SDSU researchers battle concussions with new balance board technology


by Adriana Millar, Senior Staff Writer

A portable medical device developed at San Diego State has been found to be twice as effective at determining whether a person has a concussion compared to the previous standard.

The Balance Tracking System, or BTrackS, is a device that measures body sway. Developed in 2013 by assistant professor of exercise and nutritional science Daniel Goble, the force plate offers an objective measure of balance.

“Anything that goes wrong in the brain or in the muscles, generally you can pick up in your body sway with a force plate like this,” Goble said.

Typically, balance is either measured by expensive force plates, which can cost over $10,000, or a visual test called the Balance Error Scoring System. The BESS test requires athletes to stand in six different positions while an athletic trainer counts any errors made, such as hands coming off the hips or stepping out of place or opening their eyes. The problem with the BESS test is that it is subjective to what the trainer considers an error, Goble said.

“So the accuracy of the test is not good, but people use it because it’s free and easy,” Goble sad. “The better alternative is to use a force plate like BTrackS, but up until now it’s been too expensive to be widely used in athletic training.”

Goble was inspired to create the BTrackS plate to bridge the gap between inaccurate visual clinical balance tests and expensive force plates solutions, he said.

“We wanted to create something that was in between, which used force plate technology, but you could actually afford and get good good data from,” Goble said, “That’s really the future of medical device development now.”

The BTrackS device, which costs $800, offers an affordable and accurate way of measuring balance. For the past two years, Goble has been running tests in collaboration with SDSU Athletics and head trainer Tom Abdenour with more than 500 student-athletes from high-risk sports such as football, water polo, club rugby and lacrosse. The study tested athletes at baseline using BTrackS, and also gathered data from 26 concussions that occurred.

“We were able to show that our balance test is actually twice as effective as at determining whether a person has a concussion or not compared to the previous standard,” Goble said.

On Feb. 10, Goble was notified his paper would be published next month in the International Journal of Sport Physical Therapy.

“You’d never think it, but the NFL, who has unlimited money, uses that very simple visual test instead of a force plate, and so we’re showing that we’re twice as good as what the NFL is using for their balance testing,” Goble said

The BTrackS system is also used within five different labs at SDSU. Goble hopes to have several more papers published within the next year. Different areas of research including working with Huntington’s disease patients, Parkinson’s patients, stroke patients and patients with autism, as well as finding a fall risk solution for older adults.

Kinesiology junior Carly Graff is one of Goble’s undergraduate researchers working with stroke patients. Graff said her research goal was to see if BTrackS could be implemented in a clinical setting. Using the BTrackS system, she was able to find having a stroke does increase fall risk.

“I’ve always been very interested in how pathologies affect your motor movement, and so with this system I was able to take advantage of that and take that over to the (SDSU adaptive fitness clinic) and test these people with different pathologies and see how it impacts their balance,” she said.

Finding a fall risk solution is one of Goble’s biggest goals for the next year, particularly for older adults.

“If we could implement this as a screening tool for older adults, we could potentially save lives by letting them know their balance is bad, they have high fall risk potential, and then getting them into an intervention where we train their balance and help them avoid catastrophic falls,” he said.