The evolution of technology in concussion management reflects a broader culture shift in athletics toward better recognition and care of sport-related concussions
Sport-related concussions are mild traumatic brain injuries that present a significant risk to athlete health and wellbeing.
Not long ago, concussions were brushed off as mere “bell ringers.” Early days of concussion management involved manual assessments and subjective feedback, and athletes were returned to play with inadequate evaluation and intervention.
Today, we have many more tools in the toolbox to protect our athletes. Although there is still a lot to learn about concussions, we have come a long way in our understanding and treatment strategies. Technology has played a big part in this evolution.
Technological advances in the care and management of sport-related concussions are the topic of today’s blog. Read on to learn just how much we have evolved and what you may expect to find in the future of concussion management!
The Early Days
In the early days, understanding and managing concussions relied heavily on subjective symptom reporting and essential neurological exams. It was even thought that a concussion could only occur if an athlete had experienced loss of consciousness. Fortunately, that myth has been debunked! Additionally, there was a widespread lack of awareness about the long-term impact of concussions, which led to underdiagnosis and inadequate care.
The Rise of Awareness and Initial Technological Solutions
Our view on concussions has shifted, thanks in part to high-profile football athlete cases and advancing research (Did you see the movie Concussion?). The first standardized concussion assessment was published in Neurology in 1997 and used as a sideline assessment for athletes. (1)
We still rely on subjective symptom reporting, just as we did with that first standardized assessment. However, several technological advances have emerged to improve our processes. One notable advancement was computerized cognitive testing programs, which offered the first objective tool to assess brain function post-injury. (2) Athletes would undergo cognitive testing first at a baseline (such as the beginning of a sports season) and then again following a suspected concussion to identify and document changes in brain function.
Breakthroughs in Balance Assessments
Balance assessments for sport-related concussions also saw significant technological breakthroughs. These types of evaluations offer an objective measure to complement subjective symptom reporting. Force-plate technology allowed for research into balance deficits and dysfunction experienced post-concussion. Ultimately, this research led to the creation of the clinical BESS test, which became a standard of care for athletic training clinical and sideline practice in the early 2000s. (3)
Breakthroughs in Wearable Technology
Another significant advancement was wearable sensors embedded in helmets and headbands. This was the first time impacts to the head could be monitored in real-time during athletic play. These devices provided immediate data on the forces exerted on the head, which gave us a better understanding of the force thresholds related to head injuries. In field management, it enabled a faster response to suspected concussions. (4) Wearable technologies also have uses in rehabilitation for balance assessments and recovery tracking.
Mobile Apps
Mobile apps have completely revolutionized concussion management because they offer more accessible tools for symptom tracking, cognitive and balance assessments, and recovery protocol planning. Now, athletes can hold information about their concussion status right in the palm of their hand! These apps have empowered athletes, coaches, parents, and healthcare providers with personalized information and insights, facilitating more informed decision-making and care.
Concussion Management Software
Similar to mobile apps, recent developments in concussion software have revolutionized the way sport-related concussions are managed. Communication regarding ]concussion protocols among the athlete, coach, parent, school, and healthcare team could have been much better in the past. With concussion tracking software, all parties can be informed and involved in the athlete’s recovery in real time. This integration of technology has not only improved the quality of care but also accessibility.
Artificial Intelligence (AI) in Concussion Care
Artificial Intelligence (AI) and machine learning have taken concussion research and management to a new level. Now, vast amounts of data can be analyzed over a short period. AI can help us answer one of the long-term unanswered questions in concussion research: is there a biomarker for concussion? In other words, is there a measure we can use in clinical practice to indicate the presence of a concussion, its severity, and the recovery status of the brain in a concussed state? (2) I very much look forward to the advancements that will be made in concussion care through AI in the coming years!
Virtual Reality for Rehabilitation
Virtual reality is another exciting area, particularly on the rehab side of concussion management. Recently, It has emerged as a tool for cognitive and visual rehabilitation and return-to-play assessments. Through immersive simulations, virtual reality provides a safe, controlled environment for athletes to rehabilitate their brain functioning and vestibular systems (balance, vision, and spatial awareness). (5) Virtual reality also provides a means to assess readiness for return to play in a simulated environment that will challenge an athlete more than just in your typical athletic training room or physical therapy clinic.
Challenges and Considerations to Concussion Technology
Despite all these technological advancements, several challenges remain. These biggest challenges are related to accessibility and cost. New technologies can be very expensive to purchase and implement in sports and athletic environments. Additionally, ethical considerations such as data privacy and the risk of over-reliance on technology must be addressed to ensure these innovations truly serve the best interests of athletes and patients.
Takeaways
The beautiful thing about the evolution of technology in concussion management is that it also reflects a broader culture shift in athletics toward better recognition and care of sport-related concussions. What started as rudimentary manual and paper assessments have become exciting and practical digital solutions.
As we continue to innovate, especially with the breakthroughs in artificial intelligence, the focus must remain on developing technologies that are accessible, cost-effective, and ethically sound.
HEADCHECK Health has been leading the way!
HEADCHECK Health has been integral to the evolution of concussion management software and mobile technology. Check out HEADCHECK’s special blog celebrating the field’s advancing research over the last decade.
To learn more about how HEADCHECK Health can improve your team’s management of concussions, contact us today!
References
- McCrea M, Kelly JP, Kluge J, Ackley B, Randolph C. . Standardized assessment of concussion in football players. Neurology. 1997; 48 3: 586– 588.
- Broglio SP, Guskiewicz KM, Norwig J. If You’re Not Measuring, You’re Guessing: The Advent of Objective Concussion Assessments. J Athl Train. 2017 Mar;52(3):160-166. doi: 10.4085/1062-6050-51.9.05. PMID: 28387562; PMCID: PMC5384814.
- Guskiewicz KM, Bruce SL, Cantu RC, Ferrara MS, Kelly JP, McCrea M, Putukian M, Valovich McLeod TC. National Athletic Trainers’ Association Position Statement: Management of Sport-Related Concussion. J Athl Train. 2004 Sep;39(3):280-297. PMID: 15514697; PMCID: PMC522153.
- O’Connor KL, Rowson S, Duma SM, Broglio SP. Head-Impact-Measurement Devices: A Systematic Review. J Athl Train. 2017 Mar;52(3):206-227. doi: 10.4085/1062-6050.52.2.05. PMID: 28387553; PMCID: PMC5384819.
- Hoppes CW, Lambert KH, Whitney SL, Erbele ID, Esquivel CR, Yuan TT. Leveraging Technology for Vestibular Assessment and Rehabilitation in the Operational Environment: A Scoping Review. Bioengineering (Basel). 2024 Jan 25;11(2):117. doi: 10.3390/bioengineering11020117. PMID: 38391603; PMCID: PMC10886105.
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