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

描述(申请人提供)：尽管姿势不稳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衡量这一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。这项建议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天窗口内没有恢复的人。目的1.研究大学生运动员脑震荡后姿势摆动的纵向特征。我们假设，一部分遭受脑震荡的参与者在受伤后立即会有可测量的和显着的姿势摆动增加，这种异常的姿势控制将持续一周以上。目的2.确定脑震荡后最敏感的步态指标。我们假设，在仪器化2分钟步行测试中增加挑战性的步态条件(快走、转头和次要任务)将提高后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情况，对25名脑震荡后运动员在伤后8周进行跟踪(在伤后第一周测试两次，然后每周再测试7周，共9次研究访问)。健康对照受试者将沿着相同的时间点进行测试，以进行比较。惯性传感器将提供有关姿势摆动和步态可变性的数据，作为主要的结果衡量标准。这些拟议的研究有可能改变运动员脑震荡后的监测方式，并将这一领域推向亟需的、客观的方向。到目前为止，还没有一个实用和客观的方法来衡量脑震荡后的姿势控制缺陷，我们认为，有一部分运动员在他们对复杂的平衡系统进行最佳控制之前就回到了比赛中，这进一步使他们容易发生第二次有害的脑震荡。如果我们能找出在这个经常被忽视的领域中没有恢复的人，我们就可以更有信心地建议休息、康复或在适当的时候重返赛场。此外，这项技术也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。这是第一个应用有前景的新型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。

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.