WHIPS-Volvo's Whiplash Protection Study
TL;DR: This paper is a review of Volvo's Whiplash Protection Study (WHIPS), which is the result of more than ten years of concentrated research efforts in the area of neck injuries in car collisions, with the focus on rear end car impacts.
About: This article is published in Accident Analysis & Prevention.The article was published on 2000-03-01. It has received 141 citations till now. The article focuses on the topics: Rear-end collision & Poison control.
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TL;DR: Estimates of the incidence and patterns of neck strain/sprain injury among MV occupants treated in US hospital emergency departments suggest that the problem of neck injury may be larger than has been previously demonstrated using other surveillance tools.
146 citations
TL;DR: The muscle and kinematic responses of aware (alerted and unalerted) subjects were not significantly different, and the larger retractions observed in surprised females likely produce larger tissue strains and may increase injury potential.
Abstract: Study Design. Human subjects were exposed experimentally to a single whiplash-like perturbation. Objective. To determine how awareness of the presence and timing of a whiplash-like perturbation affects the onset and amplitude of the neck muscle response and the peak magnitude of head and neck kinematics. Summary of Background Data. Although most whiplash injuries are sustained in rear-end collisions, which occur without warning, most studies of whiplash injury have used subjects aware of the imminent perturbation. Methods. Seated subjects (35 women and 31 men) underwent a single forward horizontal perturbation (peak acceleration, 1.5 g). Surface electromyography measured the sternocleidomastoid and cervical paraspinal muscle activity. Three awareness conditions were tested: a countdown for subjects alerted to their perturbation, a perturbation without an alert for subjects who expected it within 60 seconds, and an unexpected perturbation for surprised subjects who were deceived. Results. The muscle and kinematic responses of aware (alerted and unalerted) subjects were not significantly different. Sternocleidomastoid activation occurred 7 ms later in surprised subjects than in aware subjects (P < 0.0002). Cervical paraspinal amplitudes were 260% larger and angular head accelerations in flexion were 180% larger in surprised male subjects than in alerted male subjects. Surprised female subjects exhibited a 25% larger head retraction and a 30% lower forward acceleration of the mastoid process than aware female subjects. Conclusions. The larger retractions observed in surprised females likely produce larger tissue strains and may increase injury potential. Aware human subjects may not replicate the muscle response, kinematic response, or whiplash injury potential of unprepared occupants in real collisions.
140 citations
TL;DR: There is evidence supporting a lesion-based model in WAD, and lack of macroscopically identifiable tissue damage does not rule out the presence of painful lesions.
Abstract: predicted by bioengineering studies and validated through animal studies; for zygapophysial joint pain, a valid diagnostic test and a proven treatment are available. Lesions of dorsal root ganglia, discs, ligaments, muscles, and vertebral artery have been documented in biomechanical and autopsy studies, but no valid diagnostic test is available to assess their clinical relevance. The proportion of WAD patients in whom a persistent lesion is the major determinant of ongoing symptoms is unknown. Psychosocial factors, stress reactions, and generalized hyperalgesia have also been shown to predict WAD outcomes. Conclusion. There is evidence supporting a lesion-based model in WAD. Lack of macroscopically identifi able tissue damage does not rule out the presence of painful lesions. The best available evidence concerns zygapophysial joint pain. The clinical relevance of other lesions needs to be addressed by future research.
112 citations
TL;DR: Historically, a soft cervical collar has been used early after the injury in an attempt to restrict cervical range of motion and limit the chances of further injury, but more recent studies report rest and restriction of motion to be detrimental and to slow the healing process.
88 citations
TL;DR: The scientific evidence on whiplash associated disorders is of variable quality, but sufficiently robust and consistent for the purpose of guiding patient information and advice.
Abstract: Objectives: To review the literature and provide an evidence based framework for patient centred information and advice on whiplash associated disorders. Methods: A systematic literature search was conducted, which included both clinical and non-clinical articles to encompass the wide range of patients9 informational needs. From the studies and previous reviews retrieved, 163 were selected for detailed review. The review process considered the quantity, consistency, and relevance of all selected articles. These were categorised under a grading system to reflect the quality of the evidence, and then linked to derived evidence statements. Results: The main messages that emerged were: physical serious injury is rare; reassurance about good prognosis is important; over-medicalisation is detrimental; recovery is improved by early return to normal pre-accident activities, self exercise, and manual therapy; positive attitudes and beliefs are helpful in regaining activity levels; collars, rest, and negative attitudes and beliefs delay recovery and contribute to chronicity. These findings were synthesised into patient centred messages with the potential to reduce the risk of chronicity. Conclusions: The scientific evidence on whiplash associated disorders is of variable quality, but sufficiently robust and consistent for the purpose of guiding patient information and advice. While the delivery of appropriate messages can be both oral and written, consistency is imperative, so an innovative patient educational booklet, The Whiplash Book, has been developed and published.
82 citations
References
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Journal Article•
1,934 citations
TL;DR: It is pointed out that the neck injury incidence tends to become higher for women than for men, and the differences in the alignment of the cervical spine between male and female occupants should be attributed to the facet joint injury mechanism.
Abstract: Twelve male volunteers participated in this study. They sat on a seat mounted on a newly developed sled that simulated actual car impact acceleration. Impact speeds (4, 6 and 8 km/h), seat stiffness, neck muscle tension, and cervical spine alignment were selected for the parameter study of the head-neck-torso kinematics and cervical spine responses. The motion patterns of cervical vertebrae in the crash motion and in the normal motion were compared. Subject's muscles in the relaxed state did not affect the head-neck-torso kinematics upon rear-end impact. The ramping-up motion of the subject's torso was observed due to the seatback inclination. An axial compression force occurred when this motion was applied to the cervical spine, which in turn developed the initial flexion, with the lower cervical vertebral segments extended and rotated prior to the motions of the upper segments. Those motions were beyond the normal physiological cervical motion, which should be attributed to the facet joint injury mechanism. The difference in alignment of the cervical spine affected the impact responses of head and neck markedly. Based on the differences in the alignment of the cervical spine between male and female occupants, it is pointed out that the neck injury incidence tends to become higher for women than for men.(A) For the covering abstract of the conference see IRRD E201172.
226 citations
01 Jan 1996
TL;DR: Preliminary results indicate that ganglion injuries, as well as pressure transients inside the spinal canal, seem to correlate to the phase shift when the neck passes an s-shape (or maximal retraction) during the rearward motion of the head.
Abstract: In this study a mathematical model, based on Navier Stokes equations, was developed and validated against experimental data. This model predicts the pressure changes in the spinal canal as a function of the volume change inside the canal during neck bending in the x-z (sagittal) plane. Another aim of the study was to investigate pressure phenomena and ganglion injuries at static neck extension loading and dynamic neck extension trauma with a head-restraint present. Experiments on pigs were conducted. Preliminary results indicate that ganglion injuries, as well as pressure transients inside the spinal canal, seem to correlate to the phase shift when the neck passes an s-shape (or maximal retraction) during the rearward motion of the head. That is, when the upper neck quickly changes from a flexion to an extension shape. Static loading of the neck resulted in no signs of injuries to the ganglia. A possible candidate for a neck injury criterion is presented, based on the relative acceleration between the top and the bottom of the cervical spine. A tolerance level based on the pig tests is also discussed.
186 citations
01 Mar 1993
165 citations
TL;DR: To clarify the neck injury mechanisms for low impact speed car collisions, the newly developed impact sled experiment which simulates actual car impact acceleration was performed using human subjects and the component measurement method with six-degrees of freedom was applied.
144 citations