WHIPLASH INJURY MECHANISMS OF CAR REAR OCCUPANTS: A REVIEW
Whiplash injury due to low severity vehicles crash is a global problem. The injury has long-term clinical and biomechanical implications. Since the mid-1960s, injury statistics have continuously revealed that females face a higher risk of suffering the injury category compare to males. Besides, in a frontal crash, the injury measures from the adult rear dummies were mainly higher than the same size dummies located in driver and front occupant seat. However, most regulations and user crash tests have focused on vehicle drivers and front-seat passenger due to high occupancy and mortality rates in the front seat. In this paper, mechanisms of whiplash injury were reviewed to contribute a further inclusive understanding of human impact reaction, variability quantification, validation, and prevention. The objective of this study is to develop a new design of head restraint (HR) for car rear occupants. In order to raise consideration whiplash injury and prevention mechanisms, impacts are simulated with computer modelling (Ls-Dyna simulation) and validated using Matlab. Therefore, a review of these injury mechanisms indicates the development of new anti-whiplash technology in the automotive safety area is necessary.
2. W. O. Spitzer. Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining" whiplash" and its management. Spine 1995; 20: 1S-73S.
3. A. Kullgren, M. Krafft, C. Tingvall and A. Lie. Combining crash recorder and paired comparison technique: Injury risk functions in frontal and rear impacts with special reference to neck injuries. 2003;
4. C. Anderson, E. Yeung, T. Tong and N. Reed. A narrative review on cervical interventions in adults with chronic whiplash-associated disorder. BMJ open sport & exercise medicine 2018; 4: e000299.
5. A. Kullgren, M. Krafft, A. Lie and C. Tingvall. The effect of whiplash protection systems in real-life crashes and their correlation to consumer crash test programmes. 2007; 1-7.
6. R. E. Trempel, D. S. Zuby and M. A. Edwards. IIHS head restraint ratings and insurance injury claim rates. Traffic injury prevention 2016; 17: 590-596.
7. B. D. Stemper, N. Yoganandan and F. A. Pintar. Effects of abnormal posture on capsular ligament elongations in a computational model subjected to whiplash loading. Journal of biomechanics 2005; 38: 1313-1323.
8. F. Ioppolo and R. Rizzo. Epidemiology of whiplash-associated disorders. Springer 2014; 13-16.
9. M. Sterling, G. Jull and J. Kenardy. Physical and psychological factors maintain long-term predictive capacity post-whiplash injury. Pain 2006; 122: 102-108.
10. N. Kaneko, M. Wakamatsu, M. Fukushima and S. Ogawa. Study of BioRID II sled testing and MADYMO simulation to seek the optimized seat characteristics to reduce whiplash injury. 2004;
11. D. Munoz, A. Mansilla, F. Lopez-Valdes and R. Martin. A study of current neck injury criteria used for whiplash analysis proposal of a new criterion involving upper and lower neck load cells. 2005; 6-9.
12. L. Jakobsson, H. Norin and M. Y. Svensson. Parameters influencing AIS 1 neck injury outcome in frontal impacts. Traffic injury prevention 2004; 5: 156-163.
13. S. G. Storvik, B. D. Stemper, N. Yoganandan and F. A. Pintar. Population-based estimates of whiplash injury using nass cds data-biomed 2009. Biomedical sciences instrumentation 2009; 45: 244-249.
14. B. Jonsson, H. Stenlund, M. Svensson and U. Björnstig. Backset and Cervical Retraction Capacity among Occupants in a Modern Car. 2007;
15. A. Linder, A. Carlsson, M. Y. Svensson and G. Siegmund. Dynamic Responses of Female and Male Volunteers in Rear Impacts. Traffic Injury Prevention 2008; 9: 592-599.
16. S. Schick, H. S, T. K and W. Hell. Differences and commons in kinetic parameters of male and female volunteers in low speed rear end impacts. 2008;
17. J. B. Welcher and T. J. Szabo. Relationships between seat properties and human subject kinematics in rear impact tests. Accident Analysis & Prevention 2001; 33: 289-304.
18. A. Carlsson, A. Linder, J. Davidsson, W. Hell, S. Schick and M. Svensson. Dynamic Kinematic Responses of Female Volunteers in Rear Impacts and Comparison to Previous Male Volunteer Tests. Traffic Injury Prevention 2011; 12: 347-357.
