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Validation of the kinarm end-point robot for clinical assessment of acute sport concussion sensory, motor, and neurocognitive impairment in athletes
  1. Benson Brian W1,2,3,4,
  2. Cosh Madeline3,
  3. Mang Cameron S1,
  4. Stephen H. Scott5,
  5. Debert Chantel1,6,
  6. Dukelow Sean1,2,6
  1. 1Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
  2. 2Faculty of Kinesiology, University of, Calgary, Canada
  3. 3WinSport Medicine Clinic, Winter Sport Institute, Calgary, Canada
  4. 4Canadian Sport Institute Calgary, Calgary, Canada
  5. 5Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, Canada
  6. 6Hotchkiss Brain Institute, Calgary, Alberta, Canada


Objective To determine if there is a significant association between KINARM robotic sensorimotor and neurocognitive measurements at baseline, ≤10 days post-concussion (IPC), and when clinically asymptomatic (CA).

Design Double-blind, prospective case series.

Setting Four athletic seasons (2011–2015).

Participants 1,214 elite athletes (904 males, 310 females, mean age: 18 and 20 years, respectively).

Outcome measures Fifty-seven parameters from five robotic tasks (Visually Guided Reaching (VGR), Position Matching (PM), Object Hit, Object Hit and Avoid, Trail Making B (TMB)) characterising sensorimotor and neurocognitive function. Linear regression was used to determine if there was a significant association between baseline, IPC, and CA measurements, adjusting for potential predictors (age, sex, concussion history, recurrent concussion during study, number of baseline assessments, method (seated versus standing), Post-Concussion Symptom Scale Score (PCSS), days post-concussion at testing) and learning effect.

Main results 95 athletes sustained 102 concussions. There was a clear reduction in performance in concussed athletes on individual parameters compared to non-concussed repeat performance. Significant predictors of impairment were: 1) higher PCSS for VGR (IPC): Reaction Time (p<0.001), Min-Max Speed Difference (m/s) (p=0.001), Path Length Ratio (p=0.001), and TMB (CA): Test Time (p=0.003), Dwell Time (p=0.003); 2) older athletes for VGR (IPC): Speed Maxima Count (p<0.01); 3) less days post-concussion at IPC testing for PM Contraction/Expansion Ratio XY (p=0.005); and 4) recurrent concussion during study period for non-dominant PM Shift Y (p=0.005).

Conclusions Results of this large prospective study suggest the KINARM robot is a valid, objective tool for quantifying sensorimotor and neurocognitive impairment in concussed athletes.

Competing interests Brian W Benson In the future may receive a small royalty from BKIN Technologies Ltd. in consideration for assisting with development and validation of the KINARM end-point robotic device for use in acute sport concussion assessment and management.


Co-founder and CSO of BKIN Technologies that commercialises the KINARM robot.

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