Mats Y. Svensson

The Anatomy and Biomechanics of Acute and Chronic Whiplash Injury

Whiplash injury is the most common motor vehicle injury, yet it is also one of the most poorly understood. Here we examine the evidence supporting an organic basis for acute and chronic whiplash injuries and review the anatomical sites within the neck that are potentially injured during these collisions. For each proposed anatomical site—facet joints, spinal ligaments, intervertebral discs, vertebral arteries, dorsal root ganglia, and neck muscles—we present the clinical evidence supporting that injury site, its relevant anatomy, the mechanism of and tolerance to injury, and the future research needed to determine whether that site is responsible for some whiplash injuries. This article serves as a snapshot of the current state of whiplash biomechanics research and provides a roadmap for future research to better understand and ultimately prevent whiplash injuries.

Neck injuries in car collisions — a review covering a possible injury mechanism and the development of a new rear-impact dummy

A review of a few Swedish research projects on soft tissue neck injuries in car collisions is presented together with some new results. Efforts to determine neck injury mechanisms was based on a hypothesis stating that injuries to the nerve root region in the cervical spine are a result of transient pressure gradients in the spinal canal during rapid neck bending. In experimental neck trauma research on animals, pressure gradients were observed and indications of nerve cell membrane dysfunction were found in the cervical spinal ganglia. The experiments covered neck extension, flexion and lateral bending. A theoretical model in which fluid flow was predicted to cause the transient pressure gradients was developed and a neck injury criterion based on Navier-Stokes Equations was applied on the flow model. The theory behind the Neck Injury Criterion indicates that the neck injury occurs early on in the rearward motion of the head relative to the torso in a rear-end collision. Thus the relative horizontal acceleration and velocity between the head and the torso should be restricted during the early head-neck motion to avoid neck injury. A Bio-fidelic Rear Impact Dummy (BioRID) was developed in several steps and validated against volunteer test results. The new dummy was partly based on the Hybrid III dummy. It had a new articulated spine with curvature and range of motion resembling that of a human being. A new crash dummy and a neck injury criterion will be very important components in a future rear-impact crash test procedure.

Pressure measurements in the spinal canal of post-mortem human subjects during rear-end impact and correlation of results to the neck injury criterion.

The aim of this study is to validate the pressure effect theory on human beings during a realistic rear-end impact and to correlate the neck injury criterion to pressure in the spinal canal. Sled experiments were performed using a test setup similar to real rear-end collisions. Test conditions were chosen based on accident statistics and recordings of real accidents. In particular, velocity change and acceleration level were reproduced similar to actual collisions. The head restraint as well as the seat back were adjusted to different positions. Two small pressure transducer were implemented to the spinal canal of postmortem human subjects and pressure measurement similar to the pig experiments (using exactly the same equipment) were performed. A total set of 21 experiments with four different subjects were performed. The subjects were additionally instrumented with triaxial accelerometers that allowed for calculation of the NIC criterion. Results showed that NIC and pressure amplitudes of the CSF correlate well and therefore NIC seems to be able to predict these amplitudes also for human beings. Conclusions whether these pressure effects induce soft tissue neck injuries or not could not be drawn and should be investigated in further research.

Human Volunteer Kinematics in Rear-End Sled Collisions

Validation of new crash test dummies for rear-end collision testing requires human response data from pertinent test situations. Eleven human volunteers were exposed to 23 low-speed rear impacts to determine human response in well-defined test seats, and to quantify repeatability, variability and the effect of seat design on human response. The results showed vertical motion of the volunteers’ H-point caused by ramping up along the seat, and an upward motion of the volunteers’ torso and head. The latter was caused by a combination of ramping up along the seatback and straightening of the thoracic kyphosis. During the first 100 ms, the volunteers flexed their necks. Thereafter, the volunteers extended their necks. These new data have proven to be useful in validation of rear-impact dummies.

THE INFLUENCE OF SEAT-BACK AND HEAD-RESTRAINT PROPERTIES ON THE HEAD-NECK MOTION DURING REAR-IMPACT

The influence of different seat properties on the head-neck motion during a low-velocity rear-end impact was tested using a Hybrid III-dummy fitted with a modified neck (RID-neck). The results show that by modifying the properties of the seat-back and head-restraint it is possible to influence the head-neck kinematics to a great extent. It was possible to virtually eliminate the neck extension motion during a rear-impact. This will hopefully result in a significant decrease in neck injury risk in real world rear-impacts.

