Robots and telehealth are as effective as a trained medical professional or athletic trainer in diagnosing when a young athlete has suffered a concussion, says new medical research from the UT Southwestern Medical Center and Northern Arizona University and sponsored by the Mayo Clinic.

For the study, a mobile robot was stationed for two seasons on the sideline and athletic training room of Northern Arizona University’s football games. A neurologist could view the game from the robot’s camera and make evaluations of players who may have been concussed.

The findings show that mobile robots controlled by doctors and using telehealth can diagnose sports concussions with the same accuracy as on-site physicians, says Dr. Bert Vargas, the study’s lead author, who also directs the sports neuroscience and concussion program at the O’Donnell Brain Institute at UT Southwestern Medical Center. Telehealth lets a doctor use a web camera, an internet connection and access to electronic health records to hold video visits with patients and make a diagnosis.

Using diagnostic tools that measure cognition, balance and other factors, a remote neurologist made assessments in 11 cases brought to the robot for review. These assessments were later compared with separate face-to-face diagnoses made by sideline medical personnel consisting of Northern Arizona team physicians and athletic trainers. The results matched each time, says Northern Arizona director of sports medicine Cherisse Kutyreff.

“The study demonstrates that tele-concussion technology can work, but it doesn’t lessen the need to have trained personnel to help on the sidelines,” Kutyreff says.

Using robots equipped with web-enabled cameras can potentially help spot concussions in high school sports where not every team and event has a trainer or other medical profession on hand, Vargas says.

Up to 3.8 million recreational and athletic concussions occur in the U.S. each year, and children under age 15 account for the most traumatic brain injury visits to the emergency room, Vargas says.63% of public high schools do not employ a full-time athletic trainer who could spot potential concussions, and teams in rural areas are less likely than those in cities to have doctors and athletic trainers on site

Concussion awareness is a prominent topic in sports fueled by revelations that former NFL players suffered permanent damage to their brains due to repeated head impacts, Vargas says. Having personnel on hand to quickly identify and remove concussed players from games is an important part of protecting against such long-term injuries, Dr. Vargas said.

But across the country—and most notably in rural regions—many public high schools don’t have athletic trainers available to spot such incidents, increasing the chances that a concussion could go unnoticed and perhaps be exacerbated by additional injuries, Vargas says.

“Worst-case scenario, you have nobody at the games who can identify or address potential concussion cases,” Vargas says. The use of robots and telehealth can be especially beneficial in states such as Texas, which requires concussed high school players to get a physician’s approval before returning to action. In rural corners of the state, finding a doctor to do so often requires a lengthy trek, Vargas says. “This is a way of bringing physicians into these outlying areas,” he says. “One person could cover numerous schools. If you’re on-call virtually, you could be anywhere and available as soon as a consult is needed.”

While previous telehealth research has focused on diagnosing severe traumatic brain injury in the military, UT Southwestern Medical Center says its research is the first to measure how accurately telemedicine using standard sideline concussion evaluation tools can help diagnose injuries at sporting events.