On-Body Measure of Reaction Time Provides Real-time Triage of Impairment

There is an urgent need for accurate, cost-effective tools to aid the timely triage of cognitive impairment in field--forward settings. Neurocognitive assessments are used to evaluate individuals after suspected head trauma, and reaction time in particular is a measure identified as a sensitive, robust metric of performance changes. Standard reaction-time tests used in clinics are not practical in the field and mobile touchscreen tests can vary from trial to trial by tens of milliseconds, masking alterations that represent cognitive impairment. Pison has developed and commercialized a wrist-worn technology that enables on-body measurement of reaction time. The Pison device contains surface electromyography sensors that measure electrical activity associated with motion, as well as accelerometers and gyroscopes that measure actual motion. Reaction times are calculated on-device, not on-phone, removing sources of variability. This manuscript describes the Pison wearable technology and details the field-based measurements from two military demonstrations: breaching training and a special operations competition. The Pison wearable is not intended to be diagnostic, but informs users of changes in reaction time from baseline performance and may be indicative of impairment, such as sub-concussive impact or fatigue. Although the cause of impairment is not specified, the easy-to-use Pison cognitive tests empower users to track their own operational readiness and to seek medical guidance if changes from baseline performance persist.