Altered thermal sensitivity in facial skin in chronic whiplash-associated disorders

There is a close functional relationship between the jaw and neck regions and it has been suggested that trigeminal sensory impairment can follow whiplash injury.Inclusion of manageable routines for valid assessment of the facial sensory capacity is thus needed for comprehensive evaluations of patients exposed to such trauma.The present study investigated facial thermal thresholds in patients with chronic whiplash-associated disorders（WADs）with both a qualitative method and quantitative sensory testing（QST）.Ten women with pain and dysfunction following a whiplash injury were compared to 10 healthy age-matched women.Thermal detection thresholds were assessed by qualitative chair-side testing and by QST according to the method-of-limits.Seven test sites in the facial skin（overlying each trigeminal branch bilaterally,and the midpoint of the chin）were examined.The detection warm and cold thresholds were defined as the mean values of 10 individual thresholds.For the WAD patients,the qualitative assessment demonstrated both reduced and increased sensitivity compared to the healthy,whereas QST systematically showed significantly higher detection thresholds（i.e.,decreased sensitivity）for both cold and warm stimuli.For the individuals who were assessed as having increased sensitivity in the qualitative assessment,the QST displayed either normal or higher thresholds,i.e.,decreased sensitivity.The results suggest that QST is more sensitive for detecting thermal sensory disturbances in the face than a qualitative method.The impaired thermal sensitivity among the patients corroborates the notion of altered thermal detection capacity induced by WAD-related pain.

Postmortem MSCT Diagnosis of Whiplash Injuries in a Traffic Accident：A Case Report and Review of the Literature

A 45-year-old male car driver died in a traffic accident of four cars rear-end collision on the highway.He was found to have died after a respiratory and cardiac arrest at the scene.No sign of skin injuries was observed from the external inspection.The autopsy was not permitted by the family members because of the local culture.Multislice computed tomography(MSCT)was applied to the current case,showing dislocation of C3~4cervical vertebrae withⅡdegree,C4vertebral plate fractures,and spinal stenosis.Post-mortem MSCT confirmed the diagnosis as whiplash injuries.MSCT was verified to be effective in showing the severity of whiplash injuries,thus providing certain objective evidence for medicolegal expertise.

Assessment of the Biological Damage in Whiplash Syndrome: Role of Digital Infrared Thermal Imaging (DITI) and Ultrasonography (US)

Objectives: To compare DITI vs US in a cohort of patients with whiplash syndrome for assessing soft tissues injuries of the cervical and dorsal spine. Methods: 70 patients presenting to clinic with traumatic cervical and/or dorsal spine injury and with a clinical diagnosis of whiplash syndrome underwent both DITI (AVIO TVS 2000) and US (GE Logic 5) of the following muscles: sternocleidomastoid, splenius, trapezius, longus colli and paravertebral muscles. DITI considered positive in the region with the most altered temperature among the injured area examinated (normal range 0℃ - 0.8℃). US valued the cervical and dorsal region with a comparative examination of the soft tissues. The images taken with DITI were compared with the clinical and the sonographic outcomes respectively. US and DITI were considered a) congruent whether both had a positive outcome for the same muscle clinically injured;b) not congruent whether one of the two instruments had a different outcome then the clinical evidence. Wilcoxon paired test was used for statistical analysis. Results: DITI and US matched 153 of 233 (65%) injured muscles. The association between DITI and US in the evaluation of the injured muscles was statistically significant for the following muscles: left trapezius (p Conclusions: According to our preliminary study, DITI and US were both helpful for assessing soft tissues injuries in patients with whiplash syndrome, defining the extent of the biologic damage for a correct clinical-therapeutical management.