19. K. Ono, Ejima S, Suzuki Y, Kaneoka K, Fukushima M and U. S. Prediction of neck injury risk based on the analysis of localized cervical vertebral motion of human volunteers during low-speed rear impacts. Paper presented at IRCOBI Conference; September 20–22, Madrid, Spain. 2006;
20. A. C. Croft, M. T. Haneline and M. D. Freeman. Differential occupant kinematics and forces between frontal and rear automobile impacts at low speed: evidence for a differential injury risk. Proceedings of the International Research Council on the Biomechanics of Injury conference 2002; 30:
21. A. Carlsson, Siegmund GP, Linder A and S. M. Motion of the Head and Neck of Female and Male Volunteers in Rear Impact Car-to-Car Tests at 4 and 8 km/h. Paper presented at IRCOBI Conference; September 15–16, Hanover, Germany 2010; :
22. A. Kullgren, H. Stigson and M. Krafft. Development of whiplash associated disorders for male and female car occupants in cars launched since the 80s in different impact directions. 2013;
23. A. Linder, K. Holmqvist and M. Y. Svensson. Average male and female virtual dummy model (BioRID and EvaRID) simulations with two seat concepts in the Euro NCAP low severity rear impact test configuration. Accident Analysis & Prevention 2018; 114: 62-70.
24. Ivancic. and M. Xiao. Understanding whiplash injury and prevention mechanisms using a human model of the neck. Accident Analysis & Prevention 2011; 43: 1392-1399.
25. C. Dehner, M. Elbel, S. Schick, F. Walz, W. Hell and M. Kramer. Risk of injury of the cervical spine in sled tests in female volunteers. Clin Biomech (Bristol, Avon) 2007; 22: 615-22.
26. M. M. O'Driscoll Olive, P. M. Henry and C. D. Hung-Kay. Muscle activity during low-speed rear impact. Chinese journal of traumatology 2019; 22: 80.
27. V. Palepu. Biomechanical effects of initial occupant seated posture during rear end impact injury. 2013;
28. A. Linder and W. Svedberg. Review of average sized male and female occupant models in European regulatory safety assessment tests and European laws: Gaps and bridging suggestions. Accident Analysis & Prevention 2019; 127: 156-162.
29. R. Welsh and J. Lenard. Male and female car drivers—differences in collision and injury risks. Paper presented at 45th Association for the Advancement of Automotive Medicine, September 24–26, San Antonio, TX. 2001;
30. A. Kullgren, M. Krafft and O. Boström. Real-World Performance of Various Whiplash Seat Designs. 2010;
31. A. Carlsson, F. Chang, P. Lemmen, A. Kullgren, K.-U. Schmitt, A. Linder and M. Y. Svensson. Anthropometric Specifications, Development, and Evaluation of EvaRID—A 50th Percentile Female Rear Impact Finite Element Dummy Model. Traffic Injury Prevention 2014; 15: 855-865.
32. M. Kleinberger, L. Voo, A. Merkle, M. Bevan, S. Chang and F. McKoy. The role of seatback and head restraint design parameters on rear impact occupant dynamics. 2003;
33. M. M. Panjabi, A. M. Pearson, S. Ito, P. C. Ivancic and J.-L. Wang. Cervical spine curvature during simulated whiplash. Clinical Biomechanics 2004; 19: 1-9.
34. P. C. Ivancic, S. Ito, Y. Tominaga, W. Rubin, M. P. Coe, A. B. Ndu, E. J. Carlson and M. M. Panjabi. Whiplash causes increased laxity of cervical capsular ligament. Clinical biomechanics 2008; 23: 159-165.
35. C. Demetropoulos, S. Srinivasan, S. Bilkhu, W. Hardy, K. Yang, J. Bishop, C. Abjornson, M. Bey, H. Herkowitz and S. Bartol. Consequences of whiplash injury following ProDisc-C disc replacement: evaluation of cervical kinematics during low speed rear-end impact. Spine Arthroplasty Society, Miami 2008;
36. H.-b. Chen, H. Y. King and Z.-g. Wang. Biomechanics of whiplash injury. Chinese Journal of Traumatology (English Edition) 2009; 12: 305-314.
