Development of virtual-reality based concussion assessment prototype

Dr Michael Grey, University of East Anglia (UEA)

In the last decade few other sport injuries have attracted media attention to the same extent as has concussion. Concussion is classified as a mild traumatic brain injury, yet despite this nomenclature, the consequences of returning a concussed athlete or child back to the field of play can be serious. For example, repetitive concussion is now believed to accelerate the onset of neurodegenerative disorders such as dementia and Parkinson’s disease. Furthermore, if the athlete, suffers a second concussion whilst the brain is still recovering, the resulting damage can be catastrophic and is sometimes fatal, with children being particularly at risk. The vast majority of concussions resolve within a week and do not require significant resource to manage. In contrast, the personal and socioeconomic costs associated with repetitive concussion can be similar to that of moderate and severe brain injuries. However, this can be prevented by recognising concussion and removing the person from further exposure.

However, the pitch-side concussion assessment is difficult because we do not have adequate diagnostic tools to inform the return to play decision. There is a need to develop physiologic-based concussion assessments that can augment the traditional assessments, thus providing additional information to aid the return to play decision.

We have recently developed a new test using the Occulus Rift virtual reality headset coupled with a Nintendo Wii balance board. The virtual environment is manipulated whilst body sway responses are measured via the balance board. This test has received good media attention (showcased on BBC Inside-Out West, March 2017) and has attracted the attention of team doctors in both elite football and rugby. However, the current test not suitable for either pitch-side or in-clinic use due to its expense and complexity of use.

The primary objective of this project is to develop and test a prototype device that is inexpensive and portable, yet robust enough to be used as a pitch-side assessment. The system will use small chest mounted sensors somewhat like a heart rate monitor to measure body sway. The prototype will be programmed such that several tests can be performed at once, thus saving time for the assessment whilst adding valuable information to aid the diagnosis. We anticipate that the prototype to be developed in this project can be further developed such that it will be applicable more widely in the assessment of acquired brain injury. For example, we believe this device could be quickly developed to aid the assessment of balance in stroke survivors.