Inferring concussion history in athletes using pose and ground reaction force estimation and stability analysis of...

Concussions present a significant risk to athletes, with females exhibiting higher rates and prolonged recovery times than males. Current sideline concussion detection methods, such as the King-Devick test commonly used as a rapid screening tool designed to evaluate eye movement, attention, language, and cognitive processing abilities suffer from validity issues. This is especially true among young athletes highlighting the need for more accurate and objective assessment tools. This study investigates the ability of the Microsoft Kinect V2 pose estimation depth sensor to reliably measure subtle postural stability differences between athletes with a history of concussion and healthy controls. Traditional methods make use of expensive force plates which require trained personnel and controlled environments, limiting their use in resource-limited settings. Inspired by previous research utilizing force plates, our study analyzes video recordings of athletes performing specific exercises to detect dynamic balance deficits. A machine learning approach is employed to predict ground reaction forces from pose estimation video recordings, which are then analyzed to measure time to stabilization. Results reveal significant differences in movement mechanics between concussed and control groups, with the drop vertical jump (DVJ) exercise demonstrating the highest discriminatory power. Notably, concussed individuals exhibit longer time to stabilization (mean difference $=$ 0.089 s, p = 0.046) during DVJ, indicating potential lingering balance impairments. While single-leg squat (SLS) and single-leg hop (SLH) exercises showed fewer discriminatory metrics than DVJ, they still provide valuable insights into balance capabilities. The DVJ yielded the largest statistical difference between injured and healthy male athletes, while the SLH was more effective for females and the SLS, while effective for ACL rehab progress assessment, was equally ineffective for both males and females.