On the right side of history with concussion trial

By Published On: 25/02/2023
AssocProf James McLoughlin tests an Adelaide footballer's balance on the Multimetric Balance Mat
In June 2022 I received an email from Associate Professor James McLoughlin at Flinders University in Adelaide saying: “We are interested in the Balance Mat to trial for some research.”

At that early stage of development Balance Mat Pty Ltd was still on the lookout for innovation partners who could help us develop the system’s control interface. The idea was that over several months the partner would give feedback on how the system looked and functioned and recommend any necessary improvements so that our technical guys – Binod Shrestha and Abishek Shrestha (incidentally both from Nepal and no relation to each other) – could make design enhancements based on real user needs.

So I sent Assoc Prof McLoughlin a mat on 29 June and once he received it he went ahead and downloaded the software. Three days later, on 7 July 2022, Covid-19 struck me down and I was taken to hospital by emergency ambulance. The doctors found that I had pulmonary embolisms (tiny blood clots riddled throughout my lungs) that were probably a complication of the chemotherapy I’d been having for blood cancer (non-Hodgkin’s lymphoma) over the previous two years. In all, I spent 33 days in Canberra Hospital, including four days in intensive care. The situation was diabolical. Without some sort of divine or medical intervention I was not expected to survive.

My invention saved my life!

Thankfully, intervention came in the form of an intravenous immunoglobulin transfusion – a novel treatment made of many people’s immune systems that required Human Research Ethics Committee (HREC) approval before it could be administered. Fortunately my haematologist Dr Maansi Joshi vouched for me, saying:

“Oh yes, this man’s developing a new medical device. We have to save him!”

Of course she meant the Balance Mat. Fortunately the immunoglobulin transfusion worked. After three days I started to feel like myself again. And fortunately I’m alive and able to tell this tale! It wasn’t until I’d gone through several months of recovery that I managed to get in touch with James again.

The upshot of our telephone conversation was that he was finding the Balance Mat very useful in general but he needed it adjusted to accommodate the Balance Error Scoring System (BESS) that is often used to test athletes with concussion or mild traumatic brain injury. He wanted this modification so that he could take baseline balance measurements of athletes in a major concussion program that he was in the process of establishing. This was very exciting news to me. I have always loved the development part of R&D (research & development).

Back on the R&D road

Binod, Abishek and I became very busy revamping the Neurometric Balance Mat to add the BESS feet-together stance. I was happy to do so because James’ request accorded with feedback from vestibular physiotherapists like Pam Reynolds from On-Balance Physiotherapy who also wanted the system to enable the same tests.

The BESS was developed by the University of North Carolina’s Sports Medicine Research Laboratory as an outcome measure of postural stability. It comprises three basic tests: double-leg stance with the feet together, single-leg stance, and tandem stance, all with the person’s eyes closed.

Previously our Neurometric Balance Mat had enabled a total of eight balance tests: four with the eyes closed and four with the eyes open in the normal (feet shoulder width apart), tandem, left foot and right foot stances. After the revamp it now has 10: the original four testing stances plus the double-leg (feet together) stance, all with eyes open and eyes closed.

The Neurometric Balance Mat is being used together with a virtual reality concussion testing study with footballers in Adelaide

Given my precarious health and the “long Covid” symptoms I was experiencing, it is a miracle that we managed to deliver the revamped Neurometric Balance Mat to Advanced Neuro Rehab (ANR) in Adelaide a tall. But we did, on 19 December 2022, just in time for their first set of balance tests to be conducted.

In his role as a neurological physiotherapist and Director of ANR, Dr James McLoughlin and ANR Principal Lead Physiotherapist Liz Jemson-Ledger are managing an ambitious concussion study program. The aim of the program is to rapidly build a baseline set of data that will eventually include all people playing sport in South Australia, including professional sportspeople and junior athletes. By 2024 there are plans to take the program national.

