This project focuses on a smartphone-based data acquisition system which has evolved from a multisensory laboratory research system. The project involves applying objective data collection and analytics to detect and quantify gait speed, postural stability, and dynamic stability using readily accessible smartphones for low cost evaluations. The approach provides both short and long term advantages over traditional methods by removing inter-observer variability and by allowing for a big data approach to improve assessments. Over time as data are collected through the STS database, better clinical decision making will be enabled through algorithm refinement. In addition to strengthening the risk assessment result, this approach has the ability to improve the availability of accurate point of care assessments by removing the need for specialist training and facilities. The long term objectives of this effort are to improve treatment outcomes and quality of life by replacing subjective data with objective, information-rich assessments. It is anticipated that long term cost of care will be reduced accordingly.
This study has the potential for both societal benefits and as technological advancements in gait and stability measures. The system can enable the health care community to implement widespread gait and stability evaluations as part of the clinical decision making process. Though currently used, these tests are typically restricted to populations with access to large gait laboratories. Increased access may lead to broader use from Cardiac assessment to rehabilitation, to prosthetics training and fitment, and others. The longer term broader impact is the applicability of centralized objective assessment data and long-term outcome for use in medical diagnoses and risk assessments. By providing access to large scale objective data, patterns in test data that have heretofore been impossible to see will become known and useful in better understanding the suitability of different options for clinical care. Furthermore, access to this data by the research community will open the door to large scale epidemiological studies associated with gait and stability characteristics. Specifically, dynamic stability measurements fundamentally extend the clinical horizons of clinical gait and balance assessment.
Concussions have recently accelerated into the forefront of medical importance with Center for Disease Control (CDC) estimating that 1.7 million people sustain a traumatic brain injury or concussion every year. The prevalence of concussions in sports, particularly football and other contact sports, is even greater. It is estimated that each year 40,000 in 1.1 million high school football players sustain football related concussions. Despite this high rate of occurrence, the full extent of concussion damage is still unknown and existing traditional biomechanical assessment of concussions is limited to subjective tools. Assessing concussion in players is an important goal for coaches and athletic trainers. Gait and postural stability parameters offer a promising tool in assessing traumatic brain injuries (TBIs) even in the absence of cognitive symptoms. As such, this project is focusing on concussion assessment in football players as a first target market for commercialization. This project – led by gait researchers from the Virginia Polytechnic Institute and State University and start-up experts in corporate research center and Industrial Biodynamics focused on developing as well as marketing of smartphone based measurement system for concussion assessment with total available market of $15.7 million and target market of $7.8 million. The project’s key intellectual merit was focused on addressing the fundamental scientific issues related to the development, use, and validation of a ubiquitous system for assessing concussion and dangers of return-to-play in athletes. These issues included the investigation of reliability in using smartphone with embedded sensors at locations such as upper arm in the pursuit of an objective, repeatable, tester independent method to quantify balance for concussion protocols. The resulting system – a smartphone app and associated algorithms were validated against forceplate (ground truth) for linear and nonlinear tools on more than 20 subjects. Statistical relationship was established between smartphone measured parameters and that derived using forceplate. The system was then deployed in concussion assessment in high school students and cadets at Virginia Tech for a 3-week pilot study. A similar system with functionality of assessing gait speed has also been deployed in Carilion Roanoke Memorial Hospital for prediction of post-operative outcomes in cardiovascular disease patients after a surgery. Broader impacts were focused on crossing the disciplinary divide between research with technology development and business, an essential endeavor for future entrepreneur education and development in United States. Educational modules with emphasis on technology development for problem solving and entrepreneurship were developed for undergraduate courses. Undergraduate semester-long research involved assessment of balance and fall risk in community dwelling elderly using smartphone. In addition project was an effective outreach mechanism for understanding true needs of customers which consisted of community dwelling elderly, rehabilitation clinics, cardiac clinics, athletic departments. In this project, hundreds of customer interviews were conducted to understand the value propositions, pains and gains of customers and several iterations were performed on the product to meet customer needs.