Predictive Factors for Persistent Pain and Poor Recovery of Health Status 1 Year after Whiplash Injury (Quebec Grade 1 and 2): Results from the ESPARR Cohort

Background: A large number of studies have addressed whiplash injury, and many meta-analyses have sought to highlight chronicity factors;the implicated processes, however, remain a matter of debate. The present study used data from the ESPARR cohort (an on-going prospective study of a representative cohort of road accident victims in the Rh?ne administrative département of France). The objectives were to describe the consequences of whiplash injury and to determine prognostic factors for poor recovery and persistent pain at 1 year post-accident. Methods: The cohort included 255 “pure” whiplash victims, 173 of whom responded to the 1-year follow-up questionnaire. Correlations between explanatory variables and health and pain status were explored by modified Poisson regression to provide adjusted relative risk (RR) values. Results: Half of the victims had not fully recovered health status by 1 year. The main factor associated with non-recovery was pain (RR = 1.3;1.0-1.7). A birth in the family preceding the accident emerged as another factor (RR=1.5;1.2-1.9). Victims responsible for their accident were twice as likely to report being free of pain as those not responsible (RR = 0.5;0.3-0.8). No correlation emerged with accident-related characteristics or PTSD. Conclusions: The present results extend our understand- ing of whiplash injury. Residual pain is the fundamental factor causing whiplash victims to feel that they have not recovered good health. Our findings suggest this may be bound up with physical factors (gender susceptibility);external factors such as having to carry weights (such as a baby) and with perceiving oneself as a victim are not incompatible with this hypothesis.

Development of a symptom expectation questionnaire for whiplash injury

Background:Expectations and beliefs appear to be important predictors of outcome following whiplash injury.Instruments for measuring these expectations in the general population have not been well studied.The objective of this study was to develop a simple symptom expectation questionnaire for whiplash injury for use in future research studies. Methods:An existing database of 179 injury-naive subjects who completed a 56-item checklist of expected symptoms for whiplash injury was analyzed to determine which items could correctly identify an a priori case definition of an expecter(a subject who expected at least one of these symptoms would remain chronic following whiplash injury).A total of seven of the 56 items were found to be discriminatory.The identified, discriminatory items were then tested in additional subject groups against the original questionnaire. Results:From the original database of 179 subjects completing a 56-item symptom expectation checklist,119 expected at least one of the 56 symptoms would be chronic following whiplash injury.The 119 expecters.however,all chose at least one of seven items:headache,anxious or worried,depressed,neck pain,problems sleeping,back pain,or jaw pain.Using these seven items,in two new groups of subjects given the 56- item symptom expectation checklist and then a new shortened(7-item) symptom expectation checklist one week later(and the same done for another group of 100 subjects in reverse order),all those who endorsed one of the 56 symptoms as likely to be chronic following whiplash injury (expecters) could also be identified on the 7-item checklist. Conclusion:A shortened(7-item) symptom expectation checklist of commonly reported symptoms following whiplash injury(headache, anxious or worried,depressed,neck pain,problems sleeping,back pain,and jaw pain) correctly identifies subjects who expect at least one symptom will be chronic following minor head injury(i.e.,an expecter).This shortened(7-item) symptom expectation checklist can be used in future population-based studies to understand the prevalence of belief patterns and expectations for whiplash injury.

Evaluation of the test-retest repeatability of the Injury Severity Perception score in patients with acute whiplash-associated disorder

Objective： To determine the test retest repeatability of the Injttry Severity Perception （ISP） score in participants with acute whiplash-associated disorders （WADs）. Methods： Consecutive patients with WAD, presenting in the acute stage to a primary care center, were asked to complete the 1SP score. ISP was measured with a numerical rating scale that ranged from 0 to 10, on which subjects were asked to rate how severe （in terms of damage） they thought their injury was. The anchors were labeled ＂no damage＂ （0） and ＂severe, and maybe permanent damage＂ （10）. The ISP questionnaire was administered to the participants at the time of recruitment and again 7 days later. Repeatability was evaluated by calculating percentage agreement and Cohen kappa statistic between the two time points of measurement. Results： A total of 94 subjects （34 males, 60 females, mean age 40.6 ± 10.0 years, range 19-60 years） were included. The mean 1SP score was 4.9 ± 1.7 （range 2-9 out of 10） at the time of recruitment and 5.1 ± 2.1 （range 2-9 out of 10） 7 days later. The percentage agreement between the two repeat measures of the ISP was 86% and the kappa coefficient was 0.79. Conclusion： This study suggests that the test-retest repeatability for the ISP is high and that it is thus likely to have a low risk of classification bias in prognostic studies. The ISP likely has adequate reliability for use in epidemiological research of WADs.

