REMOTE SMARTPHONE ASSESSMENT OF DUAL TASK WALKING, SELF-REPORTED HEAD TRAUMA AND HEALTH IN RETIRED NFL PLAYERS. (11th November 2018) - Manor, B
Abstract: Repeated exposure to head trauma in early life has been linked to brain pathology, along with physical, mental, and emotional distress in later life. Still, the longer-term effects of such head trauma on objective metrics of cognitive-motor function remain largely unknown. We thus created and validated a smartphone-based assessment of dual task walking—a clinically-meaningful test of cognitive-motor function—to enable study of large numbers of older adults who have been exposed to head trauma. As proof-of-concept, we recruited 49 retired NFL players aged 29–75 years from the Football Players Health Study at Harvard University. They completed a health history/status questionnaire, as well as the smartphone-based dual task walking assessment within their own home. Players who self-reported suffering >5 hits to their head and/or neck followed by concussion-like symptoms during their playing careers, compared to those reporting fewer such hits, exhibited greater stride time variability, particularly when dual tasking (ANCOVA group-by-walking condition interaction: F=7.6, p=0.004). This effect was independent of age, height and body mass. Those who walked with greater dual task stride time variability also reported worse physical and mental health measured by the PROMIS Physical Function Short Form (r2>0.30, p<0.02) and the Neuro-Quality of Life questionnaire (r2=0.25, p=0.02). These results highlight the feasibility of remote, smartphone-based gait assessments to track meaningful health outcomes in aging populations, and suggest that dual task stride time variability may be sensitive to the history and long-term consequences of brain damage due to repetitive head trauma.