At Dartmouth, Sidelines Robot Could Be Key To Quickly Diagnosing Football Concussions

Oct 10, 2014

Image of VGo telepresence robot courtesy VGo Communications in Nashua.
Credit VGo/NHPR Staff

Football faces increasing criticism as mounting evidence shows the dangers of concussions, in particular undiagnosed concussions.

A new telehealth initiative at Dartmouth College aims to eliminate those undiagnosed concussions by bringing neurosurgeons to the sidelines--via robot.

On the sidelines of the Dartmouth/Penn football game, neurosurgeon Robert Singer watches carefully.

"A lot of these hits are shoulder hits. What we’re looking for are direct head to head kind of contact, that type of thing."

Dartmouth, like many colleges, has coaches and trainers watching for concussions during games. Still, sometimes, the diagnosis is tricky. That’s where Dr. Singer comes in.

Neurosurgeon Robert Singer watches from the sidelines during a game between Dartmouth and Penn.
Credit Allison Quantz for NHPR

"We’re not the primary responder for any kind of head injury or anything like that," Singer said.

"We’re just there to show support and help if there’s any question over whether or not somebody should be disqualified after a head injury."

During the first game of the season, however, Singer was out of town. So, instead of going to the game, he communicated with sideline trainers through a robot called VGo.

"VGo is a robot which is designed to absorb your presence in a distance location. Think of it as Skype on wheels," said Ned Semonite, Vice President of products at the Nashua-based VGo communications.

"It’s about four feet tall, it’s white, it’s very friendly looking."

Unlike with a skype call, where someone has to pick up on the other end, VGo is operated entirely at a distance. One of the device's primary uses is in schools.

"Let’s say you have a student who’s being treated for cancer," Semonite explains, "they would attend school using the VGo. So the VGo’s in the school and they’re at home or in the hospital. They connect to the VGo through the internet. Their face appears on the VGo’s screen, they see what the VGo sees through its camera, and of course it has two way audio, as well."

VGo's VP of Products Ned Semonite appeared on NHPR's Word of Mouth in 2011 with an earlier iteration of the Nashua firm's telepresence robot.
Credit Rebecca Lavoie for NHPR

Doctors today use VGo and other similar technology to practice telehealth, visiting with a patient from a distance. According to Singer, the neurosurgeon, visuals are key for diagnosing concussions.

 "On a phone call you can’t really see the patient," Singer said, "and there are some very specific things we look for when someone has a concussive injury having to do with their cranial nerves and having to do with their balance and so forth that you can’t really get a verbal word on that, it’s really more important to see it."

Down the road, Dartmouth hopes to use telehealth consulting in other sports, particularly the ones that don’t garner as much attention. 

Drew Galbraith is an associate athletic director at Dartmouth. He points out that in some ways, it’s easier to deal with injuries in highly visible sports like basketball or football.

"We know exactly how big a basketball court is and we’re going to put fifteen people out there, we can have one trainer watching that and feel pretty good about our risk assessment. But we also sponsor some sports that are very remote in nature: sailing, nordic skiing. That’s a very different equation."

Think of it as Skype on wheels...it's about four feet tall, it's white, it's very friendly.

Telehealth technology would give coaches far from a medical center instant access to a visual consult if a student gets injured.

"Sometimes it may be that’s probably safe you can pick them up and transport them back or maybe we need to get immediate medical attention or don’t move the individual."

Success using telehealth at Dartmouth could also provide a model for for community and youth sports. Pro and college teams have crews of trainers and doctors, but when you get down to the high school level or younger, it’s more rare to have medical professionals on the sidelines.

But concussions, Singer explains, particularly undiagnosed ones, put kids at serious risk.

"We know that over time they can have behavioral problems and they can also have learning disabilities as a result of multiple concussive episodes."

Of course, catching concussions after they happen, might not be enough. Dr. Singer grew up in Nebraska, where football is a pretty big deal. He says that everything he knows now about head injuries makes it tough to be a fan. Drew Galbraith, too, worries about the unavoidable danger of a contact sport.

Credit Courtesy of Dartmouth-Hitchcock

  "When you take two finely tuned athletic machines and collide them at a high rate of speed, you know things happen. They’re putting their bodies out there, they’re putting themselves at risk."

Maybe someday instead of well-toned bodies at risk, we’ll have actual machines playing football. But until that day, robots will stick to the sidelines.

Related: Back in 2011, a VGo telepresence robot visited the NHPR studios and was featured on Word of Mouth. You can hear that, and see a gallery of photos of the robot in NHPR's studios here.