Correlation between self-reported recovery and central sensitization in whiplash patients

Central sensitization has been associated with chronic pain in whiplash patients.Methods:Consecutive whiplash patients were assessed at 3 months post-whiplash injury with the brachial plexus provocation test(BPPT)as a sign of central sensitization.Self-reported recovery was assessed by the response to the question ‘Do you feel you have recovered fully from your accident injuries?'Results:Sixty-nine subjects(32 males,37 females,age 37.5±13.0 years(mean±SD),range 18-71)were included.Of these,34 reported a lack of recovery,and 35 reported recovery at 3 months post-injury.The mean BPPT elbow extension(from 180°)was 41.5±23.0°,and the mean VAS score for the BPPT was 2.2 ± 1.2(out of 10).Those who reported recovery had a mean BPPT elbow extension angle of 25.1±15.8 while those who did not report recovery had a mean BPPT angle of 58.4 ± 15.9(P＜0.05).The visual analogue scale(VAS)score for recovered subjects was 1.8 ± 1.1 and 2.7 ± 1.1(P＜0.05)for non-recovered.There was a moderate correlation between self-reported recovery and BPPT elbow extension angle(-0.44)and a lower correlation between self-reported recovery and VAS score(-0.30).Conclusion:Self-reported recovery correlates well with a lower likelihood of signs of central sensitization.Copyright(c)2012,Shanghai University of Sport.Production and hosting by Elsevier B.V.All rights reserved.

基于骨架几何位置调整的座椅抗鞭打性能优化

为了减小鞭打试验伤害评估中普遍较高的颈部损伤指标(Neck Injury Criterion,NIC)和上颈部伸张弯矩,基于某汽车座椅的LS-DYNA有限元模型和物理试验结果,首先对其基本结构和后碰撞下的运动响应进行分析,使用多体动力学分析软件(Mathematical Dynamic Model,MADYMO)建立座椅鞭打试验的多体动力学模型.然后,通过伤害机理分析和对座椅主要设计参数的灵敏度分析,确定座椅结构中的主要几何结构参数,并据此建立数值模型.最后,利用多目标优化算法,获得相应的座椅抗鞭打性能优化方案.结果表明,通过调整座椅骨架横梁及头枕位置,提高乘员头部和下颈部运动一致性,使NIC降低58.5%,上颈部伸张弯矩满足最高性能限值.

New Concept of Whiplash Injuries Rehabilitation

Whiplash injuries are a global health problem and a significant financial burden for both health care systems,and insurance providers.The diverse symptomatology after whiplash injury both in the somatic,emotional and behavioral sphere prompted separation of the Whiplash Associated Disorders(WAD)as a separate category of diseases.The exact mechanism of whiplash injury is still under debate and theories explaining pathogenesis of WAD are very diverse ranging from purely biomechanical to neurophysiological,emphasizing central sensitization but the core disability seems to be strictly connected to somatosensory dysfunction.As a result,the optimal algorithm of rehabilitation has not been established and data published in the current literature on effectiveness of such algorithms are inconsistent.Based on the presented here of Head Neutral Reference Point(HNRP),the objective of central desensitization is to restore valid somatosensory output from Cranio-cervical Junction(CCJ).This new concept of rehabilitation after whiplash presented here is based on clinical observations and is supported by initial results.

