Crash severity and neck strain in car occupants

Ryan, G. A.; Moore, V. M.; Dolinis, J.; Taylor, G. W.

Affiliations

¹National Health and Medical Research Council Road Accident Research Unit, University of Adelaide, South Australia

²Wayville Physical Care Centre, Adelaide, South Australia

Abstract

There has been considerable debate as to the relationship between the severity of a crash and the severity and persistence of subsequent symptoms and signs of neck strain. This study was designed to examine relationships between factors related to the crash, the initial severity of neck strain and its persistence six months after the impact. Thirty-two individuals with neck strain following a car crash, drawn from physiotherapy and general practices in Adelaide, South Australia, were interviewed and underwent a physical examination soon after the crash and again after six months. Each case vehicle and the site of each crash was inspected and the crash events reconstructed. The severity of the crash was assessed by measurement of maximum residual deformation and estimation of velocity change. Five measures of neck strain severity were used: number of body regions with symptoms, number of positive responses to palpation, cervical range of motion, subject’s own rating on an analogue pain scale, and a severity rating by the examiner. In 22 cases the impact was from the rear, the remainder were from the front or the side. Neck strain was observed in crashes of low severity, six cases having a velocity change of less than 10 km/h and eight cases a maximum residual deformation of less than 50 mm. For rear impacts, maximum residual deformation and velocity change were positively associated with measures of neck strain severity. Six months after the impact, 19 (66%) of the 29 subjects available for follow-up still had evidence of injury. There was no statistically significant association between either measure of crash severity and persistence of neck strain at six months. Subjects who were aware of the impending collision had less severe symptoms and signs initially and were much less likely to experience persisting problems. This study has shown that neck strain can occur at low levels of crash severity and that there is a correlation between crash severity and initial severity of neck strain, A study of greater statistical power would be required to investigate fully the relationship between crash severity and the persistence of neck strain.

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