Introduction and Clinical Analyses of an Accelerometer-Based Mobile Gait Assessment to Evaluate Neuromotor Sequelae of Concussion in Adolescents and Adults

Abstract

A growing consensus among concussion experts is that a formal gait assessment is an essential component in return-to-play decisions. Concussion research illustrates that gait variables follow a pattern of recovery that may be more protracted than cognitive recovery, suggesting that gait dynamics may be more sensitive to the sequelae of concussion, and accelerometer data may enhance that sensitivity. However, pediatric neuropsychologists have few available options for quantitatively assessing gait. We here introduce a novel gait technology, the BioKinetoGraph (BKG), that provides multiple metrics for assessing gait, including within the domains of power, stride, balance (stability), and symmetry. We demonstrate how BKG data can be collected using a mobile application called SportGait, which is available for use on any smartphone. We present data illustrating the test–retest reliability of the mobile BKG in a sample of 4150 ostensibly healthy individuals, with an overall mean correlation coefficient of .79 between two walks across the assessed domains. We also provide quantitative and qualitative data to illustrate recovery, including a presentation of norm- and self-referenced comparisons. Additional recovery data is presented using qualitative information in the form of stabilogram and displacement graphs. Because the BKG is broadly available, reliable, valid, and does not require extensive or costly equipment (i.e., only requiring a mobile device and the App), it represents a significant advancement in quantifying gait in a wide range of settings.