This week, we take a look at Whiplash Injury or Concussion? A Possible Biomechanical Explanation for Concussion Symptoms in Some Individuals Following a Rear-End Collision from the Journal of Orthopaedic & Sports Physical Therapy. Elkin, et al. 2016 provide their biomechanical explanation for mechanism of injury of a concussion in a rear-end type collision. These authors specifically are looking at impact forces with head seat restraints compared to head blows (direct) that are known to cause concussions (contact related sports). Study data was compiled using simulated brain/head models and corroborated some clinical trends we typically see in our MVA patients:
1) Brain and skull strain forces are significantly higher for those individuals with the head restraint that is positioned too low or absent vs properly fitted head restraint
2) Pre impact rotation of head in the MVA patient creates forces at times up to 1.5x higher in the brain/skull than if the head/neck is in neutral position
3) Cerebrum strain force is greater than in cerebellum and brainstem regions in MVA patient rearend collisions
The study authors concluded that multisystem or “integrated” evaluation of post MVA patients is the best practice to address all the complex deficits that the patient may be dealing with post MVA. Your thoughts?
For more on this important topic, join us for a new online course, Cervicothoracic MVA: Regional Interdependence, where we’ll review some of the unique features of MVA patients with possible simultaneous concussion signs and symptoms, and suggestions for treatment protocols and interventions.
–Karen Walz, PT, DPT, OCS, COMT, FAAOMPT
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