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）：尽管姿势不稳定性是脑震荡后最常见和毁灭性的抱怨之一，但目前尚无敏感，客观或简单的测量，涉及中枢神经系统的多个组成部分。因此，姿势控制的客观度量不常用于临床决策。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。该建议的目的是使用惯性传感器来量化和确定对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，以帮助识别那些在预期的5天窗口中未恢复的人。目的1。脑震荡后纵向描述大学运动员的姿势摇摆。我们假设，维持脑震荡的一部分参与者将立即受伤后的姿势震动，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。我们假设将具有挑战性的步态条件（快速步行，头转弯和次要任务）添加到仪器2分钟的步行测试将提高后的灵敏度和特异性脑震荡评估。为了评估静态和动态平衡的恢复，受伤后8周将跟踪25名运动员（在受伤后的第一周进行了两次测试，然后每周进行7周，总共9个研究就诊）。健康对照参与者将沿着同一时间点进行比较。惯性传感器将提供有关姿势摇摆和步态变异性作为主要结果指标的数据。这些拟议的研究有可能改变脑震荡后运动员的监测方式，并以急需的客观方向移动场地。到目前为止，脑震荡之后还没有实践和客观的衡量姿势控制缺陷，我们认为，一部分运动员在对其复杂的平衡系统最佳控制之前恢复了比赛，进一步使他们倾向于第二次有害脑震荡。如果我们可以确定那些在此尚未康复的人，通常被忽视的领域，我们就可以在适当时更自信地建议休息，康复或返回比赛。此外，该技术可用于其他高风险人群，包括退伍军人和遭受头部创伤的年幼儿童。这是第一个采用有希望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。