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

客观的

基本信息

批准号：
8909153
负责人：
Laurie King
金额：
$ 18.77万
依托单位：
OREGON HEALTH & SCIENCE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-08-08 至 2017-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8909153
关键词：
Acute Affect Age Ankle Athletic Behavioral Brain Brain Concussion Child Chronic Clinic Complex Consensus Craniocerebral Trauma Data Development Devices Environment Equilibrium Fostering Gait Goals Head Health Heterogeneity Hour Injury Laboratory Study Measurable Measurement Measures Medical Mission Monitor Musculoskeletal Equilibrium Neuraxis Outcome Measure Participant Patients Pattern Physicians Play Population Process Property Psychometrics Public Health Recovery Rehabilitation therapy Reporting Rest Risk Sensitivity and Specificity Solutions Specificity Speed Sports System Techniques Technology Testing Time Traumatic Brain Injury United States Veterans Visit Walking balance testing clinical decision-making college equilibration disorder high risk improved instrument kinematics mind control premature prevent primary outcome rehabilitation management sensor sensorimotor system tool

项目摘要

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.

描述（由申请人提供）：虽然姿势不稳定是脑震荡后最常见且最具破坏性的主诉之一，但目前还没有针对这一涉及中枢神经系统多个组成部分的复杂问题的敏感、客观或简单的测量方法。因此，姿势控制的客观测量在临床决策中并不常用。我们的长期目标是通过改进运动员平衡损伤的量化来改善脑震荡的管理和康复。该提案的目的是使用惯性传感器来量化和确定大脑受伤后静态和动态平衡的恢复模式，并确定最敏感的指标来帮助识别那些在预期 5-5 天内没有恢复的人。天窗。目标 1. 纵向描述大学运动员脑震荡后姿势摇摆的特征。我们假设，一部分遭受脑震荡的参与者在受伤后立即出现可测量的姿势摇摆显着增加，并且这种异常的姿势控制将持续一周以上。目标 2. 确定脑震荡后最敏感的步态指标。我们假设，在仪器化的 2 分钟步行测试中添加具有挑战性的步态条件（快速行走、转头和次要任务）将提高术后的敏感性和特异性。脑震荡评估。为了评估静态和动态平衡的恢复情况，将对 25 名脑震荡运动员受伤后进行为期 8 周的跟踪（受伤后第一周进行两次测试，然后在接下来的 7 周内每周进行两次测试，总共进行 9 次研究访视）。健康对照参与者将在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摇摆和步态变异的数据作为主要结果测量。这些拟议的研究有可能改变运动员脑震荡后监测的方式，并使该领域朝着急需的客观方向发展。到目前为止，还没有一种实用且客观的措施来衡量脑震荡后的姿势控制缺陷，我们相信一部分运动员在对复杂的平衡系统进行最佳控制之前就返回了比赛，这进一步使他们容易遭受第二次有害的脑震荡。如果我们能够识别出在这个经常被忽视的领域中尚未康复的人，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比赛。此外，这项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幼儿童。这是第一项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。