Neck strain in car occupants. The influence of crash-related factors on initial severity.

Abstract

To examine the relationship between the initial severity of neck strain in car occupants and crash-related factors, in particular, crash severity. Thirty-two individuals with neck strain after a car crash, drawn from physiotherapy and general practices in metropolitan Adelaide, were interviewed about their experience and examined by a manipulative physiotherapist. Crash severity was assessed by measurement of damage to the involved vehicles. Five measures of neck strain severity were obtained: 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 examiner's severity rating. Two measures of crash severity were used: maximum residual deformation, and velocity change of the subject's vehicle. Neck strain was observed in individuals who were involved in crashes of low severity. Maximum residual deformation of the vehicle was negatively associated with the subject's cervical range of motion and positively associated with the other measures of neck strain severity. For rear impacts, both measures of crash severity were associated with measures of neck strain severity. The group of subjects who were aware of the impending collision had a greater range of cervical spine movement and fewer positive responses to palpation than those who were unaware. Initial severity of neck strain is positively correlated with crash severity. Awareness of the impending collision may have a mitigating effect on injury severity.