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Cleveland Clinic Neurological Institute Year in Review 9
Cleveland Clinic Concussion Center:
A Multidisciplinary Team Tackles a
Massive Clinical Problem
Rapidly identifying concussion in athletes and expediting clinical intervention are crucial for optimizing safety
and timeliness of return to play. Conversely, objective analysis made quickly and accurately at the time of injury
can keep a player benched — and prevent a sometimes-fatal second impact. To that end, Cleveland Clinic is
developing better, faster, more accurate tools for diagnosing, preventing and managing concussions.
Gaming Technology with Diagnostic and
Management Potential
The gyroscope and accelerometers that make the
iPad ® 2 by Apple ® such an agile video gaming instru-
ment also make it an excellent tool for analyzing the
multi-dimensional symptoms, both motor and cogni-
tive, of concussion at the time of injury and during
the return-to-play decision-making phase.
Research led by Jay Alberts, PhD, is being conducted
on Cleveland-area high school and college athletes
using an iPad2 that is attached to the body, and a
proprietary app that collects position and time series
data along with linear and angular acceleration data
as clinical tests are performed. The data are then
analyzed to objectively quantify specific changes in
cognitive and motor functioning and any declines
in balance and postural (in)stability. This technology
represents a fundamental change in the level of
objectivity and the comprehensive nature of assessing
athletes following concussions, and has potential to
become an affordable, point-of-care tool for schools
and sports organizations to use in the baseline testing
and post-injury management of concussion.
Better Helmets, Better Protection
Football helmet testing has shown that in certain
instances, pre-World War II-era leather helmets
performed on par or better than some helmets cur-
rently used in high school, college and professional
football. Similar studies demonstrate that padding
did not always appreciably reduce risk of head and
neck trauma. Through a $100,000 grant from the
National Football League Charities, Cleveland Clinic
Concussion Center researchers are studying the role
of the neck in mitigating head trauma, and its role in
concussion in young athletes. Tests are also being
conducted to benchmark protective headgear. To this
end, Adam Bartsch, PhD, and colleagues have devel-
oped the Cleveland Clinic Intelligent Mouthguard.
Left Jay Alberts, PhD, activates a balance app on the iPad2. The iPad2’s built-in gyroscope and accelerometer allow the
device to measure position and movement of the athlete, which is then translated by the app to provide an objective measure
of postural stability.