基于鞭打试验的某座椅总成优化研究

某车型座椅总成在C-NCAP 2024鞭打试验中的主要失分点是颈部伤害值与上颈部扭矩。根据试验结果分析出假人上肩部受力较大、头枕刚性不足等缺陷。为此,建立了座椅的有限元模型,并根据分析结果提出了针对性的优化方案,通过计算结果证明了优化方案的可行性。最后按照优化方案改进了座椅样件,并通过实物试验进一步验证了方案的有效性。

某座椅鞭打试验仿真与优化

针对某款座椅在鞭打试验中假人挥鞭伤较为严重,鞭打得分较低的问题,利用HyperMesh软件建立座椅有限元模型,并进行鞭打仿真分析,得到对鞭打伤害影响较大的因素分别为调角器刚度系数、头枕杆直径、靠背左侧支撑板厚度、靠背右侧支撑板厚度、靠背后部支撑板厚度、座垫右侧支撑板厚度和座垫左侧支撑板厚度,利用哈默斯雷试验设计方法对上述7个设计变量进行样本点采集,并利用移动最小二乘法进行近似模型拟合,采用全局响应面法对近似模型进行多目标优化,验证结果表明,优化模型的精度满足要求,优化后鞭打得分提高,座椅抗挥鞭伤性能显著提升。

冥想应用于颈椎病的研究进展

随着社会节奏的加快,颈椎病已经成为城市人群的常见病、多发病。颈椎病患者时常遭受着颈痛,久而久之造成焦虑、抑郁等负面情绪,严重影响患者的生活质量,给个人、家庭带来巨大的经济及精神负担。近年来,冥想作为一种具有强大生理调节功能的心理训练方式受到了越来越多的关注。冥想可以通过调节机体的神经-内分泌-免疫网络等机制,达到有效去除抑郁、焦虑和缓解压力等作用。冥想有机整合了祖国医学中经络学说、脏象学说、五行学说以及天人合一的理论、情志理论、扶正理论;并结合了现代心身医学、心理治疗和正念冥想中的重要理论与实践;充分利用了传统医学中的自然疗法和音乐疗法。本文将从冥想的概念、冥想对颈椎病的研究成果、冥想对颈椎病的干预策略等方面进行综述。

基于文献计量学分析挥鞭样损伤的研究热点及趋势

目的 基于文献计量学分析挥鞭样损伤(WI)的研究热点及趋势。方法 检索Web of Science^(TM) Core Collection数据库,检索时限为1999年1月1日至2022年12月31日,搜集WI的相关文献,采用CiteSpace6.1.R6软件分析年度发文量变化趋势、国家/地区发文量、研究机构发文量、作者发文量,并进行关键词共现分析、关键词聚类分析、关键词突现分析。结果 1999—2022年Web of Science^(TM) Core Collection数据库收录的WI相关文献共2 790篇,年度发文量总体呈现波动上升的趋势。发文量排名前三的国家为美国、澳大利亚、加拿大。发文量排名前三的研究机构是昆士兰大学、阿尔伯塔大学、悉尼大学。发文量排名前三的作者为Sterling M、Cote P、Nijs J。关键词共349个,出现频次最高的关键词是颈痛、挥鞭样损伤、损伤。关键词可形成8个聚类,分别为颈痛、颈椎、本体感觉、挥鞭样损伤、恢复、效度、中枢敏化、核磁共振。生活质量、慢性挥鞭伤、创伤性脑损伤、中/重度残疾、心理测量特性、震荡等为WI研究领域未来的研究趋势。结论 WI研究热度总体呈现波动上升趋势,研究热点集中于颈痛、挥鞭样损伤、本体感觉、中枢敏化、核磁共振成像等方面,改善患者生活质量、关注患者心理状态、促进慢性WI患者康复、尽早识别合并颅脑损伤的WI患者或将是该领域未来的研究趋势。

复杂钢混组合线下式高铁站房结构设计与抗震分析

钢-混凝土不规则组合框架体系对于线下式高铁站房具有良好的适用性。依托济南至莱芜高速铁路历城站结构设计,研究了钢-混凝土不规则组合线下站房结构设计的关键技术。研究结果表明:采用民用建筑规范与铁路规范相协调的设计方法,能较好地满足线下式站房的要求;钢-混凝土不规则组合结构中的侧向组合能够有效减少上下组合结构中的鞭梢效应;超长门厅钢拱组合桁架采取“抗放结合”的处理措施,可有效解决温度应力的影响;钢混锥台过渡转换节点能确保混凝土与钢结构转换的可行性与可靠性。通过对结构进行动力弹塑性分析,验证了该组合结构满足了既定的性能目标,安全可靠。

