• Miller KoopMandyM0000-0003-3047-8091Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH 44195, USA., Anson B Rosenfeldt, Kelsey Owen, Eric Zimmerman, Joshua Johnston, Matthew C Streicher, Alec Albright, Amanda L Penko, and Jay L Alberts.
• Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH 44195, USA.
• Mil Med. 2023 Nov 8; 188 (Suppl 6): 9210192-101.

IntroductionAugmented reality systems, like the HoloLens 2 (HL2), have the potential to provide accurate assessments of mild traumatic brain injury (mTBI) symptoms in military personnel by simulating complex military scenarios while objectively measuring the user's movements with embedded motion sensors. The aim of this project was to determine if biomechanical measures of marching and squatting, derived from the HL2 motion sensors, were statistically equivalent, within 5%, to metrics derived from the gold-standard three-dimensional motion capture (MoCap) system.Materials And MethodsSixty-four adults (18-45 years; 34 males) completed a squatting and a marching task under single- (motor) and dual-task (motor + cognitive) conditions. Positional data from the HL2 and MoCap were simultaneously collected during the tasks and used to calculate and compare biomechanical outcomes. The HL2's augmented reality capabilities were utilized to deliver the cognitive component of the marching dual task.ResultsEquivalence testing indicated the HL2 and MoCap measures were within 5% in all squatting metrics-trial time, squat duration, squat velocity, squat depth, and dwell time. Marching metrics, including trial time, step count, stepping rate, and step interval, were also equivalent between the two systems. The mean reaction time for responses during the Stroop test was 810 (125) milliseconds per response.ConclusionsBiomechanical outcomes characterizing performance during two common military movements, squatting and marching, were equivalent between the HL2 and MoCap systems in healthy adults. Squatting and marching are two military-relevant tasks that require strength, motor coordination, and balance to perform, all of which are known to be affected by mTBI. Taken together, the data provide support for using the HL2 platform to deliver military-specific assessment scenarios and accurately measure performance during these activities. Utilizing objective and quantitative measures of motor function may enhance the management of military mTBI and reduce unnecessary risk to service members.© The Association of Military Surgeons of the United States 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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