Man or machine? Robot proves effective in diagnosing sports concussions

While most sports concussions are diagnosed through an individual’s experience or an onsite MRI or CT scan, a new technique is offering a tool that is much more accessible for players.

The so-called "doctor robot" is a remote-controlled unit that is placed on the sidelines of a football game. Behind the screen is a neurologist sitting hundreds of miles away from the field, able to evaluate athletes for concussion with the same accuracy as an onsite visit to the hospital.

The Peter O’Donell Jr. Brain Institute and Mayo Clinic partnered to conduct a study to ease the dilemma of players who experience head injuries and who are often too far away from physicians to quickly diagnose them. The study provided preliminary data to support a potential movement to utilize teleconcussion equipment at all school sporting events where neurologists or concussion experts are not on hand to diagnose a player.

“Having personnel on hand to quickly identify and remove concussed players from games is an important part of protecting against such long-term injuries,” said Bert Vargas, MD, an associate professor of neurology and neurotherapeutics at the UT Southwestern Medical Center, in a statement

"Worst-case scenario, you have nobody at the games who can identify or address potential concussion cases. You're putting the athlete in a position to have a more severe injury with prolonged symptoms and longer recovery time."

There has been previous research done on teleconcussion, focused on diagnosing severe traumatic brain injury in the military, but this study, published in Neurology, is the first to measure how accurately telemedicine using standard sideline concussion evaluation tools can help diagnose concussions at sporting events.

For two seasons, the mobile robot was stationed on the sideline and athletic training room of Northern Arizona University’s football games. The neurologist behind the screen would be able to watch the game and make evaluations of players who may have been concussed. The neurologist used diagnostic tools to measure cognition, balance and other various factors in 11 cases brought to the robot for review. These assessments were then compared with separate face-to-face diagnoses made by sideline medical personnel who were part of Northern Arizona team physicians and athletic trainers.

Findings were that the mobile robots controlled by doctors were able to diagnose sports concussions with the same accuracy as onsite physicians.

“The study demonstrates that teleconcussion technology can work, but it doesn't lessen the need to have trained personnel to help on the sidelines,” said Cherisse Kutyreff, Director of Sports Medicine at Northern Arizona, who helped make the on-field assessments during the study.

This robot only has a limited future in college athletics and professional sporting events because qualified doctors and athletic trainers are already accessible. Dr. Vargas’ main goal is to get teleconcussion into high school athletics where concussion professionals are not usually on hand.

"Removal from play decisions are of utmost importance in the setting of an acute concussion," said Dr. Starling, a neurologist and concussion expert. "This teleconcussion study demonstrates that a remote concussion neurologist accessible through telemedicine technology can guide sideline personnel to make those decisions in a meaningful and timely manner."