Parameters influencing AIS 1 neck injury outcome in frontal impacts

In order to gain more knowledge of the neck injury scenario in frontal impacts, a statistical study of parameters influencing incidences of AIS 1 neck injuries was performed. The data set consisted of 616 occupants in Volvo cars. Information regarding the crash, the safety systems, occupant characteristics (including prior neck problems), behavior and sitting posture at the time of impact, and neck symptoms (including duration) was collected and analyzed. Occupant characteristics (mainly gender, weight, and age), kinematics (head impacts) and behavior at the time of impact were identified as the most prominent parameter areas with regard to AIS 1 neck injury outcome. Specifically, women had a significantly higher AIS 1 neck injury rate as compared to men, occupants under the age of 50 had a significantly higher AIS 1 neck injury rate as compared to those above 50 and occupants weighing less than 65 kg have a significantly higher AIS 1 neck injury rate than heavier occupants. Drivers stating that they impacted their head against a frontal interior structure had a significantly higher AIS 1 neck injury rate than those without head impact. Also, occupants who stated they had tensed their neck muscles at the time of impact, had a significantly higher AIS 1 neck injury rate as compared to occupants who did not. Occupant activities, such as tightly gripping the steering wheel or straightening their arms showed a significantly increased AIS 1 neck injury rate, indicating that occupant behavior at time of impact could be influential with respect to AIS 1 neck injury outcome. Also, occupants reporting prior neck problems had a higher rate of persistent symptoms (> 1 year) but no difference with respect to passing symptoms (< 3 months) as compared to those without prior neck problems. Additionally, there was no distinct pattern for the duration of neck symptoms.

Dynamic Kinematic Responses of Female Volunteers in Rear Impacts and Comparison to Previous Male Volunteer Tests

Objectives: The objective was to quantify dynamic responses of 50th percentile females in rear impacts and compare to those from similar tests with males. The results will serve as a basis for future work with models, criteria, and safety systems. Methods: A rear impact sled test series with 8 female volunteers was performed at velocity changes of 5 and 7 km/h. The following dynamic response corridors were generated for the head, T1 (first thoracic vertebra) and head relative to T1: (1) accelerations in posterior–anterior direction, (2) horizontal and vertical displacements, (3) angular displacements for 6 females close to the 50th percentile in size. Additionally, the head-to-head restraint distance and contact time and neck injury criterion (NIC) were extracted from the data set. These data were compared to results from previously performed male volunteer tests, representing the 50th percentile male, in equivalent test conditions. T-tests were performed with the statistical significance level of .05 to quantify the significance of the parameter value differences for the males and females. Results: At 7 km/h, the females showed 29 percent earlier head-to-head restraint contact time (p = .0072); 27 percent shorter horizontal rearward head displacement (p = .0017); 36 percent narrower head extension angle (p = .0281); and 52 percent lower NIC value (p = .0239) than the males in previous tests. This was mainly due to 35 percent shorter initial head-to-head restraint distance for the females (p = .0125). The peak head acceleration in the posterior–anterior direction was higher and occurred earlier for the females. Conclusions: The overall result indicated differences in the dynamic response for the female and male volunteers. The results could be used in developing and evaluating a mechanical and/or mathematical average-sized female dummy model for rear impact safety assessment. These models can be used as a tool in the design of protective systems and for further development and evaluation of injury criteria.

Motion of the head and neck of female and male volunteers in rear impact car-to-car impacts

