Whiplash disorder Flashcards
most common mechanism for WAD
MVA (rear end specifically)
when does hyperextension occur in a rear end compred to ant neck musculature
hyperextensuin within first 250ms
neck muscles take atleast 220ms, too late
at what vertebral lvl is the center of force for hyperext
C5-6
the use of a hard seat back can decrease horizontal acceleration by
70%
the the incident is less than 15mph what can the driver do
the pt may be aware and can brace on the steering wheel, activate front neck muscles and put foot on break (decreasing acceleration)
what is the best indicator for injury likelihood
chance V= change in velocity undergone by a given vehicle
C spine kinematics @44ms and @110ms
@44- cspine thrusts upwards
@110- upper is flexed and lower in extended (s shape)
are males or female more susceptible to WAD
females (mainly lighter mass)
how much do head restraints reduce extension by (and how many are properly pos)
24%
10% properly pos
what angle should the seat not be extended beyond
> 30
seat belts are most effective in these types of accidents
rear
front
far sided
serious injury is less likely if speeds are under
20mph (30kph)
when type of MVA cause hyper flex injuries
usually a frontal collision
rear end impact with a change of velocity below ______ appear to be within normal tissue tollerence
less than 8km/h
top 3 symptoms of WAD
Neck pain + stiffness
Headaches
Lowback pain
4 grades of WAD
pain, tenderness, stiffnes AND
- no physical signs
- just MSK signs
- Neuro signs
- fracture or dislocation
what diagnosis method has best validity in detecting cervical trauma
CT
Canadian C spine rules
- > 65
- parestetia
- not simple MOI
- midline tenderness
- unable to sit
- unable to rot 45
what % of cases become chronic
20-67% of cases become chronic
What are some predictors of chronicity
hx of neck pain
- fear avoidance
- belief it is serious
- females
- depression etc.
stage 1 and 2 of tx + goals
- goals of pain control, educate, light ex- ice, ifc, tens, maybeee SMT
- goal to start rehab- physio, education, active rehab
stage 3 + 4 of Tx and goals
3- goal to restore function, return to work adds
4- focus on independent coping traits, longest phase, little residual pain
How many people return to work in 3-6m and 1 year according to quebec task force
3-6-> 70%
1 year-> 80%
Neck pain task force found effective tx to be
- low lvl laser
- combined exercise + SMT
- education, mobs, manual therapy, accu
OPTIM colab found these to be effective
supervised qigong
lyengar yoga
combined programs (ROM, ex)
Natural hx of WAD
75% will recover in 6m-2y
5 evidence based tx by quebec task force
manip pain control ex education rea\assurance
factors that have effect on prognosis
symptoms beyond 6-12 m sig injury delay in implementing tx older etc
