of whiplash From the 19th century train
injuries to present day motor vehicle injuries,
this often maligned condition has been the subject
of unending debate. Fortunately, there has been
a great surge of new interest in the condition
among the scientific community in recent years.
Epidemiology of whiplash We
take a critical look at the problem and present
the real statistics; from incidence and risk to
prevalence. The size of the problem is growing
worldwide and the real reasons for this unexpected
growth are revealed.
for patients, physicians, and attorneys This
section explores the myths and misconceptions
promoted by groups wishing to marginalize the
whiplash problem as insignificant or even non-existent.
This section contains three optional expansion
modules (Red Boxes) that allow presenters to
explore the commonly held belief that injuries
are unlikely or impossible in certain kinds of
crashes in greater detail, as well as to take
a closer look at the current state of low speed
auto crash reconstruction and its limitations.
We discuss the recent research with bumper systems
and event data recorders (EDR)—the vehicle’s
black box. We explore the known relationships
between vehicle damage and injury risk. This
section also contains slow motion footage of
crash tests which juxtapose non-destructive bumper-to-bumper
collisions with the relatively violent occupant
kinematics occurring in the same crashes.
Biomechanics of whiplash After
an introduction to key terminology (delta V, closing
velocity, etc.) we explore the relationships between
crash speed, crash duration, and acceleration as
a way of understanding how some occupants of a
vehicle can escape injury—even in crashes
with large amounts of damage—while others
can be injured in collisions with little or no
vehicle damage. This section contains crash test
footage contrasting a very high speed crash with
a low speed crash in which the subjects, nevertheless,
experienced similar head acceleration. Close-up
occupant footage also highlights a number of important
phenomena, such as ramping, the effects of varying
head restraint geometry, variances between male
and female occupants, and much more. The sequence
of events in typical crashes is covered, as well
as important vehicle and occupant variables affecting
Soft tissue injuries As
regards injury, the key tissues are now known to
be disc, ligament, and the facet joints. End plates
can also be damaged during whiplash injury, as
our research has shown. This section also details
the potential range of other spinal area lesions.
Important symptom patterns, such as dermatomal
and scleratomal patterns are explained. Mild traumatic
brain injuries (MTBI) are not uncommon in whiplash
trauma and are detailed in this section as well.
New research findings have also shown a connection
between whiplash and allergy, breathing disorders,
low back pain, cardiac problems, and digestive
traditional approach to diagnosis is plain radiography,
but even CT and MRI may fail to disclose the soft
tissue lesions attributable to whiplash trauma.
Other forms of evaluation include videofluoroscopy
(cineradiography) and single photon emission computed
tomography (SPECT). Electrodiagnostic tests can
also be useful in some cases and these are discussed
briefly as well.
program touches on the goals of guideline-based
treatment, emphasizing co-management with appropriate
health care providers when required, and stresses
the importance of supportive management, which
might include the use of cervical pillows, nutritional
intervention, home cervical traction, exercise,
and advice regarding activities of daily living.
Risk assessment Risk
assessment is a critically important component
of those cases that are associated with legal action.
The most meaningful evaluation, i.e., the one with
the greatest construct validity from a medicolegal
standpoint, is one in which a trained and experienced
physician has interviewed the victim, performed
a detailed physical examination, reviewed other
available documents and tests, and considered all
of these within the overall framework of known
risk factors (age, gender, stature, awareness of
the crash, the numerous crash parameters, and so
on). Dozens of risk factors have been identified
in clinical and epidemiological research in recent
years and are presented here in the context of
risk for acute injury and risk for poor outcome.
As always, these facts are fully referenced.
The DC as expert Chiropractic
physicians, when well educated in this special
area of traumatology and skilled in forensic examination
and testimony, can provide indispensable assistance
in legal matters pertaining to personal injury.
This section explores the dimensions of their input.
[Note: because this program is easily edited, virtually
any specialist in medicine or chiropractic can
modify it to highlight their special emphasis in
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