New Smartphone App Could Transform Concussion Management of Military Personnel

Researchers from the Department of Biomedical Engineering, led by Jay Alberts, PhD, have developed a mobile application that can accurately quantify cognitive and motor functions, which may be used in the management of mild traumatic brain injury (mTBI, or concussion). In an article in Military Medicine, the researchers report that the application has the potential to be extremely helpful in assessing performance in military personnel, who may experience mTBI in the field.

Up to 20 percent of people who have an mTBI have symptoms for months after the incident, including trouble with balancing and difficulty with certain aspects of cognition, such as attention and processing information. These effects can be especially detrimental to military personnel, who must often utilize cognitive and motor skills (dual-task) simultaneously under high-pressure situations, such as on a combat field.

The application was born of the lab’s desire to improve diagnostic ability and management of mTBI. “We wanted to address what we felt was a fundamental gap—the lack of an objective and rapid assessment of motor and cognitive performance under dual-task conditions,” said Amanda Penko, PhD, research associate in the Alberts lab and first author on the study.

Single- and dual-task testing

In the study, 50 healthy civilians took part in both single- and dual-task tests that involved balance and cognitive tasks. Tests were performed in a variety of positions—standing, sitting, and with eyes open and closed. Dual tasks while standing included discriminating between words and colors; even and odd numbers; and male and female voices. Balance tasks involved static (non-moving) standing trials with eyes open and closed.

Dr. Penko noted that maintaining balance depends in large part on the visual system—in other words, it’s easier to maintain balance when your eyes are open than when they are closed, because vision provides information on the world around us.

A new day for mTBI management?

The mobile device application was able to successfully quantify cognitive and balance performance under dual-task conditions. “What’s exciting about this application is that because it is so portable, using only a mobile device, it can be used in a variety of environments, such as a military field or in a clinic,” said Dr. Penko. “It doesn’t require any special equipment, so it’s very convenient and cost-effective.”

She added that the results of the study and the application may provide information that can be used in clinical decision-making, which can lead to a higher quality of care for those with mTBI. For instance, if a patient is having difficulty under dual-task conditions, he or she could be referred for rehabilitation to improve performance. The application could thus be useful for other people at high risk of concussion and trauma, such as football players.

“This opens up so many possibilities for standardization in the treatment of mTBI,” Dr. Penko said. “The ability to assess motor and cognitive function simultaneously, with the help of a consumer electronics device, could really transform the way we manage mTBI.”

This study was supported by the Department of Defense.

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