Powell Dylan, Stuart Samuel, Godfrey Alan
Department of Computer and Information Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom.
Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-upon-Tyne, United Kingdom.
Phys Ther. 2022 May 5;102(5). doi: 10.1093/ptj/pzac016.
Challenges remain in sports-related concussion (SRC) assessment to better inform return to play. Reliance on self-reported symptoms within the Sports Concussion Assessment Tool means that there are limited data on the effectiveness of novel methods to assess a player's readiness to return to play. Digital methods such as wearable technologies may augment traditional SRC assessment and improve objectivity in making decisions regarding return to play.
The participant was a male university athlete who had a recent history of SRC. The single-participant design consisted of baseline laboratory testing immediately after SRC, free-living monitoring, and follow-up supervised testing after 2 months. The primary outcome measures were from traditional assessment (eg, Sports Concussion Assessment Tool and 2-minute instrumented walk/gait test; secondary outcome measures were from remote (free-living) assessment with a single wearable inertial measurement unit (eg, for gait and sleep).
The university athlete (age = 20 years, height = 175 cm, weight = 77 kg [176.37 lb]) recovered and returned to play 20 days after SRC. Primary measures returned to baseline levels after 12 days. However, supervised (laboratory-based) wearable device assessment showed that gait impairments (increased step time) remained even after the athlete was cleared for return to play (2 months). Similarly, a 24-hour remote gait assessment showed changes in step time, step time variability, and step time asymmetry immediately after SRC and at return to play (1 month after SRC). Remote sleep analysis showed differences in sleep quality and disturbance (increased movement between immediately after SRC and once the athlete had returned to play [1 month after SRC]).
The concern about missed or delayed SRC diagnosis is growing, but methods to objectively monitor return to play after concussion are still lacking. This report showed that wearable device assessment offers additional objective data for use in monitoring players who have SRC. This work could better inform SRC assessment and return-to-play protocols.
Digital technologies such as wearable technologies can yield additional data that traditional self-report approaches cannot. Combining data from nondigital (traditional) and digital (wearable) methods may augment SRC assessment for improved return-to-play decisions.
Inertia-based wearable technologies (eg, accelerometers) may be useful to help augment traditional, self-report approaches to sports-related concussion assessment and management by better informing return-to-play protocols.
在与运动相关的脑震荡（SRC）评估中，要更好地为重返比赛提供依据仍存在挑战。依赖于《运动脑震荡评估工具》中的自我报告症状意味着，关于评估运动员重返比赛准备情况的新方法有效性的数据有限。可穿戴技术等数字方法可能会增强传统的SRC评估，并提高在做出重返比赛决策时的客观性。
参与者是一名有近期SRC病史的男性大学运动员。单参与者设计包括SRC后立即进行的基线实验室测试、自由生活监测以及2个月后的随访监督测试。主要结局指标来自传统评估（例如，《运动脑震荡评估工具》和2分钟仪器化步行/步态测试）；次要结局指标来自使用单个可穿戴惯性测量单元的远程（自由生活）评估（例如，用于步态和睡眠）。
该大学运动员（年龄 = 20岁，身高 = 175厘米，体重 = 77千克[176.37磅]）在SRC后20天康复并重返比赛。主要指标在12天后恢复到基线水平。然而，监督（基于实验室）的可穿戴设备评估显示，即使运动员被批准重返比赛（2个月后），步态障碍（步时增加）仍然存在。同样，24小时远程步态评估显示，SRC后立即以及重返比赛时（SRC后1个月）步时、步时变异性和步时不对称性都有变化。远程睡眠分析显示，SRC后立即与运动员重返比赛时（SRC后1个月）的睡眠质量和干扰存在差异（运动增加）。
对SRC诊断遗漏或延迟的担忧日益增加，但仍缺乏客观监测脑震荡后重返比赛的方法。本报告表明，可穿戴设备评估为监测患有SRC的运动员提供了额外的客观数据。这项工作可以更好地为SRC评估和重返比赛方案提供依据。
可穿戴技术等数字技术可以产生传统自我报告方法无法获得的额外数据。将非数字（传统）和数字（可穿戴）方法的数据结合起来，可能会增强SRC评估，以改善重返比赛的决策。
基于惯性的可穿戴技术（例如，加速度计）可能有助于增强传统的、自我报告的与运动相关的脑震荡评估和管理方法，通过更好地为重返比赛方案提供依据。