37. S. Sundararajan, P. Prasad, C. K. Demetropoulos, S. Tashman, P. C. Begeman, K. H. Yang and A. I. King. Effect of head-neck position on cervical facet stretch of post mortem human subjects during low speed rear end impacts. 2004;
38. K. H. Yang, J. Hu, N. A. White, A. I. King, C. C. Chou and P. Prasad. Development of numerical models for injury biomechanics research: a review of 50 years of publications in the Stapp Car Crash Conference. Stapp car crash journal 2006; 50: 429-490.
39. R. W. Nightingale, J. Sganga, H. Cutcliffe and R. Cameron. Impact responses of the cervical spine: a computational study of the effects of muscle activity, torso constraint, and pre-flexion. Journal of biomechanics 2016; 49: 558-564.
40. E. De Bruijn, F. Van der Helm and R. Happee. Analysis of isometric cervical strength with a nonlinear musculoskeletal model with 48 degrees of freedom. Multibody System Dynamics 2016; 36: 339-362.
41. T. Mustafy, M. El-Rich, W. Mesfar and K. Moglo. Investigation of impact loading rate effects on the ligamentous cervical spinal load-partitioning using finite element model of functional spinal unit C2–C3. Journal of biomechanics 2014; 47: 2891-2903.
42. M. B. Panzer and D. S. Cronin. C4–C5 segment finite element model development, validation, and load-sharing investigation. Journal of biomechanics 2009; 42: 480-490.
43. Y. Kitagawa, T. Yasuki and J. Hasegawa. Research study on neck injury lessening with active head restraint using human body FE model. Traffic injury prevention 2008; 9: 574-582.
44. S. Ejima, K. Ono, K. Kaneoka and M. Fukushima. Development and validation of the human neck muscle model under impact loading. International Research Council on Biomechanics of Injury 2005; 33: 11p-11p.
45. P. Halldin and K. Brolin. Investigation of conditions that affect neck compression-flexion injuries using numerical techniques. 2000;
46. K. Brolin, J. Östh, M. Svensson, F. Sato, K. Ono, A. Linder and A. Kullgren. Aiming for an average female virtual human body model for seat performance assessment in rear-end impacts. 2015;
47. J. Östh, M. Mendoza-Vazquez, F. Sato, M. Y. Svensson, A. Linder and K. Brolin. A female head–neck model for rear impact simulations. Journal of biomechanics 2017; 51: 49-56.
48. J. D. John, G. S. Kumar and N. Yoganandan. Rear-impact neck whiplash: Role of head inertial properties and spine morphological variations on segmental rotations. Journal of biomechanical engineering 2019;
49. O. Boström, M. Y. Svensson, B. Aldman, H.-A. Hansson, Y. Håland, P. Lövsund, T. Seeman, A. Säljö and T. Örtengren. A new neck injury criterion candidate-based on injury findings in the cervical spinal ganglia after experimental neck extension trauma. 1996; 123-136.
50. K.-U. Schmitt, M. H. Muser, F. H. Walz and P. F. Niederer. N km--a proposal for a neck protection criterion for low-speed rear-end impacts. Traffic injury prevention 2002; 3: 117-126.
51. F. Heitplatz, R. Sferco, P. Fay, J. Reim, A. Kim and P. Prasad. An evaluation of existing and proposed injury criteria with various dummies to determine their ability to predict the levels of soft tissue neck injury seen in real world accidents. 2003;
52. D. C. Viano. Seat Influences on Female Neck Responses in Rear Crashes: A Reason Why Women Have Higher Whiplash Rates. Traffic Injury Prevention 2003; 4: 228-239.
53. J. Östh, K. Brolin, M. Y. Svensson and A. Linder. A female ligamentous cervical spine finite element model validated for physiological loads. Journal of Biomechanical Engineering 2016; 138: 061005.
54. J. Östh, M. Mendoza-Vazquez, M. Y. Svensson, A. Linder and K. Brolin. Development of a 50th percentile female human body model. 2016;
55. L. Schneider. Development of anthropometrically based design specifications for an advanced adult anthropomorphic dummy family, volume 1. final report. 1983;
56. L. Jakobsson, I. Isaksson-hellman and M. Lindman. WHIPS (Volvo Cars' Whiplash Protection System)—The Development and Real-World Performance. Traffic Injury Prevention 2008; 9: 600-605.
57. Viano and S. Olsen. The Effectiveness of Active Head Restraint in Preventing Whiplash. Journal of Trauma and Acute Care Surgery 2001; 51: 959-969.