James and Liz are using the Neurometric Balance Mat to provide a baseline measurement of athletes’ postural sway, enabling the impact of concussions to be monitored over time. Our system is being used in conjunction with a combination of virtual reality headsets from Canadian firm Neuroflex that track eye movements plus concussion questionnaires.

So far, balance testing has been done with 93 athletes from North Adelaide Football Club. (Thank you to University of Canberra’s Dr Maryam Ghahramani for taking the photos of James setting up to test the athletes’ balance.)

The following chart shows Balance Mat results for athletes tested in the tandem stance. You will see that the scores are ranked in the order of lowest to highest.

Balance testing graph shows baseline scores for athletes in Adelaide

The lowest score of 2.3 shows a relatively low degree of postural sway signifying excellent balance. The highest score of 30.3 shows a relatively high degree of postural sway and that correlates to poor balance.

Just as the novel medical intervention in the form of my immunoglobulin transfusion undoubtedly saved my life, I am confident that the combination of these virtual reality and balance measurement technologies in this far-reaching project will stop players going back onto the field too soon and reduce the lifelong impacts and possibly deaths that could occur as a result of concussion.

Surviving the “valley of death”

Having survived blood cancer, Covid-19, pulmonary embolisms and the so-called technological “valley of death” that most inventors go through, complete with close to seven years of sustained struggle along the road to commercialisation, I can already see that this is a pivotal point for the Balance Mat technology. And for myself too.

With my health steadily improving, I can finally start looking through the windscreen instead of constantly checking in the rear-view mirror. And I can see that there are more exciting opportunities ahead.

It is abundantly clear that this concussion study managed by James and Liz at Advanced Neuro Rehab is happening at the forefront of neurological physiotherapy. It is an honour to support this important frontier-of-science project.

I truly do feel we are on the right side of history!

On the right side of history with concussion trial

By Published On: 25/02/2023Comments Off on On the right side of history with concussion trial
AssocProf James McLoughlin tests an Adelaide footballer's balance on the Multimetric Balance Mat
In June 2022 I received an email from Associate Professor James McLoughlin at Flinders University in Adelaide saying: “We are interested in the Balance Mat to trial for some research.”

At that early stage of development Balance Mat Pty Ltd was still on the lookout for innovation partners who could help us develop the system’s control interface. The idea was that over several months the partner would give feedback on how the system looked and functioned and recommend any necessary improvements so that our technical guys – Binod Shrestha and Abishek Shrestha (incidentally both from Nepal and no relation to each other) – could make design enhancements based on real user needs.

So I sent Assoc Prof McLoughlin a mat on 29 June and once he received it he went ahead and downloaded the software. Three days later, on 7 July 2022, Covid-19 struck me down and I was taken to hospital by emergency ambulance. The doctors found that I had pulmonary embolisms (tiny blood clots riddled throughout my lungs) that were probably a complication of the chemotherapy I’d been having for blood cancer (non-Hodgkin’s lymphoma) over the previous two years. In all, I spent 33 days in Canberra Hospital, including four days in intensive care. The situation was diabolical. Without some sort of divine or medical intervention I was not expected to survive.

My invention saved my life!

Thankfully, intervention came in the form of an intravenous immunoglobulin transfusion – a novel treatment made of many people’s immune systems that required Human Research Ethics Committee (HREC) approval before it could be administered. Fortunately my haematologist Dr Maansi Joshi vouched for me, saying:

“Oh yes, this man’s developing a new medical device. We have to save him!”

Of course she meant the Balance Mat. Fortunately the immunoglobulin transfusion worked. After three days I started to feel like myself again. And fortunately I’m alive and able to tell this tale! It wasn’t until I’d gone through several months of recovery that I managed to get in touch with James again.

The upshot of our telephone conversation was that he was finding the Balance Mat very useful in general but he needed it adjusted to accommodate the Balance Error Scoring System (BESS) that is often used to test athletes with concussion or mild traumatic brain injury. He wanted this modification so that he could take baseline balance measurements of athletes in a major concussion program that he was in the process of establishing. This was very exciting news to me. I have always loved the development part of R&D (research & development).