基于鞭打性能的座椅靠背型面优化方法

为降低追尾时的挥鞭伤危害,提出一种座椅靠背型面优化方法,论述该方法对头后间隙的影响机制。基于该方法对某款座椅的鞭打性能进行优化,根据CNCAP规程进行试验验证。结果表明:该方法对座椅造型的影响程度较小,优化目标与试验结果吻合较好,假人颈部伤害值降低16.6%,上颈部载荷与下颈部载荷显著降低。

软头枕对某款座椅鞭打损伤的影响分析

佩戴软头枕会改变座椅在追尾事故中的保护效果,但是目前针对佩戴软头枕时的鞭打性能研究几乎没有。为探索软头枕在追尾事故中的作用,设计并完成了佩戴软头枕和未佩戴软头枕两种工况下的鞭打对比试验。结果表明,座椅佩戴软头枕会使假人头部较早的接触座椅,支撑并缓冲假人的头部运动,减缓假人头部向后甩动的剧烈程度;并使假人各部位的损伤减小,颈部伤害峰值明显降低;同时,具有提高座椅鞭打得分的作用。研究成果作为追尾事故的一种预研数据积累,将服务于后续新版鞭打规程的制修订工作。

岩质边坡爆破振动速度的高程放大效应研究

岩质边坡爆破振动的高程放大效应是边坡上振动速度传播规律的重要研究内容之一。基于岩质边坡爆破振动高程响应机制的理论分析以及边坡开挖爆破振动的数值模拟与实例分析,研究边坡爆破振动速度的高程放大效应。结果表明,边坡爆破振动速度的高程放大效应是在一定的条件下产生的,受爆破振动荷载特性及边坡坡形等因素的影响。爆破振动荷载作用下,边坡坡面不同高程台阶岩体结构的自振主频率处于爆破振动荷载主频带范围内,台阶部位岩体结构的振动响应会产生"鞭梢效应",导致台阶部位岩体振动速度放大。在边坡坡形骤变、坡度增大时,边坡上一级台阶岩体的振动速度可大于下一级台阶岩体的振动速度,产生显著的振动速度高程放大效应。坡形相近的条件下,台阶坡脚处的振动速度随高程的增加逐渐减小,不出现振动速度高程放大效应。"鞭梢效应"影响下,边坡台阶边沿的振动速度较大,但应力、应变较同高程台阶坡脚处的小,边沿部位的振动速度不适宜评价边坡的稳定性。

高层结构的鞭梢效应分析

系统地探讨了结构产生鞭梢效应的原因 ,发现当突出物的基本频率与整体结构的固有频率相同或相近 ,并与地面扰频相接近时 ,最易发生鞭梢效应 ,通过适当调整结构的刚度或质量分布使突出物的频率与整体结构的频率的差值增大 ,可减少鞭梢效应的影响 。

筒承式群仓的地震作用分析及试验研究

通过模型试验及计算机分析,对钢筋混凝土筒承式群仓的自振特性及地震作用进行了研究,分析其变化规律和影响因素。提出了筒承式群仓平动自振基频、结构基本振型指数的计算公式及简化设计方法。

中国汽车安全技术的现状与展望

面对中国交通事故伤亡率高的现状,企业、学校、研究机构都加大了对汽车安全技术研究开发的投入,加快了安全技术研发能力的提升和产品化进程。自主品牌汽车C-NCAP五星高分的获得标志着中国被动安全技术的飞跃性发展。进一步开展对行人保护、后排乘员保护、防后碰鞭打保护以及骑自行车人保护等被动安全研究的同时,主动安全系统、预碰撞系统、智能化汽车网络系统的研究开发已经成为关注的热点,更高层次的乘员、车和环境等相关主被动安全技术的统合协调,将推动零碰撞零伤亡汽车安全理念的实现。国家级研究开发及产业化大课题的设立、法规标准的建立和完善将会成为汽车安全技术快速发展的动力。