Center for Injury Research and Prevention

Concussion Recovery App: Use of Ecologic Momentary Assessment to Track Symptoms

Ecologic Momentary Assessment to Accomplish Real-Time Capture of Symptom Progression and the Physical and Cognitive Activities of Patients Daily Following Concussion

Concussion Recovery App: Ecological Momentary Assessment

In this concussion recovery app study, researchers and clinicians tested the feasibility of using Ecologic Momentary Assessment (EMA) to help patients and clinicians assess cognitive and physical activity as well as concussion symptoms in real-time during recovery after pediatric concussion.

As a research method, EMA involves repeated sampling of subjects' current behaviors and experiences in real time, in subjects' natural environments. EMA aims to minimize recall bias, maximize ecological validity, and allow study of microprocesses that influence behavior in real-world contexts.

In the study of 34 patients who wore an accelerometer and carried an iPod Touch®, 82 percent of patients responded to 80 percent of iPod prompts to log activity and symptoms in real time. For this sample, the research team found that cognitive rest and higher physical activity were associated with lower symptom scores. 

As a research strategy, the research team found that EMA can capture objective measures of physical activity, reports of cognitive activity, and symptomatology in real time in pediatric patients. EMA could be used in future research to explore relationship between activity and symptoms over the course of recovery from pediatric concussion.

As a concussion recovery app, an EMA-driven mHealth technology holds the promise of helping clinicians monitor their patients’ recovery in real-time and adjust care plans accordingly, rather than waiting for follow-up visits and relying on remote patient and parent recall.

The research team included CHOP's Christina L. Master, MD, Michael L. Nance, MD, Eileen Houseknecht, RN, and Matthew Grady, MD as well as Penn co-authors Douglas Wiebe, PhD (a CIRP Senior Fellow), Nicole Otto, MD and Danielle Sandsmark, MD. 

Read the study abstract.

Read the press release.

Funding: Penn Medicine Translational Neuroscience Center