Abstract
BackgroundMotor vehicle collisions remain a common cause of spinal cord injury. Biomechanical studies of spinal movement often lack “real world” context and applicability. Additional data may enhance our understanding of the potential for secondary spinal cord injury. We propose the metric ‘travel’ (total movement) and suggest that our understanding of movement related risk of injury could be improved if travel was routinely reported. We report maximal movement and travel for collar application in vehicle and subsequent self-extrication.MethodsBiomechanical data on application of cervical collar with the volunteer sat in a vehicle were collected using Inertial Measurement Units on 6 healthy volunteers. Maximal movement and travel are reported. These data and a re-analysis of previously published work is used to demonstrate the utility of travel and maximal movement in the context of self-extrication.ResultsData from a total of 60 in-vehicle collar applications across three female and three male volunteers was successfully collected for analysis. The mean age across participants was 50.3 years (range 28–68) and the BMI was 27.7 (range 21.5–34.6). The mean maximal anterior–posterior movement associated with collar application was 2.3 mm with a total AP travel of 4.9 mm. Travel (total movement) for in-car application of collar and self-extrication was 9.5 mm compared to 9.4 mm travel for self-extrication without a collar.ConclusionWe have demonstrated the application of ‘travel’ in the context of self-extrication. Total travel is similar across self-extricating healthy volunteers with and without a collar. We suggest that where possible ‘travel’ is collected and reported in future biomechanical studies in this and related areas of research. It remains appropriate to apply a cervical collar to self-extricating casualties when the clinical target is that of movement minimisation.
Highlights
MethodsBiomechanical data on application of cervical collar with the volunteer sat in a vehicle were collected using Inertial Measurement Units on 6 healthy volunteers
Motor vehicle collisions remain a common cause of spinal cord injury [1]
Data from total of 60 in-vehicle collar applications across three female and three male volunteers was successfully collected for analysis
Summary
We undertook an experimental biomechanical study which considers spinal movement at the cervical spine when a cervical collar is applied “in car” prior to an extrication attempt. Data were collected for 10 applications of the cervical collar for each of the 6 participants (total 60 collar applications). Maximum excursions (movement from a hypothetical midline) were calculated for anterior/posterior (AP) and lateral (Lat) movement of the cervical spine. We have previously reported data collected using similar techniques which describes maximal movements at the cervical and lumbar spine for self-extrication with and without a collar [5]. A reanalysis of this previously collected data was performed to allow the calculation and reporting of ‘travel’ [5]. Combining the analysis of data collected for both studies allowed for comparative analysis between ‘travel’ for extrication with and without a collar and ‘travel’ associated with collar application. BMI body mass index, AP anterior posterior movement a Mean movement across ten applications per participant. 20.1 12.2 26.7 − 5.5 a Self-extrication with no collar—(Collar application + self-extrication with collar), a negative value indicates larger movement (travel) with collar application and subsequent self-extrication
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