The effectiveness of active head restraint in preventing whiplash

wbldb

Viano, David C.^1,2; Olsen, Stefan¹

The effectiveness of active head restraint in preventing whiplash

J Trauma. November 2001;51(5):959-969

©2001 Lippincott Williams & Wilkins, Inc.

Affiliations

¹General Motors R&D Center, Warren, Michigan

²Saab Automobile AB, Trollhattan, Sweden
Abstract and keywords

Background: Whiplash injury claims have increased for two decades and manual head restraints are often incorrectly adjusted. A Self-Aligning Head Restraint (SAHR) was designed to move upward and forward by occupant motion in a rear crash providing earlier neck support, even when the head restraint is positioned low. This study determines its field effectiveness.

Methods: Insurance records were analyzed for consecutive Saab rear crashes in Sweden over 18 months. The Saab 9000/900 had standard head restraints and Saab 9-5/9-3 had SAHR. A questionnaire was mailed to the occupants, insurance and medical records were reviewed, and phone interviews were conducted.

Results: SAHR reduced whiplash injury risks by 75 ± 11% from an 18 ± 5% incidence in 85 occupants with standard head restraints to 4 ± 3% in 92 occupants with SAHR. No SAHR seat required repair or replacement after the crashes.

Conclusion: SAHR is effective in reducing whiplash injury in rear crashes and is a passive public-health approach that works irrespective of manual head-restraint adjustment.

Keywords: Whiplash, Neck injury, Rear crashes, Traffic safety, Injury prevention
Links

DOI: 10.1097/00005373-200111000-00022

PubMed: 11706347

WoS: 000172351600028

Ovid: 00005373-200111000-00022
History

Received: 2001-02-06

Accepted: 2011-06-25

Cited Works (22)

Year	Entry
1993	Maag U, Laberge-Nadeau C, Tao X-T. Neck sprains in car crashes: incidence, associations, length of compensation and costs to the insurer. In: 37th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). November 4-6, 1993; San Antonio, TX.15-26.
2000	Watanabe Y, Ichikawa H, Kayama O, Ono K, Kaneoka K, Inami S. Influence of seat characteristics on occupant motion in low-speed rear impacts. Accid Anal Prev. March 2000;32(2):243-250.
2000	Krafft M, Kullgren A, Tingvall C, Boström O, Fredriksson R. How crash severity in rear impacts influences short- and long-term consequences to the neck. Accid Anal Prev. March 2000;32(2):187-195.
1992	Evans RW. Some observations on whiplash injuries. Neurol Clin. November 1992;10(4):975-997.
1993	Galasko CSB, Murray PM, Pitcher M, Chambers H, Mansfield S, Madden M, Jordon C, Kinsella A, Hodson M. Neck sprains after road traffic accidents: a modern epidemic. Injury. 1993;24(3):155-157.
2000	Luan F, Yang KH, Deng B, Begeman PC, Tashman S, King AI. Qualitative analysis of neck kinematics during low-speed rear-end impact. Clin Biomech (Bristol, Avon). November 2000;15(9):649-657.
1972	O'Neill B, Haddon W Jr, Kelley AB, Sorenson WW. Automobile head restraints: frequency of neck injury claims in relation to the presence of head restraints. Am J Public Health. March 1972;62(3):399-406.
2000	Chapline JF, Ferguson SA, Lillis RP, Lund AK, Williams AF. Neck pain and head restraint position relative to the driver’s head in rear-end collisions. Accid Anal Prev. March 2000;32(2):287-297.
1996	Viano DC, Gargan MF. Headrest position during normal driving: implication to neck injury risk in rear crashes. Accid Anal Prev. November 1996;28(6):665-674.
1988	Lövsund P, Nygren A, Salen B, Tingvall C. Neck injuries in rear end collisions among front and rear seat occupants. In: Proceedings of the 1988 International IRCOBI Conference on the Biomechanics of Impact. September 14-16, 1988; Bergisch-Gladbach, West Germany.319-325.
1972	States JD, Balcerak JC, Williams JS, Morris AT, Babcock W, Polvino R, Riger P, Dawley RE. Injury frequency and head restraint effectiveness in rear-end impact accidents. In: Proceedings of the 16th Stapp Car Crash Conference. November 8-10, 1972; Detroit, MI. Warrendale, PA: Society of Automotive Engineers:228-257. SAE 720967.
1999	Zuby DS, Vann DT, Lund AK, Morris CR. Crash test evaluation of whiplash injury risk. In: Proceedings of the 43rd Stapp Car Crash Conference. October 25-27, 1999; San Diego, CA. Warrendale, PA: Society of Automotive Engineers:267-278. SAE 99SC17.
1985	Nygren A, Gustafsson H, Tingvall C. Effects of different types of headrests in rear-end collisions. In: Proceedings of the 10th International Technical Conference on Experimental Safety Vehicles (ESV). July 1-4, 1985; Oxford, England.85-90. SAE 856023.
1999	Kaneoka K, Ono K, Inami S, Hayashi K. Motion analysis of cervical vertebrae during whiplash loading. Spine. 1999;24(8):763-769.
1995	Instrumentation for impact test, I: electronic instrumentation. Society for Automotive Engineers International; March 1995. SAE J211-1.
1998	Krafft M. Non-Fatal Injuries to Car Occupants: Injury Assessment and Analysis of Impacts Causing Short- and Long-Term Consequences With Special Reference to Neck Injuries [PhD thesis]. Stockholm, Sweden: Karolinska Institute; 1998.
2000	Svensson MY, Boström O, Davidsson J, Hansson H-A, Håland Y, Lövsund P, Suneson A, Säljö A. Neck injuries in car collisions: a review covering a possible injury mechanism and the development of a new rear-impact dummy. Accid Anal Prev. March 2000;32(2):167-175.
1992	Svensson MY, Lövsund P. A dummy for rear-end collisions: development and validation of a new dummy-neck. In: Proceedings of the 1992 International IRCOBI Conference on the Biomechanics of Impact. September 9-11, 1992; Verona, Italy.299-310.
1997	Dolinis J. Risk factors for "whiplash" in drivers: a cohort study of rear-end traffic crashes. Injury. April 1997;28(3):173-179.
1996	Ono K, Kanno M. Influences of the physical parameters on the risk to neck injuries in low impact speed rear-end collisions. Accid Anal Prev. 1996;28(4):493-499.
1993	Ono K, Kanno M. Influences of the physical parameters on the risk to neck injuries in low impact speed rear-end collisions. In: Proceedings of the 1993 International IRCOBI Conference on the Biomechanics of Impact. September 8-10, 1993; Eindhoven, The Netherlands.201-212.
2000	Richter M, Otte D, Pohlemann T, Krettek C, Blauth M. Whiplash-type neck distortion in restrained car drivers: frequency, causes and long-term results. Eur Spine J. April 2000;9(2):109-117.

