Overview
A multi-disciplinary team of content experts have developed and implemented a state-of-the-art concussion protocol that standardizes clinical care methodology for the triage, assessment, and treatment of those patients presenting with a potential concussion, regardless of their point of origin.
Technology in the form of the Cleveland Clinic Concussion Application (C3 app) was developed and validated in-house and serves to enable the protocol by creating a standardized set of outcomes that guides clinical decision-making. A review of data from 2010-2016 revealed that utilization of the C3 app-enabled protocol has resulted in decreased encounter lengths, decreased cost, and improved resource utilization.
Clinical Research within the center focuses on (a) in-game biomechanical impacts, (b) sideline assessment, and (c) diagnostic data analysis from the clinical care continuum. Cleveland Clinic’s “Intelligent Mouthguard” incorporates advanced sensor technology to enable accurate monitoring of impact dosimetery of its user in real-time. This technology reliably and repeatedly provides information as to the experiences at the brain for each discrete impact to medical personnel nearby, allowing for immediate monitoring, diagnosis, and intervention. The C3 App is an Application developed on the iPad to objectively and quantitatively assess the major symptoms of concussion (memory, balance, motor function, vision, and information processing). The iPad, with its accelerometer and gyroscope technology, provides data that can be used to quantify balance on the sideline or in the locker room. We have also developed software capable of identifying specific aspects of cognitive or motor function that are affected by concussion. Assessing multiple symptoms associated with concussion is critical as each concussion is slightly different in terms of which functions are most affected. Providing a multi-symptom approach allows our clinical team to make better educated and more comprehensive return to play decisions and guides rehabilitation approaches if necessary.
Contact Information:
Jay L. Alberts
albertj@ccf.org
Funding Sources (if applicable):
NIH (Alberts Co-Inv) U01NS093334 Chronic Traumatic Encephalopathy: Detection, Diagnosis, Course and Risk Factors, $167,915, 12/15/2015-11/30/2022 The aim of this project is to evaluate the risk factors and develop a predictive model related to incidence of neurological disease in professional athletes and military personnel. The Concussion App developed by Dr. Alberts is one of the primary evaluation tools.
NIH (PI: Taksler PI: Alberts Co-Inv) R21AG052849-01A1 Individualizing Disease Prevention For Middle-aged Adults, $328,307, 09/01/17 – 03/31/2019
Department of Defense, (Alberts, PI) W81XWH-16-1-0052 06/01/2016-05/31/2019, The quantification of Visual Function and Postural Stability under Single- and Dual-task Conditions Using Mobile Technology. $1,499,989. The aim of this project is to develop mobile application software quantifying oculomotor and dual-task function to enhance the detection and management of concussive injuries and their sequelae in military members
US Department of Transportation, (Alberts, PI) No number Department of Transportation. Determining Loss of Consciousness in Fighters and Development of Associated Injury Assessment Reference Values. Total Cost: $687,112. 25% effort
NFL Players Association/The Trust (Alberts and Bernick, Co-PI) , Retired Athlete Brain Health and Restoration Program. Cleveland Clinic Main Campus; Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV; Cleveland Clinic Florida. $1.700.000 administrative budget + 100% reimbursement of all clinical services. 2-1-14 to 1-31-19 (annual contract)
NIH (Kirsch, PI; Alberts, Co-Inv) 5T32EB004314 (R. Kirsch, PI; Alberts Co-Inv) Integrated Engineering and Rehabilitation Training. $285,825. 7-1-09 to 6-30-14. 7-1-14 to 6-30-19 (Renewed)
Publications
Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion., Alberts JL, Modic MT, Udeh B, Dey T, Cherian K, Lu X, Figler R, Russman A , Linder SM. Jove (2018) [In-Press]
Normative Performance on the Balance Error Scoring System by Youth, High School, and Collegiate Athletes. Ozinga SJ, Linder SM, Koop MM, Dey T, Figler R, Russman AN, So R, Rosenthal AH, Cruickshank J, Alberts JL. Journal of Athletic Training. (2018) 53:7, PMCID: PMC6138268.
Cleveland Clinic-Postural Stability Index Norms for the Balance Error Scoring System. Linder SM, Ozinga SJ, Koop MM, Dey T, Figler R, Cruickshank J, Alberts JL. Medicine & Science in Sports & Exercise (2018) 50:1998–2006.
Quantification of the Balance Error Scoring System with Mobile Technology. Alberts JL, Thota A, Hirsch J, Ozinga S, Dey T, Schindler DD, Koop MM, Burke D, Linder SM. Medicine & Science in Sports & Exercise. (2015) 47:2233-40, PMCID: PMC4576723.
Using Accelerometer and Gyroscopic Measures to Quantify Postural Stability. Alberts JL, Hirsch JR, Koop MM, Schindler DD, Kana DE, Linder SM, Campbell S, Thota AK. Journal of Athletic Training. (2015) 50:578-88, PMCID: PMC4527441.
The utilization of biomechanics to understand and manage the acute and long-term effects of concussion. Alberts JL, Linder SM. Kinesiology review (Champaign, Ill.). 2015.
