Space & Innovation

Diagnosing Sports Concussions: There's an App for That

Diagnosing concussions from sports remains tricky, but a number of tech companies are trying to take the guesswork out of it. Continue reading →

A number of technology startups are devising creative new ways of detecting concussions in pro and amateur athletes, using apps, tablets and sensors to monitor the often debilitating brain injury.

Sports organizations increasingly are looking for better concussion detection methods, and a sense of urgency has grown with the release of the 2015 film "Concussion" starring Will Smith on the problem of chronic brain injury suffered by American football players.

Although some concussions may be unavoidable in contact sports, an important concern is getting a rapid diagnosis to keep an injured player off the field, to avoid potentially severe secondary impacts. Also key is followup, to determine when a player is ready to return.

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When players take a hit, "they will always say they are fine," said Adam Gross, chief executive of Bethesda, Maryland-based startup RightEye, which has developed a one-minute eye-tracking test that helps reveal the extent of trauma to the brain.

"This is a tool that could keep parents from sending their kids (with concussions) back on the field."

RightEye says its test - with a specially configured computer that monitors how quickly the eyes follow moving objects - can be useful for monitoring someone recovering from a concussion.

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Eye movement offers insight into brain health and brain trauma, and can also help detect other disorders such as dementia or Alzheimer's disease, according to the company.

The service, being marketed to sports teams and eye professionals, can be used to help improve performance of athletes and others such as military marksmen.

"This can be used in the locker room, but it is more valuable in helping people recover from a concussion," said RightEye president Barbara Barclay.

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Another system designed to be used on the sidelines in sports is the King-Devick test, a tablet-based system which can be easily administered after an impact.

Steve Devick, an optometrist who helped develop the test in the 1970s as a tool to diagnose learning disabilities and later helped adapt it to diagnose concussion, calls it a "proven" detection system which can be simply administered in less than two minutes.

Players ‘obviously concussed' Devick said many professional sports teams - including the National Football League, America's most popular sport - still use "seat of the pants" methods for concussion diagnosis such as asking questions or requiring a player to follow finger movements.

"All NFL games will have four or five doctors on the sidelines but you can still sometimes see a player go back on the field who is obviously concussed," he said.

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Such concerns were raised at last year's Super Bowl, when Patriots' star Julian Edelman returned to action even after he appeared disoriented.

The NFL, which has implemented a "concussion protocol" for suspected brain trauma, announced at the start of the season it would be evaluating new technologies including from the Illinois-based King-Devick group as part of player safety efforts.

The King-Devick test requires an athlete to read single-digit numbers displayed on cards or on a tablet to test "saccadic" eye movement - very fast, almost imperceptible movements from one eye to the other - which according to research can be used to diagnose concussion and other neurological disorders.

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Other systems are also being explored by tech startups.

Arizona-based startup Saccadous is developing a tablet-based system which, unlike those of RightEye and King-Devick, tracks involuntary "micro" eye movements.

"We measure 100 micro-movements to make a determination about what is going on in the brain," said Saccadous co-founder and chief executive Craig Cafarelli He added that using this system measuring involuntary "micro-saccades" is better than a cognitive test which can be gamed by athletes who want to return to action.

"Our goal would be to have a baseline of every player in a healthy state, so we know if we scan them again, we could compare it against the baseline," he said.

Collegiate solutions NCAA, the governing body for US collegiate sports, in January reached a settlement with athletes to provide $70 million for research in concussion testing.

A handful of universities have agreed to equip their American football players with helmet sensors that measure the speed, intensity and location of hits to the head as part of its concussion research. Some high school football programs also use helmet sensors.

Data collected will help improve detection and provide a foundation to improve helmet design and ratings, according to Stefan Duma, head of Virginia Tech University's department of biomedical engineering and mechanics, which is working on the research.

The University of California at Los Angeles meanwhile is using a grant from the NCAA and the Department of Defense to use "big data" to assess concussion injuries and recovery.

The goal "is to develop scientific, evidence-based tools that will enable doctors to more accurately gauge when it is safe for an athlete to return to play," UCLA neuroscientist Christopher Giza said in announcing the program last year.

An app for that New York University researchers meanwhile developed an app which works with Apple's HealthKit platform to measure signals on how a concussion patient is progressing.

By seeing daily variations in a person's stride, heart rate and ability to concentrate, "we are no longer bound by visits to the doctor's office," said Paul Testa, an NYU researcher on the project and emergency room physician.

"We have so many people who scribble down symptoms on small pieces of paper, and the app takes care of that."

Patients using the Apple Watch and iPhone can automatically provide data on progression by monitoring health signals such as gait and heart rhythms. The app is being used for NYU hospital patients as well as others around the US who download it.

