工口影院

Citation

Powell D, Stuart S & Godfrey A (2022) Examining the use of wearables for remote monitoring of balance,gait and sleep in sports-related concussion: A single-subject study in rugby-union. Physiotherapy, 114 (Supplement 1), pp. e9-e10. https://doi.org/10.1016/j.physio.2021.12.250

Abstract
Purpose: Challenges remain in sports-related concussion (SRC) assessment to inform return to play (RTP) protocols. Reliance on self-reported symptoms within the Sports Concussion Assessment Tool (SCAT5) means there are no scalable and objective assessment methods to better inform RTP. Disruptive digital technologies (e.g., wearables) may provide promising avenues to remotely detect subtle balance, gait and sleep deficits and supplement traditional methods in the SCAT5. The primary purpose of this project is to explore the use of wearable technology to augment traditional methods of assessment and RTP. Methods: A single-subject design consisted of assessment at baseline, immediate post-SRC and once returned to play (RTP) (1 month post-SRC and 2 months post-SRC). Traditional assessment: Two-minute walk test and Sports Concussion Assessment Tool (SCAT5) 24-hour remote gait, balance and sleep analysis. Conducted using the low-cost AX6 inertial measurement unit (Axivity, Newcastle-upon-Tyne, UK. Dimensions: 2.3 × 3.3 × 0.8 cm, weight: 11 g), set via the devices proprietary software (OmGUI). The subject wore the device continuously for 24 hours during laboratory tasks and for remote assessment. Raw data captured was analysed for gait characteristics and for generic nocturnal activity indicating sleep quality. Results: The university athlete (age 20 years, height 174 cm, weight 80.20 kg) recovered and returned to play (RTP) 20 days after suffering a SRC. Traditional measures returned to baseline after around 12 days. However, laboratory-based digital assessment showed gait impairments (increased step time, stance time and reduced step length) remained even after being cleared for RTP (1 month post-SRC). Similarly, 24-hour remote gait assessment found changes in step time, stance time, step length and step velocity between immediately post-concussion and once RTP (1 month post-SRC). Moreover, remote sleep analysis showed differences in sleep quality/ disturbance (increased movement) between immediately post-SRC and once RTP (1-month post-SRC). Conclusion(s): The prevalence of concussion in contact sports growing, but methods to objectively and remotely monitor return to play post-concussion are lacking. This project showed that remote wearable assessment offers additional objective outcomes to monitor players who suffer SRC, alongside traditional methods. Indeed, digital methods may provide more informed and holistic data for clinicians to use in recovery and return to play following SRC. Impact: Physiotherapists are directly involved in the management of individuals during their recovery from SRC. SRC causes a number of different impairments (balance, gait and sleep) which can be subtle and difficult to assess using subjective methods (SCAT5). Digital assessment (e.g wearables) may improve objectivity in return-to-play concussion protocols and be readily deployed by physiotherapists and other medical professionals in low resource settings.

Keywords
Digital-Health; Concussion; Wearables

Journal
Physiotherapy: Volume 114, Issue Supplement 1