Exploring inertial-based wearables for objective monitoring in sports related concussion: A single-subject report

Dylan Powell, Samuel Stuart, Alan Godfrey*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective: Challenges remain in sports related concussion (SRC) assessment to better inform return to play (RTP). Reliance on self-reported symptoms within the Sports Concussion Assessment Tool (SCAT) means there has been little investigation with objective methods to robustly assess a player’s readiness to RTP. Digital methods such as wearables may augment traditional SRC assessment and improve objectivity in RTP.
Subject: The subject was a male university athlete who had a recent history of SRC.

Methods: A single subject design consisted of; baseline laboratory testing, immediate post-SRC, free-living monitoring and follow up supervised testing 2 months later. The primary outcome measures were from traditional assessment (e.g., SCAT and 2-minute walk/gait) with secondary outcome measures from remote (free-living) assessment with a single wearable inertial measurement unit (IMU)(e.g., gait and sleep)
Results: The university athlete (20 years, 174cm, 80kg) recovered and RTP 20 days after suffering SRC. Primary measures returned to baseline levels after 12 days. However, supervised (laboratory-based) wearable assessment showed gait impairments (increased step time) remained even after being cleared for RTP (2 months). Similarly, 24-hour remote gait assessment showed changes in step time, step time variability and step time asymmetry immediately post-SRC and RTP (1-month post-SRC). Remote sleep analysis showed differences in sleep quality/disturbance (increased movement, between immediately post-SRC and once RTP (1-month post-SRC).
Conclusion: The concern of missed or delayed SRC diagnosis is growing, but methods to objectively monitor RTP post-concussion are still lacking. This report showed wearable assessment offers additional objective outcomes to monitor players who suffer SRC. This work could better inform SRC assessment and RTP protocols.
Impact Statement: Digital technologies such as wearables can yield additional objective data that traditional subjective approaches cannot. Combining data from non-digital (traditional) and digital (wearables) may better augment SRC assessment for improved RTP decisions.
Original languageEnglish
JournalPhysical Therapy
Publication statusAccepted/In press - 13 Oct 2021


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