Cited By (36)

Year	Entry
2015	Prasad P. Injury criteria and motor vehicle regulations. In: Yoganandan N, Nahum AM, Melvin JW, eds. Accidental Injury: Biomechanics and Prevention. 3rd ed. New York: Springer; 2015:793-809.
2010	Schmitt K-U, Niederer PF, Muser MH, Walz F. Trauma Biomechanics: Accidental Injury in Traffic and Sports. 2nd ed. Deidelberg, Germany: Springer; 2010.
2003	Kullgren A, Eriksson L, Boström O, Krafft M. Validation of neck injury criteria using reconstructed real-life rear-end crashes with recorded crash pulses. In: Proceedings of the 18th International Technical Conference on the Enhanced Safety of Vehicles (ESV). May 19-22, 2003; Nagoya, Japan.
2005	Kuppa S, Saunders J, Stammen J, Mallory A. Kinematically based whiplash injury criterion. In: Proceedings of the 19th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 6-9, 2005; Washington, DC.
2005	Edwards M, Smith S, Zuby DS, Lund AK. Improved seat and head restraint evaluations. In: Proceedings of the 19th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 6-9, 2005; Washington, DC.
2007	Deter T, Malczyk A, Kuehn M. Validation of a seat-dummy simulation model for rear-impact. In: Proceedings of the 20th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 18-21, 2007; Lyon, France.
2007	Kullgren A, Krafft M, Lie A, Tingvall C. The effect of whiplash protection systems in real-life crashes and their correlation to consumer crash test programmes. In: Proceedings of the 20th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 18-21, 2007; Lyon, France.
2009	Distner M, Bengtsson M, Broberg T, Jakobsson L. City safety: a system addressing rear-end collisions at low speeds. In: Proceedings of the 21st International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 15-18, 2009; Stuttgart, Germany.
2015	Kullgren A, Fildes B, van Ratingen M, Ellway J, Keall M. Evaluation of the Euro NCAP whiplash protocol using real-world crash data. In: Proceedings of the 24th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 8-11, 2015; Gothenburg, Sweden.
2004	Bunketorp O, Jakobsson L, Norin H. Comparison of frontal and rear-end impacts for car occupants with whiplash-associated disorders: symptoms and clinical findings. In: Proceedings of the 2004 International IRCOBI Conference on the Biomechanics of Impact. September 22-24, 2004; Graz, Austria.245-256.
2004	Jakobsson L, Norin H. AIS1 neck injury reducing effect of whips (whiplash protection system). In: Proceedings of the 2004 International IRCOBI Conference on the Biomechanics of Impact. September 22-24, 2004; Graz, Austria.297-305.
2004	Krafft M, Kullgren A, Ydenius A, Boström O, Håland Y, Tingvall C. Rear impact neck protection by reducing occupant forward acceleration: a study of cars on Swedish roads equipped with crash recorders and a new anti-whiplash device. In: Proceedings of the 2004 International IRCOBI Conference on the Biomechanics of Impact. September 22-24, 2004; Graz, Austria.221-231.
2004	Linder A, Avery M, Kullgren A, Krafft M. Real-world rear impacts reconstructed in sled tests. In: Proceedings of the 2004 International IRCOBI Conference on the Biomechanics of Impact. September 22-24, 2004; Graz, Austria.233-244.
2007	Bostrom O, Kullgren A. Characteristics of anti-whiplash seat designs with good real-life performance. In: Proceedings of the 2007 International IRCOBI Conference on the Biomechanics of Impact. September 19-21, 2007; Maastricht, The Netherlands.219-232.
2007	Stemper BD, Yoganandan N, Gennarelli TA, Pintar FA. Toward a lower neck rear impact injury criterion: correlation of lower neck loads with spinal kinematics. In: Proceedings of the 2007 International IRCOBI Conference on the Biomechanics of Impact. September 19-21, 2007; Maastricht, The Netherlands.249-260.
2010	Kullgren A, Krafft M. Gender analysis on whiplash seat effectiveness: results rrom real-world crashes. In: Proceedings of the 2010 International IRCOBI Conference on the Biomechanics of Impact. September 15-17, 2010; Hannover, Germany.17-28.
