ReCoUPS – Recovering Concussion Update on Progression of Symptoms.The primary objective of the ReCoUPS study cluster is to utilize an app-based survey tool to measure symptom progression and recovery status of an individual in the days and weeks following a concussion. As the appropriate amount of physical and cognitive activity and exertion after concussion injury is still unclear, ReCoUPS seeks to define this balance by utilizing Ecological Momentary Assessment, or real-time measurement, to collect information on patients’ symptoms and activities. An optional feature that is employ in some studies provide that information daily to the patients’ physician, who can then better guide the treatment process.
The ReCoUPS survey tool prompts participants at random times through the day, including questions on cognitive activity, physical activity, and the validated Post Concussion Symptom Scale. Cognitive activity is measured by school attendance and participation, text messages sent, homework and reading time, and screen time. Physical activity is measured by type and length of time of exercise participation.
ReCoUPS is currently active in 3 studies: 2 cohort studies and 1 randomized controlled trial. The RCT incorporates the Buffalo Concussion Treadmill Test, and recruits participants at The Children’s Hospital of Philadelphia, the University of Buffalo, and Boston University. Participants are assigned a daily amount of physical activity and tracked for any indication of either worsening or improvement of symptoms as a result of the activity. ReCoUPS sends a daily report to the lead physician on each study, who actively monitors their symptoms and adjusts the treadmill activity if warranted.
The 2 cohort studies are being conducted at The Children’s Hospital of Philadelphia. “ReCoUPS ED” is measuring the efficacy of incorporating a FitBit tracker into the ReCoUPS study design, following children ages 5-17 and adults ages 18-45 at the Presbyterian Hospital ED. This study is using an an incentive-based approach to determine the most effective technique to prevent study attrition in a longitudinal follow-up study of concussion patients.
“ReCoUPS Shipley” is enrolling concussed adolescent and teenage participants, as well as healthy control group adolescents and teenage participants, to investigate the efficacy of EMA and objective survey measures including diagnostic tools in concussion recovery, and evaluate the accuracy of the PCSS to measure physiology and mood in this population.
Contact us for more information or to use ReCoUPS for your team or your study.
Wiebe DJ, Nance ML, Houseknecht E, Grady MF, Otto N, Sandsmark DK, Master CL. Ecologic momentary assessment to accomplish real-time capture of symptom progression and the physical and cognitive activities of patients daily following concussion. JAMA Pediatrics 2016 Nov 1; 170(11)1108-1110.
Funded by the Penn Medicine Translational Neuroscience Center.