Dennis Cardone, an NYU sports medicine physician who is part of the project, said the research could be applied to treatment for concussions.

"There is some evidence that possibly we've been wrong in putting athletes at complete rest after a concussion," he said.

"There are some studies which suggest they may do better with a low-level activity program. So we hope to learn more with this program."

Whether you love their dance moves or hate their outfits, cheerleaders are a staple at most top-level football games, and they'll surely make an appearance at Sunday's Super Bowl.

And while today's cheerleaders use far more hairspray and perform more acrobatics than their forebears, their pep and spirit evokes more than a century of cheerleading history.

PHOTO: Houston Texans cheerleaders perform during a game against the Tennessee Titans at Reliant Stadium on Jan. 1, 2012 in Houston, Texas.

Not long after Yale played Harvard in the nation's first official college football game in 1869, a group of male Princeton students formed a "pep club" to cheer at games in the 1880s, according to the International Cheer Union, the sport's governing organization.

Cheerleading was officially born at the University of Minnesota on November 2, 1898, when "yell leader" Johnny Campbell picked up a megaphone and led the crowd in a rousing rendition of an already popular school chant: "Rah, Rah, Rah! Ski-U-Mah! Hoo-Rah! Hoo-Rah! Varsity! Varsity! Minn-e-so-tah!"

Minnesota beat Northwestern that day.

Original caption for photo: Columbia University cheerleaders (left to right) Sullivan, Walker, Campbell and Winkoop, with their canine mascot Peter, at the Thanksgiving Day Game in New York, when Syracuse defeated Columbia, 9 to 6. Nov. 27, 1924.

After 25 years as a men's club, cheerleading first welcomed women at the University of Minnesota in 1923.

Still, men dominated sideline squads until the 1940s, when many male students left to fight in World War II. The gender balance never restored itself: Today, more than 90 percent of the world's cheerleaders are female.

At the college level, about 60 percent of cheerleaders are women. "Before Title IX in the 70s, cheerleading was a great athletic outlet for women and girls and a great self-esteem builder," said Sheila Noone, vice president of public relations for Varsity, an organization that produces cheerleading events and camps. "It takes a lot of guts to stand in front of 40,000 fans and tell them what to do."

Photo: A group of female cheerers ca. 1936

In the early days, cheerleading involved lots of yelling and jumping around. In the 1920s, tumbling and acrobatics entered the genre. By the 1970s, the sport had become more athletic, adopting sharper movements, music-enhanced routines, pyramids, and other entertaining tricks and stunts. The 80s saw the invention of All-Star cheerleading, in which unaffiliated teams began to compete against each other. People continue to debate whether cheerleading qualifies as a true sport, but ESPN has been broadcasting competitions for more than two decades and a new cheerleading-derived team sport called STUNT is vying to be considered as an NCAA Emerging Sport.

In 1948, a charismatic cheerleader named Lawrence "Herkie" Herkimer at Southern Methodist University in Texas, started the first cheerleading camp with about 50 participants.

Today, hundreds of thousands of cheerleaders attend officially sanctioned camps and clinics each summer, and millions of people participate in more than 100 countries. With the front leg straight and the back leg bent, the Herkie is still a popular cheerleading jump. And cheerleaders now appear at more than just football games. They also root for basketball, soccer, cricket, rugby and other sports.

Photo: Lawrence Herkimer

The list of cheerleading alumni is full of famous names, including newscasters Katie Couric and Diane Sawyer; entertainment professionals Aaron Spelling, Meryl Streep and Steve Martin; and presidents Ronald Reagan, Dwight D. Eisenhower, Franklin D. Roosevelt and George W. Bush.

Cheerleading has always required character and the ability to command respect, and cheerleaders often act as role models and leaders in their schools, said Karen Lawrence, senior vice president of the National Cheerleaders Association in Garland, Texas.

"If you are trying to lead, there need to be reasons why people are going to follow you, besides that you are standing up and yelling," Lawrence said. "Cheerleading helps develop character. There is an emphasis on the positives in life and how to be the best you can be."

Photo: George W. Bush, Andover Philips Academy Year Book in 1964.

Despite anecdotal evidence that cheering boosts morale for players, there is no scientific proof that the fanfare helps teams play better, and it may do just the opposite.

Several studies in the 1980s showed a home-field advantage for baseball and basketball teams -- until crunch time, said Arnold LeUnes, a sports psychologist at Texas A&M University in College Station. In the seventh and deciding games of the World Series or the NBA finals, teams made more errors and shot fewer successful free throws when playing at home. That research has been criticized but offers food for thought.

"The home team was at a disadvantage in the most critical games," LeUnes said, "probably due to the effects of anxiety brought about by performing in front of loud, adoring but sometimes critical friends and family."