Abstract
ObjectiveChallenges 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.MethodsThe 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).ResultsThe 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]).ConclusionThe 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.ImpactDigital 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.Lay SummaryInertia-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.
Highlights
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The participant was a male university athlete who had a recent history of sports-related concussion (SRC)
The single-participant design consisted of baseline laboratory testing immediately after SRC, freeliving monitoring, and follow-up supervised testing after 2 months
Summary
Single copies of full items can be reproduced, displayed or performed, and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided the authors, title and full bibliographic details are given, as well as a hyperlink and/or URL to the original metadata page. The full policy is available online: http://nrl.northumbria.ac.uk/policies.html. This document may differ from the final, published version of the research and has been made available online in accordance with publisher policies. T Dylan Powell, MSc,[1] Samuel Stuart, PhD,[2] Alan Godfrey, PhD,1* IP 1Department of Computer and Information Sciences, Northumbria University, Newcastleupon-Tyne, United Kingdom. CR 2Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-uponUNCORRECTED MANUS Tyne, United Kingdom.
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