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

Project Summary Sport related concussions are a serious public health concern in the United Stateswithtomillion concussions reported annuallyYoung athletes who suffer a concussion experience quality of life alterationswith cognitive impairmentreduction in balance or coordinationand memory lossUnfortunatelyseveral factors limit the ability to accurately and feasibly evaluate the deleterious effects resulting from a concussionFirstcurrent concussion assessment guidelines are consensusnot evidence basedresulting in variable practice patterns that often rely on subjective measurementsSecondimpairments in neurological function are difficult to quantify using currently available testing techniquesleading to potential misdiagnosis or early clearance for return to play or schoolFinallythough gait evaluations are recommended as part of a thorough neurological examination following a concussionfinancialtimeand personnel limitations prohibit the use of instrumented gait testing in most sports medicine and athletic training clinical environmentsThereforethe 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 managementGait analysis can not only be used to reveal overall health statusbut is also beneficial in assessing abnormal ambulationquantifying disease progression and prognosismeasuring treatment effectivenesspredicting injury riskand informing return to playFurthermoreinvestigating dual task gait function highlights the demanding nature of sportswhere athletes must quickly react to stimuli by balancing gait and cognitive demandsWith the ubiquity of smartphonesand the availability of numerous embedded sensorswalking performance metrics can be easily and accurately measuredRecentlywe have demonstrated the reliability and validity of a smartphone based accelerometer in quantifying spatiotemporal gait parametersgait velocitycadencestep lengthstep timewhen attached to the body or in a bagbelthandor pocket during comfortableslowand fast speedsIn additionwe have validated smartphone based gait measures among healthy athletes in singleand dual task conditionsThereforethis 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 environmentThe aims of this proposal are toDevelop a clinical tool to evaluate singleand dual task gait and cognitive function in an automated fashion among high school athletes using a smartphoneandDetermine the reliability and sensitivity of this tool across time in a cohort of concussed and uninjured high school athletesThe ultimate goal of this project is to establish an objectiveeasy to uselow cost instrument for evaluating concussed athletes in order to monitor recoveryguide return to play decisionsand reduce future injury Project Narrative Tracking progression and recovery of concussion related dysfunction remains challengingas both clinicians and researchers have found less than optimal reliability in the currently available tools to longitudinally assess impairmentand subsequently monitor recovery and inform return to play decisionsThe goal of this studythereforeis to develop and establish a smartphone based application that assesses singleand dual task gait in real time for eventual use in clinical concussion assessmentsThe development of a quantitative gait assessment as an affordablerapidly deployedfield based medical device provides clinical valueease of useand can be administered in a ubiquitous manner across a variety of clinical points of care and geographical settings