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Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion
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Integrated linear and nonlinear trunk dynamics identify residual concussion deficits.

Scott Bonnette1, Jed A Diekfuss1, Dustin Grooms2

  • 1The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Neuroscience Letters
|April 17, 2020
PubMed
Summary

Mild traumatic brain injury, or concussion, significantly impacts postural sway. A combination of single and dual-task sway measures, using both linear and nonlinear analyses, effectively differentiates concussed athletes from healthy controls.

Keywords:
Inertial SensorsMild Traumatic Brain Injury (mTBI)Postural ControlRecurrence Quantification Analysis (RQA)

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Area of Science:

  • Neurology
  • Biomechanics
  • Sports Medicine

Background:

  • Postural sway is a sensitive indicator of neurological function, often disrupted by mild traumatic brain injury (concussion).
  • Quantifying concussion severity relies on various methods, with postural sway analysis showing promise.

Purpose of the Study:

  • To quantify postural sway differences in youth athletes with concussion versus healthy controls using inertial sensors.
  • To compare the effectiveness of linear and nonlinear analysis techniques in differentiating concussion from control groups during single and dual-task conditions.

Main Methods:

  • Inertial sensors measured postural sway in 43 concussed youth athletes and 38 healthy controls.
  • Recurrence quantification analysis (RQA) and linear measures quantified sway dynamics during single and dual tasks.
  • Logistic regression identified the optimal combination of variables for classifying participants.

Main Results:

  • Concussed athletes exhibited significant differences in percent determinism, laminarity, and standard deviation of sway acceleration compared to controls.
  • Additional significant differences in mean diagonal line length and trapping time were observed during single-task sway.
  • A combined set of linear and nonlinear measures across both tasks best classified concussed individuals, with prior concussion history as a significant covariate.

Conclusions:

  • A combination of postural sway tasks and measurement types (linear and nonlinear) is superior for differentiating concussed athletes.
  • Findings underscore the need for further research to validate these methods in diverse populations and refine classification strategies.