Monday, February 26, 2018

Innovations in Sports Science - Assessment

In the world of sports science, there is a lot that is being done with technologies to assist us in getting more objective information about our athletes and what may put them at risk for injury.  Some of the biggest advances have been done in the area of wearable sensor technologies.  Many of these wearables use IMUs or inertial measurement units.  These IMUs can include accelerometers, gyrometers and magnetometers which provides us with a very sensitive measure of motion, rotation and acceleration data.

One of these technologies that we have discussed previously is the DorsaVi.  DorsaVi is an Australian based company that has developed a wearable sensor that can be used to quantify movement.  This is the one that we have talked about in previous posts that we are using in several of our studies with Division I athletics to assess those athletes at risk for lower extremity injury.  With the DorsaVi technology and the ViPerform AMI movement assessment (a part of the DorsaVi System), we are able to quantify movement in both 2D and 3D.  The DorsaVi sensor captures 3 dimensional movement at 200 frames per second via the IMUs.  In addition to the ability to quantify the magnitude of movement that occurs (varus/valgus), we are also able to quantify the SPEED at which this movement occurs.  For example, we know that if your knee moves into >10 degrees of valgus, this is bad and puts you at increased risk.  We also know if this happens in a single leg hop at >100 degrees per second, this is really bad.  Historically, we might be able to see the magnitude of motion and that this is occurring quickly, but now with technology like this, we can actually quantify this with a high degree of reliability.  This allows us to identify those at risk for injury and to see if our correctives or treatment we are doing is truly having an impact on these risk factors.  Being able to quantify this and more accurately track the impact of our interventions will allows us to dial in what we do and make it that much more effective and efficient.

Another amazing technology that uses wearable sensors is Protxx.  This is a new start up company out of California that has developed a
wearable IMU that can help in preventing concussions.  This IMU contains an accelerometer to detect the the speed of motion as well as forces that occur to the head during athletic activities.  This small IMU is worn behind the athlete's ear and can track these forces over time.  This can be worn under an helmet or without a helmet and track during an entire practice or game.  Research indicates there are certain thresholds that once reached or surpassed results in a concussion.  This IMU communicates to the athletic trainers or medical professional's Ipad or phone via an app and thereby provides them with real time data instantaneously.  This app will allow the medical professional to see at a glance where all the athletes are at any given point in a practice or game.  The idea being that the app will notify the medical professional if an athlete is getting close to this threshold and the appropriate call can be made.  This way the athlete can be pulled from the game or practice prior to receiving a concussion or experiencing a concussive event.

Another amazing technology out there is the Boditrack.  Boditrack is a
portable wireless force sensing mat that uses iOS application to provide users with force plate grade data via an Ipad or Iphone.  This technology provides the user the ability to get both 2D video data and force plate data simultaneously.  This allows us to quantify not only risk factors for athletes but also force data which has a direct impact on athletic performance.  Several ways we are using this is to quantify the force variance right to left in an athlete during a squatting motion.  During the squatting motion, if you were to take a plumb line from the pelvis to the sacrum, throughout the motion, the athletes hips should remain relatively equal distance from the plumb line.  If an athlete has a lateral shift (or as research calls it - a lateral displacement of the pelvis during the squatting motion) this results in more force being placed on one side versus the other, variance in lower extremity recruitment patterns and increased limb asymmetry.  This is not only bad for risk of injury but also athletic performance.  With this device, we can not only see that on video but also quantify that motion with force data directly from Boditrack.  Another application we are using this for is to measure limb symmetry in single limb squatting motion as well as single leg hop.  We know high ground reaction forces in single limb activities is associated with reduced force attenuation which puts an athlete at greater risk.  In addition, if there is an asymmetry from one side to the other in how those forces are absorbed then this has not only an impact on injury risk but also athletic performance. 

This is just a few of the amazing technologies out there to help us objectively assess our athletes.  With the advances in technology, I am confident there will be many more coming on the market soon.  One thing to keep in mind with all technologies is that use your clinical judgement.  These are being sold by technology people and most of the time they do not have a clinical background.  If they tell you it measures something or provides valid data, always question.  Use your clinical judgement and don't be star struck by the technology itself.  Stay tuned next week as we continue our discussion on innovations in exercise.

Dr. Nessler is a practicing physical therapist with over 20 years sports medicine clinical experience and a nationally recognized expert in the area of athletic movement assessment.  He is the founder | developer of the ViPerform AMI, the ACL Play It Safe Program, Run Safe Program and author of a college textbook on this subject.  Trent has performed >5000 athletic movement assessments in the US and abroad.  He serves as the National Director of Sports Medicine Innovation for Select Medical, is Vice Chairman of Medical Services for USA Obstacle Racing and movement consultant for numerous colleges and professional teams.  Trent is also a competitive athlete in Brazilian Jiu Jitsu. 

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