Concussion Analysis – An Objective Approach
In the field of sports, Mild Traumatic Brain Injury, (mTBI) or concussion, frequently goes unreported. The estimated annual U.S. incidence of 1.6 to 3.8 million likely reflects an underestimation. More importantly, identifying mTBI is crucial for return-to-play decisions and preventing premature susceptibility to additional injury. (1, 2)
Because a disturbance of balance is often seen in players with mTBI, the Balance Error Scoring System (BESS) is used to measure instability. Typically, this includes subjectively counting the number of errors in balance maintenance made by a patient in various stances. However, over many studies, the BESS test has shown insensitivity and unreliability in determining player safety.
APDM is changing this paradigm.
By instrumenting the BESS test, researchers have found a superior ability to classify mTBI diagnosis. Using APDM Opal sensors and Mobility Lab software, Postural Sway displacement was objectively measured in healthy and concussed athletes, and found to be much more sensitive than original subjective BESS testing.
To put this into perspective, of 13 athletes that self-reported instability, only 3 (23%) were classified as having an abnormal original BESS score, which could lead to premature return-to-play and missed treatment of a serious issue. Conversely, when instrumented using APDM technology, 31% more (7 of 13) athletes were documented as having abnormal BESS scores. As the study suggests, many young people experience social pressure to return to their sport before symptoms have fully resolved, which is contrary to their best interests. The widespread use of self-report measures coupled with the tendency to underreport symptoms have prompted the call for more objective forms of measurement.
Screening for signs of concussion is one of the many things APDM technology can achieve in the world of athletics. Our solutions, customized for each team, allow users to analyze things like synchronization, rotation, timing, efficiency of movement, repetition, balance, and fatigue. This allows coaches to fully quantify athletic ability and make changes to performance in real-time.
For more information on APDM Athletics, visit our athletics webpage here.
Study by Laurie King, et al., 2014, Instrumenting the Balance Error Scoring System for Use With Patients Reporting Persistent Balance Problems After Mild Traumatic Brain Injury
Image: Portland State University Athletics
1. Langlois JA, Marr A, Johnson RL. Tracking the silent epidemic and educating the public: CDC’s traumatic brain injury-associated activities under the TBI Act of 1996 and the Children’s Health Act of 2000. J Head Trauma Rehabil 2005;20:196-204.
2. McCrea M, Hammeke T, Olsen G, Leo P, Guskiewicz K. Unreported concussion in high school football players: implications for prevention. Clin J Sport Med 2004;14:13-7.
