Sports related concussion: an emerging era in digital sports technology

Abstract

Sports-related concussion (SRC) is defined as a mild traumatic brain injury (mTBI) leading to complex impairment(s) in neurological function with many seemingly hidden or difficult to measure impairments that can deteriorate rapidly without any prior indication. Growing numbers of SRCs in professional and amateur contact sports have prompted closer dialog regarding player safety and welfare. Greater emphasis on awareness and education has improved SRC management, but also highlighted the difficulties of diagnosing SRC in a timely manner, particularly during matches or immediately after competition. Therefore, challenges exist in off-field assessment and return to play (RTP) protocols, with current traditional (subjective) approaches largely based on infrequent snapshot assessments. Low-cost digital technologies may provide more objective, integrated and personalized SRC assessment to better inform RTP protocols whilst also enhancing the efficiency and precision of healthcare assessment. To fully realize the potential of digital technologies in the diagnosis and management of SRC will require a significant paradigm shift in clinical practice and mindset. Here, we provide insights into SRC clinical assessment methods and the translational utility of digital approaches, with a focus on off-field digital techniques to detect key SRC metrics/biomarkers. We also provide insights and recommendations to the common benefits and challenges facing digital approaches as they aim to transition from novel technologies to an efficient, valid, reliable, and integrated clinical assessment tool for SRC. Finally, we highlight future opportunities that digital approaches have in SRC assessment and management including digital twinning and the “digital athlete”.

Gait Impairment in Traumatic Brain Injury: A Systematic Review

“…Significant barriers limit the objective measure of gait in TBI within clinical practice, as current TBI assessment guidelines recommend the use of subjective/clinical visual assessment [18,19]. Objective gait measurement may be useful for diagnosis and management post-TBI, as it provides sensitive outcome measures for clinical interpretation [20]. However, there are many challenges to the transition of objective gait assessment into clinical settings.…”

Exploring Inertial-Based Wearable Technologies for Objective Monitoring in Sports-Related Concussion: A Single-Participant Report

“…However, an unwanted consequence of that is generalizability-namely, the adoption of a one-size-fits-all approach for assessment and return to play with the use of the SCAT5 only. 8 Because of the SRC response and recovery heterogeneity, return-to-play periods of mandatory rest and rehabilitation are guidelines (generalized and nonspecific), making it difficult to know when it is safe for an individual who may take longer to recover to return to play. 9,10 Furthermore, the SCAT5 is a snapshot assessment tool, confounded by subjective approaches of manual rating and self-reporting during each subcomponent/test.…”

Free-living gait does not differentiate chronic mTBI patients compared to healthy controls

“…The BESS requires a clinician to manually record errors each time the patient fails to maintain a balance stance position. However, the sensitivity of the BESS is highly variable due to considerable subjectivity in error counting, which impacts the replicability and validity of results [15][16][17][18]. Additionally, subtle balance deficits may be visually undetectable by a clinician's subjective assessment and therefore unmeasurable.…”