Monitoring of postural sway with a head-mounted wearable device: effects of gender, participant state, and concussion

Scott T Grafton,1 Andreas B Ralston,2 John D Ralston21Department of Psychological & Brain Sciences, UC Santa Barbara, Santa Barbara, CA 93106-9660, USA; 2Clinical Studies Department, Protxx Inc, Menlo Park, CA, 94025-4317, USAObjective: To assess the utility of a head-mounted wearable inerti...

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Autores principales:	Grafton ST, Ralston AB, Ralston JD
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	wearable sensor balance impairments postural sway concussion Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/2af2bae5aba44c9b883e8de44504aea6
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spelling	oai:doaj.org-article:2af2bae5aba44c9b883e8de44504aea62021-12-02T03:57:25ZMonitoring of postural sway with a head-mounted wearable device: effects of gender, participant state, and concussion1179-1470https://doaj.org/article/2af2bae5aba44c9b883e8de44504aea62019-05-01T00:00:00Zhttps://www.dovepress.com/monitoring-of-postural-sway-with-a-head-mounted-wearable-device-effect-peer-reviewed-article-MDERhttps://doaj.org/toc/1179-1470Scott T Grafton,1 Andreas B Ralston,2 John D Ralston21Department of Psychological & Brain Sciences, UC Santa Barbara, Santa Barbara, CA 93106-9660, USA; 2Clinical Studies Department, Protxx Inc, Menlo Park, CA, 94025-4317, USAObjective: To assess the utility of a head-mounted wearable inertial motion unit (IMU)-based sensor and 3 proposed measures of postural sway to detect outliers in athletic populations at risk of balance impairments.Methods: Descriptive statistics are used to define a normative reference range of postural sway (eyes open and eyes closed) in a cross-sectional sample of 347 college students using a wireless head-mounted IMU-based sensor. Three measures of postural sway were derived: linear sway power, eyes closed vs eyes open sway power ratio (Ec/Eo ratio), and weight-bearing asymmetry (L-R ratio), and confidence intervals for these measures were calculated. Questionnaires were used to identify potentially confounding state variables. A prospective study of postural sway changes in 47 professional, college, and high school athletes was then carried out in on-field settings to provide estimates of session-to-session variability and the influence of routine physical activity on sway measures. Finally, pre-post-injury changes in sway are measured for a participant who was diagnosed with a concussion.Results: Despite the heterogenous population and sampling environments, well-defined confidence intervals were established for all 3 sway measures. Men demonstrated significantly greater sway than women. Two state variables significantly increased sway: the use of nicotine and prescription medications. In the athletes, session-to-session variability and changes due to routine physical activity remained well within 95% confidence intervals defined by the cross-sectional sample for all 3 sway measures. The increase in sway power following a diagnosed concussion was more than an order of magnitude greater than the increases due to session-to-session variability, physical activity, or other participant state variables.Conclusion: The proposed postural sway measures and head-mounted wearable sensor demonstrate analytic utility for on-field detection of abnormal sway that could be potentially useful when making remove-from-activity and return-to-activity decisions for athletes at risk of impact-induced balance impairments.Keywords: wearable sensor, balance impairments, postural sway, concussionGrafton STRalston ABRalston JDDove Medical Pressarticlewearable sensorbalance impairmentspostural swayconcussionMedical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol Volume 12, Pp 151-164 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	wearable sensor balance impairments postural sway concussion Medical technology R855-855.5
spellingShingle	wearable sensor balance impairments postural sway concussion Medical technology R855-855.5 Grafton ST Ralston AB Ralston JD Monitoring of postural sway with a head-mounted wearable device: effects of gender, participant state, and concussion
description	Scott T Grafton,1 Andreas B Ralston,2 John D Ralston21Department of Psychological & Brain Sciences, UC Santa Barbara, Santa Barbara, CA 93106-9660, USA; 2Clinical Studies Department, Protxx Inc, Menlo Park, CA, 94025-4317, USAObjective: To assess the utility of a head-mounted wearable inertial motion unit (IMU)-based sensor and 3 proposed measures of postural sway to detect outliers in athletic populations at risk of balance impairments.Methods: Descriptive statistics are used to define a normative reference range of postural sway (eyes open and eyes closed) in a cross-sectional sample of 347 college students using a wireless head-mounted IMU-based sensor. Three measures of postural sway were derived: linear sway power, eyes closed vs eyes open sway power ratio (Ec/Eo ratio), and weight-bearing asymmetry (L-R ratio), and confidence intervals for these measures were calculated. Questionnaires were used to identify potentially confounding state variables. A prospective study of postural sway changes in 47 professional, college, and high school athletes was then carried out in on-field settings to provide estimates of session-to-session variability and the influence of routine physical activity on sway measures. Finally, pre-post-injury changes in sway are measured for a participant who was diagnosed with a concussion.Results: Despite the heterogenous population and sampling environments, well-defined confidence intervals were established for all 3 sway measures. Men demonstrated significantly greater sway than women. Two state variables significantly increased sway: the use of nicotine and prescription medications. In the athletes, session-to-session variability and changes due to routine physical activity remained well within 95% confidence intervals defined by the cross-sectional sample for all 3 sway measures. The increase in sway power following a diagnosed concussion was more than an order of magnitude greater than the increases due to session-to-session variability, physical activity, or other participant state variables.Conclusion: The proposed postural sway measures and head-mounted wearable sensor demonstrate analytic utility for on-field detection of abnormal sway that could be potentially useful when making remove-from-activity and return-to-activity decisions for athletes at risk of impact-induced balance impairments.Keywords: wearable sensor, balance impairments, postural sway, concussion
format	article
author	Grafton ST Ralston AB Ralston JD
author_facet	Grafton ST Ralston AB Ralston JD
author_sort	Grafton ST
title	Monitoring of postural sway with a head-mounted wearable device: effects of gender, participant state, and concussion
title_short	Monitoring of postural sway with a head-mounted wearable device: effects of gender, participant state, and concussion
title_full	Monitoring of postural sway with a head-mounted wearable device: effects of gender, participant state, and concussion
title_fullStr	Monitoring of postural sway with a head-mounted wearable device: effects of gender, participant state, and concussion
title_full_unstemmed	Monitoring of postural sway with a head-mounted wearable device: effects of gender, participant state, and concussion
title_sort	monitoring of postural sway with a head-mounted wearable device: effects of gender, participant state, and concussion
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/2af2bae5aba44c9b883e8de44504aea6
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Monitoring of postural sway with a head-mounted wearable device: effects of gender, participant state, and concussion

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