟议的研究有可能改变运动员在赛后接受监测的方式 震荡，并使磁场朝着亟需的、客观的方向发展。到目前为止，还没有既有 脑震荡后姿势控制缺陷的实用和客观测量，我们认为 运动员们在对他们复杂的平衡系统进行最佳控制之前就重返赛场，而且 使他们容易发生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，或者在什么时候重新开始比赛 恰如其分。此外，该技术还可用于其他高危人群，包括退伍军人和 遭受头部创伤的年龄较小的儿童。这是第一次应用有前景的新型惯性传感器的研究。 用于确定脑震荡如何影响静态和动态姿势控制的技术。

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.