Objectives: The objectives of this study were to quantify and compare dynamic motion responses between 50th percentile female and male volunteers in rear impact tests. These data are fundamental for developing future occupant models for crash safety development and assessment. Methods: High-speed video data from a rear impact test series with 21 male and 21 female volunteers at 4 and 8 km/h, originally presented in Siegmund et al. (1997), were used for further analysis. Data from a subset of female volunteers, 12 at 4 km/h and 9 at 8 km/h, were extracted from the original data set to represent the 50th percentile female. Their average height was 163 cm and their average weight was 62 kg. Among the male volunteers, 11 were selected, with an average height of 175 cm and an average weight of 73 kg, to represent the 50th percentile male. Response corridors were generated for the horizontal and angular displacements of the head, T1 (first thoracic vertebra), and the head relative to T1. T-tests were performed with the statistical significance level of .05 to quantify the significance of the differences in parameter values for the males and females. Results: Several differences were found in the average motion response of the male and female volunteers at 4 and 8 km/h. Generally, females had smaller rearward horizontal and angular motions of the head and T1 compared to the males. This was mainly due to shorter initial head-to–head restraint distance and earlier head-to–head restraint contact for the females. At 8 km/h, the female volunteers showed 12 percent lower horizontal peak rearward head displacement (P = .018); 22 percent lower horizontal peak rearward head relative to T1 displacement (P = .018); and 30 percent lower peak head extension angle (P = .001). The females also had more pronounced rebound motion. Conclusions: This study indicates that there may be characteristic differences in the head–neck motion response between 50th percentile males and females in rear impacts. The exclusive use of 50th percentile male rear impact dummies may thus limit the assessment and development of whiplash prevention systems that adequately protect both male and female occupants. The results of this study could be used in the development and evaluation of a mechanical and/or computational average-sized female dummy model for rear impact safety assessment. These models are used in the development and evaluation of protective systems. It would be of interest to make further studies into seat configurations featuring a greater head-to–head restraint distance.

Dynamic Responses of Female and Male Volunteers in Rear Impacts

Objectives: Whiplash injuries from vehicle collisions are common and costly. These injuries most frequently occur as a result of a rear impact and, compared to males, females have up to twice the risk of whiplash-associated disorders (WAD) resulting from vehicle crashes. The present study focuses on the differences in the dynamic response corridors of males and females in low-severity rear impacts. Methods: In this study, analysis of data from volunteer tests of females from previously published data has been performed. Corridors for the average female response were generated based on 12 volunteers exposed to a change of velocity of 4 km/h and 9 volunteers exposed to a change of velocity of 8 km/h. These corridors were compared to corridors for the average male response that were previously generated based on 11 male volunteers exposed to the same test conditions. Results: Comparison between the male and female data showed that the maximum x-acceleration of the head for the females occurred on average 10 ms earlier and was 29% higher during the 4 km/h test and 12 ms earlier and 9% higher during the 8 km/h test. Head-to-head restraint contact for the females occurred 14 ms earlier at 4 km/h and 11 ms earlier at 8 km/h compared to the males. For the same initial head-to-head restraint distance, head restraint contact occurred 11 and 7 ms earlier for the females than the males at 4 and 8 km/h, respectively. Furthermore, the calculated Neck Injury Criteria (NIC) values were similar for males and females at 4 km/h, whereas they were lower for females compared to the males at 8 km/h (3.2 and 4.0 m2/s2, respectively). Conclusions: The results of this study highlight the need to further investigate the differences in dynamic responses between males and females at low-severity impacts. Such data are fundamental for the development of future computer models and dummies for crash safety assessment. These models can be used not only as a tool in the design and development process of protective systems but also in the process of further evaluation and development of injury criteria.

Backset and cervical retraction capacity among occupants in a modern car

Objectives. The horizontal distance between the back of the head and the frontal of the head restraint (backset) and rearward head movement relative to the torso (cervical retraction) were studied in different occupant postures and positions in a modern car. Methods. A stratified randomized population of 154 test subjects was studied in a Volvo V70 year model 2003 car, in driver, front passenger, and rear passenger position. In each position, the subjects adopted (i) a self-selected posture, (ii) a sagging posture, and (iii) an erect posture. Cervical retraction, backset, and vertical distance from the top of the head restraint to the occipital protuberance in the back of the head of the test subject were measured. These data were analyzed using repeated measures ANOVA and linear regression analysis with a significance level set to p < 0.05. Results. In the self-selected posture, the average backset was 61 mm for drivers, 29 mm for front passengers, and 103 mm for rear passengers (p < 0.001). Women had lower mean backset (40 mm) than men (81 mm), particularly in the self-selected driving position. Backset was larger and cervical retraction capacity lower in the sagging posture than in the self-selected posture for occupants in all three occupant positions. Rear passengers had the largest backset values. Backset values decreased with increased age. The average cervical retraction capacity in self-selected posture was 35 mm for drivers, 30 mm for front passengers, and 33 mm for rear passengers (p < 0.001). Conclusions. Future design of rear-end impact protection may take these study results into account when trying to reduce backset before impact. Our results might be used for future development and use of BioRID manikins and rear-end tests in consumer rating test programs such as Euro-NCAP.