SCIENCE
Globally Recognized by Governing Bodies:
FDA
FDA 510k Clearance in the US
CE Marking in the European Union
Medical Device status in Canada and Oceania
Medical advisory board
As a critical first step in the realization of EQ, the founders began to engage academic leaders in the neurosciences and clinical medicine. These thought leaders represented a range of clinical expertise as well as a global representation with major University affiliations in the United States, Canada, European Union, and Australia. Our Medical Advisors are active clinicians, researchers and speakers, each with an internationally established credibility.
Dr. Christopher C. Giza
Professor, Departments of Pediatrics and Neurosurgery
UCLA
Dr. Grant L. Iverson
Professor, Department of Physical Medicine and Rehabilitation
Harvard Medical School
Dr. Karen Barlow
Chair of Paediatric Rehabilitation and Associate Professor
University of Queensland Child Health Research Centre, Faculty of Medicine
Dr. Frederick Carrick
Senior Research Fellow
Cambridge University, UK
Dr. Mihaly Kis
Neurosurgeon
Trilium Health Partners
METHODOLOGY
EQ initially evolved as a series of concepts in the minds of the founders in response to what they saw as challenges within the current status quo of functional neurologic assessment.
During the last decade, the scientific understanding of human brain function shifted dramatically from a perceived static functioning organ to one that was, in fact, dynamic and capable of daily change. However, the assessment of brain function remained ‘dated’. The assessment of neurologic function continued to focus on “snapshot” assessments. This lack of development in assessment failed to match the rapid evolution in the understanding of function.
EQ sought to address this gap and to do so capitalizing on another evolving trend; the prevalence of mobile medical technology and game culture. EQ was developed as a means of measuring neurological function in a manner that is clinically relevant, scientifically accurate and technologically contemporary. The data that EQ captures and presents provides a clinical perspective of the user that is a ‘movie’; a movie of the function of the mercurial organ that is the human brain.
The founders identified challenge and opportunity, and it is this opportunity that is the heart of true innovation.
Balance
The EQ Balance test evaluates the vestibular (inner ear) and proprioceptive (ankle, knee, hip) system and the circuits connecting these areas. The balance system is affected in a variety of medical conditions and is of critical concern in sport, work, and of course aging.
EQ utilizes the internal accelerometer in mobile devices (phone/tablet) to measure the subject’s movement of the center of mass (COM) while performing stances in three different positions with the eyes closed.
Visual
Functional visual assessment evaluates large aspects of the geography of the brain with some aspects located in the frontal, parietal and brainstem movement centers. These systems represent 50% of the brain’s pathways and are frequently affected by a variety of conditions that are of critical concern in traumatic brain injury, sport performance and visually demanding occupations. In addition, since the visual system is present in so much of the brain’s geography, it is sensitive to deteriorations in overall processing speed as is seen in many age-related neurologic conditions.
The EQ visual test, utilizing a phone/tablet, is a timed, rapid tactile indication of arrow direction designed to capture eye movements in saccades as well as vergence and other aspects of vision and visual information processing.
Cognitive
EQ evaluates elements of executive function, letter and number recognition, mental flexibility, and reaction time utilizing variations of established clinical assessments.
EQ cognitive testing provides scoring in each of the above cognitive metrics utilizing just the mobile device.
our games
Typical symptoms that are reported following concussion include headache, dizziness, visual difficulties, nausea, difficulty concentrating, difficulty with memory, neck pain and feeling like in a fog. These symptoms may be caused by a variety of different sources, thus a multifaceted assessment to evaluate numerous different systems is recommended. EQ contains seven tests that measure key brain health metrics relevant to concussion.
Balance Error Scoring System (BESS Poses)
Clinical trajectory: Balance
Neurological function: Vestibular & proprioception
Game name: Tire Toss
This test measures vestibular and proprioceptive function (balance and reflexes). These functions are often affected when someone suffers a concussion, and can also be affected by nausea, headache, orthopedic injury, ear infection, medications, dehydration and lack of sleep. Dizziness and postural instability have been reported in 40% to 50% of children after concussion and acute dizziness and imbalance have been correlated with a prolonged concussive recovery in young athletes.
The balance score is measured as the cumulative movement of the player’s center-of-mass during each test, then averaged across the five tests for the final performance score (out of 100).
