Reliability and Minimal Detectable Change for a Smartphone-Based Motor-Cognitive Assessment: Implications for Concussion Management

in Journal of Applied Biomechanics
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  • 1 Children’s Hospital Colorado
  • | 2 University of Colorado School of Medicine
  • | 3 University of Georgia
  • | 4 Control One LLC
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Our purpose was to investigate the reliability and minimal detectable change characteristics of a smartphone-based assessment of single- and dual-task gait and cognitive performance. Uninjured adolescent athletes (n = 17; mean age = 16.6, SD = 1.3 y; 47% female) completed assessments initially and again 4 weeks later. The authors collected data via an automated smartphone-based application while participants completed a series of tasks under (1) single-task cognitive, (2) single-task gait, and (3) dual-task cognitive-gait conditions. The cognitive task was a series of continuous auditory Stroop cues. Average gait speed was consistent between testing sessions in single-task (0.98, SD = 0.21 vs 0.96, SD = 0.19 m/s; P = .60; r = .89) and dual-task (0.92, SD = 0.22 vs 0.89, SD = 0.22 m/s; P = .37; r = .88) conditions. Response accuracy was moderately consistent between assessments in single-task standing (82.3% accurate, SD = 17.9% vs 84.6% accurate, SD = 20.1%; P = .64; r = .52) and dual-task gait (89.4% accurate, SD = 15.9% vs 85.8% accurate, SD = 20.2%; P = .23; r = .81) conditions. Our results indicate automated motor-cognitive dual-task outcomes obtained within a smartphone-based assessment are consistent across a 1-month period. Further research is required to understand how this assessment performs in the setting of sport-related concussion. Given the relative reliability of values obtained, a smartphone-based evaluation may be considered for use to evaluate changes across time among adolescents, postconcussion.

Howell, Seehusen, Wingerson, and Wilson are with the Sports Medicine Center, Children’s Hospital Colorado, Aurora, CO, USA. Howell and Wilson are also with the Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA. Wilson is also with the Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA. Lynall is with the UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, GA, USA. Lugade is with Control One LLC, Atlanta, GA, USA.

Howell (David.Howell@CUAnschutz.edu) is corresponding author.
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