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Chiropractic Research Review

Reviewing Motor Vehicle Collision-Related Whiplash

Cervical spine disorders (CSD) sustained in motor vehicle accidents - commonly referred to as whiplash or whiplash-associated disorders (WAD) - often result in long periods of sick leave, medical disability claims, disability pensions and legal ramifications, all of which can have negative socioeconomic impacts.

The objective of this study was to analyze auto-injury WADs that resulted in long sick leaves, placing special emphasis on the biomechanical assessment of these cases.

Over a 20-month period, researchers studied 668 CSD cases resulting from vehicle collisions in which patients took more than four weeks' sick leave as a result of their injuries. Researchers evaluated the technical, medical and biomechanical aspects of each injury. This included examination of delta-v, the collision-induced velocity change that corresponds to vehicle deceleration in one unidirectional-impact collisions. Patient medical records were also reviewed; from each, a Quebec Task Force (QTF) grade was established, ranging from 0 (no complaints) to 4 (complaint and fracture or dislocation).

Data for the technical aspect relied on accident reconstruction, photos of vehicles involved in collisions, vehicle repair costs, and delta-v information. The biomechanical assessment, composed of the technical and medical evaluations, as well as evaluation of each patients individual physique, sought to determine the extent of the injury caused by each accident.

The study concluded that QTF values for patients with pre-existing neck injuries or pre-existing signs or symptoms of neck injury were significantly different from patients without a prior history; moreover, the research showed that in approximately 50% of the cases, patient history combined with the collision factors could more accurately explain the patient's symptoms, in comparison to a sole evaluation of the collision's technical aspects. The authors suggest that a medical evaluation based solely on QTF scores cannot assess injury without factoring in collision circumstances, and recommend assessment of a collisions biomechanical factors.

Schmitt KU, Walz F, Vetter D, Muser M. Whiplash injury: cases with a long period of sick leave need biomechanical assessment. European Spine Journal 2003:12, pp247-254.

Chiropractic Research Review

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