Assessment Tools & Research

Oct 27, 2025

Abstract:

Psychologists are increasingly called upon to make complex decisions affected by an individuals’ effort, relying at least in part on performance validity testing. Because most measures of performance validity are cognitively-based, there is utility in exploring alternative assessment modalities. Recently, an accelerometer-based gait assessment has been validated for use with sports concussion outcomes. The current, preregistered study serves as an experimental proof of concept utilizing the same measure of gait to differentiate individuals instructed to simulate a mild Traumatic Brain Injury (mTBI) from those with a sports-related mTBI (concussion).

Key Findings:

1. mTBI is one of the most commonly malingered medical conditions
2. Current measures of malingering are almost exclusively cognitive in nature.
3. Using a simulator sample of 75 naive and coached malingerers were shown to have a different gait pattern relative to 102 healthy controls and 75 of those with mTBI
4. BKG variables in all four conceptual domains of power, balance, stride and symmetry were able to provide discriminatory power.
5. BKG also correlated modestly with another measure of effort (TOMM-2), suggesting that the BKG can provide unique information relative to cognitive measures of effort.
6. Overall, the findings suggest the utility in the BKG informing decisions about effortful responding and malingering in cases of suspected mTBI.

May 14, 2024

Abstract:

May 04, 2023

Abstract:

A growing consensus among concussion experts is that a formal gait assessment is an essential component in return-to-play decisions. Concussion research illustrates that gait variables follow a pattern of recovery that may be more protracted than cognitive recovery, suggesting that gait dynamics may be more sensitive to the sequelae of concussion, and accelerometer data may enhance that sensitivity. However, pediatric neuropsychologists have few available options for quantitatively assessing gait. We here introduce a novel gait technology, the BioKinetoGraph (BKG), that provides multiple metrics for assessing gait, including within the domains of power, stride, balance (stability), and symmetry. We demonstrate how BKG data can be collected using a mobile application called SportGait, which is available for use on any smartphone. We present data illustrating the test–retest reliability of the mobile BKG in a sample of 4150 ostensibly healthy individuals, with an overall mean correlation coefficient of .79 between two walks across 16 assessed domains. We also provide qualitative and quantitative data to illustrate recovery, including a presentation of norm- and self-referenced comparisons. Additional recovery data is presented using qualitative information in the form of stabilogram and displacement graphs. Because the BKG is broadly available, reliable, valid, and does not require extensive or costly equipment (i.e., only requiring a mobile device and the App), it represents a significant advancement in quantifying gait in a wide range of settings.

Key Findings:

1. Establishes test-retest reliability for BKG Mobile data in a sample of over 4,000 subjects with mean r-value of .79 across the four domains of power, stride, balance and symmetry.
2. Establishes norms for the BKG Mobile
3. Introduces a clinical analysis of recovery using quantitative data from the 4 domains.
4. Introduces a clinical analysis of qualitative data in the form of stabilogram and displacement graphs.

Feb 20, 2023

Abstract:

Gait accelerometer (sensor) technology has proven effective in predicting several medical outcomes, but less is known about its ability to predict concussion symptoms relative to conventional measures of gait and balance. To establish the reliability and validity of gait accelerometer data. We first examine test-retest reliability and the impact of footwear and walking surfaces on gait. We then examine the convergent validity between gait accelerometer data and the NIH 4-meter gait test. Finally, we examine the predictive validity of gait accelerometer data to gait speed and balance measures for predicting concussion symptoms.

Jan 6, 2023

Abstract:

The quantitative assessment of the sequelae of concussion is of increasing importance given the prevalence of concussions, also referred to as mild traumatic brain injuries (mTBIs), and our evolving understanding of the adverse consequences associated with their clinical mismanagement (e.g., Daneshvar et al., 2011). For example, when individuals return to activities such as sports when they have not fully recovered, their risk of subsequent concussive and orthopedic injury is markedly elevated (e.g., Jildeh, Mela, Young, Page, Nwachukwu, Westermann, & Okoroha, 2021; Nyberg, Mossberg, Lysholm, & Tegner, 2015). This highlights the need to properly assess concussions and their sequelae.

June 29, 2021

Abstract:

A recent Consensus Conference proposed subtyping concussive injuries into 5 categories. We propose adding a neuromotor subtype. Abnormal motion is a key feature of brain injury, as concussions can impact the neurological systems controlling gait. Neuromotor function can remain abnormal after symptom resolution and may be superior to self-report for tracking recovery. Neuromotor function can also define co-occurring orthopedic injuries and reveal vulnerabilities which could reduce injury risk.

May 7, 2021

Abstract:

This validation study examines the effectiveness of a shortened form of the Continuous Performance Test 3rd Edition as a screening tool for predicting post-concussion symptoms across different age groups.

Apr 14, 2021

Abstract:

This research examines the limitations of single-assessment baseline concussion testing and addresses concerns about false-positive rates in concussion safety decision-making.

Nov 29, 2019

Abstract:

This comprehensive guide explores the application of machine learning techniques in concussion research and clinical practice, providing clinicians with practical insights into modern analytical approaches.

Sep 25, 2019

Abstract:

Effective screening for concussion is increasingly important, and medical professionals seek a critical role in diagnostic and return-to-play decisions. However, few well-validated measures are available to assist in these decisions. This study aims to determine whether previously validated measures assessing neurocognitive and neurobehavioral abilities can predict Centers for Disease Control (CDC) concussion symptom endorsement in a sample of child or youth athletes.

June 1, 2018

Abstract:

Sports-related concussions are particularly dangerous injuries due to their complex nature and difficulties associated with diagnostic and return-to-play decisions. Some of the most commonly employed assessment tools have been shown to be unreliable, leading to misdiagnoses. Guidelines for selecting more effective concussion assessment instruments and the use of such tests in urgent care settings are here suggested as an optimal framework for improved care.