Back on the R&D road

Binod, Abishek and I became very busy revamping the Neurometric Balance Mat to add the BESS feet-together stance. I was happy to do so because James’ request accorded with feedback from vestibular physiotherapists like Pam Reynolds from On-Balance Physiotherapy who also wanted the system to enable the same tests.

The BESS was developed by the University of North Carolina’s Sports Medicine Research Laboratory as an outcome measure of postural stability. It comprises three basic tests: double-leg stance with the feet together, single-leg stance, and tandem stance, all with the person’s eyes closed.

Previously our Neurometric Balance Mat had enabled a total of eight balance tests: four with the eyes closed and four with the eyes open in the normal (feet shoulder width apart), tandem, left foot and right foot stances. After the revamp it now has 10: the original four testing stances plus the double-leg (feet together) stance, all with eyes open and eyes closed.

The Neurometric Balance Mat is being used together with a virtual reality concussion testing study with footballers in Adelaide

Given my precarious health and the “long Covid” symptoms I was experiencing, it is a miracle that we managed to deliver the revamped Neurometric Balance Mat to Advanced Neuro Rehab (ANR) in Adelaide a tall. But we did, on 19 December 2022, just in time for their first set of balance tests to be conducted.

In his role as a neurological physiotherapist and Director of ANR, Dr James McLoughlin and ANR Principal Lead Physiotherapist Liz Jemson-Ledger are managing an ambitious concussion study program. The aim of the program is to rapidly build a baseline set of data that will eventually include all people playing sport in South Australia, including professional sportspeople and junior athletes. By 2024 there are plans to take the program national.

James and Liz are using the Neurometric Balance Mat to provide a baseline measurement of athletes’ postural sway, enabling the impact of concussions to be monitored over time. Our system is being used in conjunction with a combination of virtual reality headsets from Canadian firm Neuroflex that track eye movements plus concussion questionnaires.

So far, balance testing has been done with 93 athletes from North Adelaide Football Club. (Thank you to University of Canberra’s Dr Maryam Ghahramani for taking the photos of James setting up to test the athletes’ balance.)

The following chart shows Balance Mat results for athletes tested in the tandem stance. You will see that the scores are ranked in the order of lowest to highest.

Balance testing graph shows baseline scores for athletes in Adelaide

The lowest score of 2.3 shows a relatively low degree of postural sway signifying excellent balance. The highest score of 30.3 shows a relatively high degree of postural sway and that correlates to poor balance.

Just as the novel medical intervention in the form of my immunoglobulin transfusion undoubtedly saved my life, I am confident that the combination of these virtual reality and balance measurement technologies in this far-reaching project will stop players going back onto the field too soon and reduce the lifelong impacts and possibly deaths that could occur as a result of concussion.

Surviving the “valley of death”

Having survived blood cancer, Covid-19, pulmonary embolisms and the so-called technological “valley of death” that most inventors go through, complete with close to seven years of sustained struggle along the road to commercialisation, I can already see that this is a pivotal point for the Balance Mat technology. And for myself too.

With my health steadily improving, I can finally start looking through the windscreen instead of constantly checking in the rear-view mirror. And I can see that there are more exciting opportunities ahead.

It is abundantly clear that this concussion study managed by James and Liz at Advanced Neuro Rehab is happening at the forefront of neurological physiotherapy. It is an honour to support this important frontier-of-science project.

I truly do feel we are on the right side of history!

  • The Neurometric Balance Mat is measuring the balance ability of elderly Singaporeans at the Singapore Eye Research Institute (SERI). Pictured is Mr Leow Zhun Hong (study senior clinical research coordinator).

Research into balance and sensory health

08/03/2024|0 Comments

A team of leading ophthalmology researchers who have been using the Neurometric Balance Mat in Singapore for the past nine months have provided me with this brief research update. Known as the PopulatION HEalth and Age-Related ...