Rapid Scanning
Clinical trajectory: Visual
Neurological function: Binocular Vision and Visual processing
Game name: Dance Off
This task requires rapid visual processing and eye movement control, as well as sensorimotor control and coordination. The visual system can be affected by headache, stress, anxiety and lack of sleep and is often affected when someone suffers a concussion.
Trailmaking
Clinical trajectory: Cognitive
Neurological function: Executive function
Game name: Pylon Pivot
This test measures multiple processes, often referred to collectively as ‘executive function’, including attention, visual scanning, sequencing and shifting, psychomotor speed, flexibility, planning, and maintaining two trains of thought. These functions are often affected by concussion and can also be impacted by headache, fatigue, stress, anxiety and lack of sleep. The cognitive function of athletes after concussion is now commonly used to determine suitability to return to play and to inform rehabilitation strategies.
Immediate Memory
Clinical trajectory: Cognitive
Neurological function: Verbal memory – immediate recognition
Game name: Recipe Recall
This test measures the ability to recognize the difference between previously-seen words vs. novel words, often referred to as ‘immediate memory discriminability’. This function is often affected when someone suffers a concussion, and can also be affected by headache, fatigue, stress, anxiety and lack of sleep.
Delayed Memory
Clinical trajectory: Cognitive
Neurological function: Verbal memory – delayed recognition
Game name: Recipe Recall with delay
This test measures delayed memory. These functions are often affected when someone suffers a concussion, and can also be affected by headache, fatigue, stress, anxiety and lack of sleep. A recent study has found that results of this test correlate highly with the Standardized Assessment of Concussion (manuscript under review).
Digits Backwards
Clinical trajectory: Cognitive
Neurological function: Working memory and attention
Game name: Jersey Reversey
This test measures attention and working memory. These functions are often affected when someone suffers a concussion, and can also be affected by headache, fatigue, stress, anxiety and lack of sleep.
Simple Reaction
Clinical trajectory: Cognitive
Neurological function: Reaction
Game name: Fastball
This test measures reaction time. These functions are often affected when someone suffers a concussion, and can also be affected by stress, anxiety and lack of sleep. Research has found that 75% of athletes have reduced reaction time within 48h of a concussion.
EQ DASHBOARD
The EQ Dashboard is a key component and represents an important merger of:
- The desire of our clinical and scientific advisors to accurately and objectively illustrate patient neurologic function
- The desire of the EQ team to ensure that our representation of individual neurological function is intuitive and readily understood across a broad representation of expertise
- The need for administrators to probe, in detail, the comprehensive data and trends that the testing has established
- The practical ability to manage groups of individuals, quickly, thoroughly, and securely
RESEARCH
Concussion Management
- Research completed (U of T) on EQ tests in Healthy population
- Research completed (U of T) on EQ balance in Healthy and Concussion populations
- Research Completed with EQ at University of Calgary in Healthy and Concussion populations
- Research underway at University of Calgary focused on the EQ Algorithm predictive diagnostics and ‘Return to Play’
- Research underway at University of Calgary focused on the EQ Algorithm predictive diagnostics and ‘Return to Play’ power of EQ in large cohort of high-level hockey athletes followed prospectively\\Research in process with the University of Waterloo on Machine Learning algorithms and Predictive Analytics
- Research planning underway with University of Queensland (Aus.) studying EQ as both diagnostic and Therapeutic in concussion population
Workplace Safety
- Research relationship established with one of Canada’s largest academic hospitals at the University of Toronto to evaluate the efficacy of EQ assessing impairment with cannabinoids and the impact on performance in driving, as well as in industrial applications utilizing Virtual Reality
Mental Health
- Pilot study discussion underway with one of one of Canada’s largest academic hospitals at the University of Toronto to evaluate the efficacy of EQ in remote management of PTSD and Mood Disorder patients from a therapeutic perspective as well as from the perspective of identifying progressive deterioration in cognitive function
Cannabis
- Research relationship established with one of Canada’s largest academic hospitals at the University of Toronto to evaluate the efficacy of EQ assessing functional impairment after medicinal cannabinoids in elders and efficacy of EQ facilitating safe dose titration of cannabinoids
Elder Care
- Research relationship established with one of Canada’s largest academic hospitals at the University of Toronto to evaluate the diagnostic and therapeutic efficacy of EQ in Elder care
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