Motor vehicle crash reconstruction: Does it relate to the heterogeneity of whiplash recovery?


Autoři: James M. Elliott aff001;  Brad E. Heinrichs aff003;  David M. Walton aff004;  Todd B. Parrish aff005;  D. Mark Courtney aff002;  Andrew C. Smith aff007;  Jasmine Hunt aff002;  Mary J. Kwasny aff008;  Marie Wasielewski aff002;  Gunter P. Siegmund aff003
Působiště autorů: Faculty of Health Sciences, The University of Sydney & the Northern Sydney Local Health District, The Kolling Research Institute, St Leonards, NSW, Australia aff001;  Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America aff002;  MEA Forensic Engineers & Scientists, Richmond, British Columbia, Canada aff003;  School of Physical Therapy, Western University, London, Ontario, Canada aff004;  Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago IL, United States of America aff005;  Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America aff006;  School of Physical Therapy, Regis University, Denver, CO, United States of America aff007;  Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America aff008;  School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada aff009
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225686

Souhrn

Whiplash injury is a common consequence of motor vehicle crashes (MVC), yet it is also one of the most poorly understood. While more than 50% of those injured should expect to rapidly recover, others are not as fortunate with approximately 25% of those exposed to and injured in an MVC transitioning from acute to chronic pain and disability. The purpose of this prospective study was to determine if the severity and direction of collisions involving participants enrolled in a longitudinal study of recovery from whiplash are able to differentiate between different recovery groups based on the neck disability index (NDI) percentage scores at 3-months, and if these crash specific parameters are associated with known risk factors for recovery. Here, we examined objective collision data, repair invoices, and characteristics of the crash for 37 acutely injured participants consented and enrolled at their emergency department visit and further assessed at three time points; < 1 week, 2-weeks, and 3-months post MVC. Collision data were used to reconstruct and estimate the severity of the crash and determine if they aligned with the heterogeneity of whiplash injury recovery. Wilcoxon rank sum tests were used to determine if % scores on the Neck Disability Index (NDI) at 3-months post MVC were associated with the following variables: sex, head turned at time of impact, seatbelt use, whether or not airbags deployed, if the vehicle was struck while stopped or while turning, or the principle direction of force (PDOF). Spearman’s correlation coefficients were used to determine if NDI at 3-months post MVC was associated with age, Body Mass Index, pain-related disability at baseline, signs of post-traumatic distress, intrusion/hyperarousal, negative affect, pain intensity, estimated speed change from the impact, and damage estimates (in US$). There was a significant positive association between self-reported neck disability at 3-months post MVC, post-traumatic distress, negative affect and uncontrolled pain. There was no direct effect of participant characteristics, arousal, intrusion/hyperarousal sub-score, damage, PDOF, speed change, or other crash characteristics. Established crash parameters were not associated with the heterogeneity of whiplash injury recovery in a small sample of injured participants.

Klíčová slova:

Critical care and emergency medicine – Ligaments – Longitudinal studies – Myalgia – Pain psychology – Pain sensation – Road traffic collisions – Traumatic injury


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