2013	Kullgren A, Stigson H, Krafft M. Development of whiplash associated disorders for male and female car occupants in cars launched since the 80s in different impact directions. In: Proceedings of the 2013 International IRCOBI Conference on the Biomechanics of Injury. September 11-13, 2013; Gothenburg, Sweden.51-61.
2015	Jakobsson L, Lindman M, Björklund M, Victor T. Rear‐end impact: crash prevention and occupant protection. In: Proceedings of the 2015 International IRCOBI Conference on the Biomechanics of Injury. September 9-11, 2015; Lyon, France.803-813.
2017	Mang DWH, Blouin J, Siegmund GP. A comparison of anti‐whiplash seats during low/moderate‐speed rear‐end collisions. In: Proceedings of the 2017 International IRCOBI Conference on the Biomechanics of Injury. September 13-15, 2017; Antwerp, Belgium.648-649.
2021	Jakobsson L, Östh J, Bohman K. Rear-end impact assessment expanded with pre-impact posture variations. In: Proceedings of the 2021 International IRCOBI Conference on the Biomechanics of Injury. September 8-10, 2021; Online.753-770.
2011	Siegmund GP. What occupant kinematics and neuromuscular responses tell us about whiplash injury. Spine. December 2011;36(suppl 25S):S175-S179.
2011	Curatolo M, Bogduk N, Ivancic PC, McLean SA, Siegmund GP, Winkelstein BA. The role of tissue damage in whiplash-associated disorders: discussion paper 1. Spine. December 2011;36(suppl 25S):S309-S315.
2002	Viano DC, Davidsson J. Neck displacements of volunteers, BioRID P3 and Hybrid III in rear impacts: implications to whiplash assessment by a neck displacement criterion (NDC). Traffic Inj Prev. 2002;3(2):105-116.
2002	Hell W, Schick S, Langwieder K, Zellmer H. Biomechanics of cervical spine injuries in rear end car impacts: influence of car seats and possible evaluation criteria. Traffic Inj Prev. 2002;3(2):127-140.
2002	Krafft M, Kullgren A, Ydenius A, Tingvall C. Influence of crash pulse characteristics on whiplash associated disorders in rear impacts: crash recording in real life crashes. Traffic Inj Prev. 2002;3(2):141-149.
2003	Farmer CM, Wells JK, Lund AK. Effects of head restraint and seat redesign on neck injury risk in rear-end crashes. Traffic Inj Prev. 2003;4(2):83-90.
2003	Viano DC. Seat influences on female neck responses in rear crashes: a reason why women have higher whiplash rates. Traffic Inj Prev. 2003;4(3):228-239.
2008	Farmer CM, Zuby DS, Wells JK, Hellinga LA. Relationship of dynamic seat ratings to real-world neck injury rates. Traffic Inj Prev. December 2008;9(6):561-567.
2008	Linder A, Carlsson A, Svensson MY, Siegmund GP. Dynamic responses of female and male volunteers in rear impacts. Traffic Inj Prev. 2008;9(6):592-599.
2009	Siegmund GP, Winkelstein BA, Ivancic PC, Svensson MY, Vasavada A. The anatomy and biomechanics of acute and chronic whiplash injury. Traffic Inj Prev. 2009;10(2):101-112.
2011	Viano DC, Parenteau CS. BioRID dummy responses in matched ABTS and conventional seat tests on the IIHS rear sled. Traffic Inj Prev. 2011;12(4):339-346.
2012	Carlsson A. Addressing Female Whiplash Injury Protection: A Step Towards 50th Percentile Female Rear Impact Occupant Models [PhD thesis]. Gothenburg, Sweden: Chalmers University of Technology; 2012.
2023	Soltan Mohammadzadeh N. Cervical Cerebrospinal Fluid Pressure in an in-Vivo Porcine Model of Simulated Whiplash Loading [Master's thesis]. Vancouver, BC: University of British Columbia; July 2023.
2006	Gibson T. Development and Validation of a C5/C6 Motion Segment Model [PhD thesis]. University of New South Wales; January 4, 2006.
2012	Beck B. Optimising Protection for Motor Vehicle Rear Seat Occupants [PhD thesis]. University of New South Wales; 2012.
2006	Ivancic PC. Cervical Spine Injury During Simulated Automobile Collisions [PhD thesis]. Yale University; May 2006.