This is the second half of a two-part article on digital tools for concussion testing based on the recommendations of Jose Posas, MD, a neurologist with the Concussion Management Program at Ochsner Health System in New Orleans.
In part one we covered where to start if you are old-school or moderately tech savvy. In this article we go beyond the basics.
The newest generation of digital concussion tools utilizes smart phones and tablets to collect data that is then stored and managed in the cloud. They offer the perfect marriage between portability and the power of computing. The mobile device apps are designed to be used only by medical professionals to collect patient data, which they then interpret, whether in the field or in the clinic. This is possible because today’s mobile devices integrate unprecedented computer processing with highly sensitive accelerometers that detect the slightest movement.
Clinicians can enter relevant data into the app, and the mobile device itself can directly measure things like balance, reaction time, and eye movements. Once the data is collected, it is safely stored in the cloud where it can be accessed and managed via computer—usually for a subscription fee.
In most cases, the mobile apps themselves are not designed to stand alone but are to be used in conjunction with a larger HIPAA-compliant data management system. In some cases you can’t find the apps on iTunes or other mobile app stores, and if you do, you need a subscription code to sign in. So, even though data is collected via a mobile app, these digital concussion tools are more accurately referred to as concussion management systems rather than simply as apps.
Sports concussion specialists like Posas utilize these kinds of systems to manage large numbers of players over time. Philanthropy, schools and sports leagues often foot the bill for them, but the price is not necessarily prohibitive for a private practitioner who might manage a smaller number of concussion patients. As Posas said about the tools in part one of this story, it is certainly worth looking into the price points if you want to expand that service for your patients or your community.
C3 Logix is a product of Neurologix Technologies. It was designed by the Director of the Cleveland Clinic Concussion Center kinesiologist Dr. Jay Alberts as a tool to manage concussions across disciplines. For this reason it is one of the most comprehensive of the digital concussion management systems. It can be used to assess patients in multiple domains including neurocognitive, neuromotor, balance, vestibular-ocular, and physical symptoms.
Data can be collected locally on a mobile device and later uploaded to the cloud in cases where there is no onsite internet service. To learn more about this system or to get the app you need to contact C3 Logix via their website.
Sway, made by Sway Medical, is the brainchild of neuroscientist Chase Curtiss. He developed this system as a less expensive and far more mobile alternative to the force plates traditionally used to measure balance in the clinic or lab. The mobile app is FDA-cleared to measure balance by having the patient hold the mobile device to their chest as they stand in different postures. With a patient standing on one leg, for example, the finely tuned accelerometer measures movement away from the center of gravity—in other words it measures “sway” (hence the name).
The app also uses the accelerometer to measure reaction time to color changes on the mobile screen. It too can store data locally for later upload to the cloud. To learn more or to gain access to the mobile app, contact Sway Medical via their website.
King-Devick Test in association with Mayo Clinic is the digital version of the long-used King-Devick or K-D Test for rapid number naming. The test itself goes back to the 1970s when it was traditionally used for evaluating eye movements during reading. But about a decade ago neurologists began using the test to look for neurological deficits following head trauma, starting with MMA fighters. Today it is used as a baseline and screening measure for anyone thought to have suffered from a concussion.
This system is used by schools and professional sports leagues as well as individual athletes to track their scores over time. For the private practitioner, more likely to see the patient in their office days or weeks following injury, the company recommends their companion app K-D Test Pro Monitoring on the iPad, or the King-Devick Eye Tracking System Software for more advanced oculometrics. Learn more on the King-Devick website.
Whichever one of these digital concussion tools you choose (from part one of this article or the ones mentioned above), Posas says to remember that they are just that—tools. As for himself, he says, “I’m sort of technology agnostic at the end of the day for my patients. Concussion is still a clinical diagnosis.” Think of these systems as any other clinical tool you might use. “It’s not the tool, it’s how you use it.”