Wednesday, March 25, 2009

Car ratings Atlanta

The insurance industry designated dozens of new cars and trucks, led by Ford Motor Co. and its Volvo subsidiary, to its annual list of the safe st vehicles Tuesday, helped by the increased use of anti-rollover technology. Ford and Volvo had 16 vehicles in the 2009 model year on the Insurance Institute for Highway Safe ty's list of the safe st new cars , followed by Honda Motor Co. with 13 vehicles. Seventy-two cars , trucks and SUVs received the top safe ty pick designation for 2009, more than double the number of vehicles in the 2008 model year and three times the number in 2007. "The sheer number of this year's winners indicates that automakers have made huge strides to improve crash protection," said Institute president Adrian Lund. The selected vehicles are the best in protecting people in front, side and rear crash tests based on institute evaluations during the year.

The vehicles are required to have electronic stability control, or ESC, to qualify for the award. IIHS said electronic stability control is now standard equipment on virtually all new SUVs and three-quarters of passenger cars for the 2009 model year. ESC is standard on more than one-third of 2009 pickups. Ford was led by the Ford Fusion and Mercury Milan midsize cars with optional ESC; the Ford F-150 pickup, Ford Edge and Ford Flex midsize sport utility vehicles; and the Ford Escape and Mercury Mariner small SUVs.

The list also included the Mazda Tribute, which has the same underpinnings as the Escape and Mariner. Ford CEO Alan Mulally argued last week in Washington that the automaker had made safe ty strides when he testified along with other Big Three executives seeking massive government aid. "Every year, we're going to improve the quality, we're going to improve the fuel efficiency, we're going to improve the safe ty, and we're going to keep improving the productivity so we can offer the consumer the very best value," Mulally told a House committee.

Honda and its Acura unit had vehicles in nearly every category, including top-sellers such as the Honda Accord; the Honda Civic 4-door with optional ESC; and the Acura MDX and RDX midsize SUVs; and the Honda Fit with optional ESC. The Fit is the first mini-car to earn the safe ty award. Volkswagen AG and its Audi brand had nine vehicles on the list, including the Volkswagen Jetta and Passat and the Audi A3, A4 and A6. General Motors Corp. and Toyota Motor Corp. both had eight vehicles on the list. GM's included the Cadillac CTS and the Buick Enclave, Chevrolet Traverse, GMC Acadia and Saturn Outlook large SUVs. Toyota's top performers were the Toyota Corolla with optional ESC, Toyota RAV4, Toyota Tacoma, Toyota Tundra and Scion xB.

Using the awards, consumers can compare vehicles without having to review results from multiple tests. Automakers pay close attention to the institute's findings and frequently note positive ratings in television commercials. The institute has advocated for an early adoption of anti-rollover technology such as ESC ahead of a government requirement for the systems by the 2012 model year. Electronic stability control senses when a driver may lose control and automatically applies brakes to individual wheels to keep the vehicle stable and avoid a rollover. It helps motorists avoid skidding across icy or slick roads or keep control when swerving to avoid an unexpected object in the road.

IIHS said Chrysler LLC was the only major automaker that did not receive a single award. They said Chrysler could have picked up five awards if the head restraints had been improved in the Dodge Avenger and Chrysler Sebring, the Sebring convertible and the Dodge Grand Caravan and Chrysler Town and Country. Chrysler spokesman Cole Quinnell said he could not comment on whether the head restraints might be upgraded in the future. He said Chrysler vehicles are equipped with a variety of safe ty features and the institute's results "are just one of the sources of information about a vehicle's crash performance."

Friday, March 20, 2009

Whiplash Symptoms

Whiplash is a nonmedical term used to describe neck pain following an injury to the soft tissues of your neck (specifically ligaments, tendons, and muscles). It is caused by an abnormal motion or force applied to your neck that causes movement beyond the neck's normal range of motion.

* Whiplash happens in motor vehicle accidents, sporting activities, accidental falls, and assault.

* The term whiplash was first used in 1928, and despite its replacement by synonyms (such as acceleration flexion-extension neck injury and soft tissue cervical hyperextension injury), it continues to be used to describe this common soft tissue neck injury. Your doctor may use the more specific terms of cervical sprain, cervical strain, or hyperextension injury.

The most frequent cause of whiplash is a car accident. The speed of the cars involved in the accident or the amount of physical damage to the car may not relate to the intensity of neck injury; speeds as low as 15 miles per hour can produce enough energy to cause whiplash in occupants, whether or not they wear seat belts.

* Other common causes of whiplash include contact sport injuries and blows to the head from a falling object or being assaulted.

*Repetitive stress injuries or chronic strain involving the neck (such as using your neck to hold the phone) are a common, non-acute causes.

These signs and symptoms may occur immediately or minutes to hours after the initial injury; the sooner after the injury that symptoms develop, the greater the chance of serious damage.

* Neck pain

* Neck swelling

* Tenderness along the back of your neck

* Muscle spasms (in the side or back of your neck)

* Difficulty moving your neck around

* Headache

* Pain shooting from your neck into either shoulder or arm

Friday, March 6, 2009

Who's at Risk of Developing Chronic Whiplash?

Auto injuries are a common problem seen in clinical practice. Most of the time, a patient will have some temporary discomfort that will resolve within a few weeks. A significant percentage of patients – around 20 to 30% – will develop some kind of chronic pain or disability from their injury. Four recent studies have looked at the issue of chronic pain to see if there are any predictive factors that can help us determine who is at risk of developing long-term problems.

The following is a list of documented risk factors found in these studies:

Gender. One of the four studies4 found that women were more likely than men to be injured in general, which confirms previous studies. Researchers speculate that the lower muscle mass in female necks may increase the risk of injury.

Turned head. Two recent studies have been done on this issue, and they both have found that when the occupant’s head is turned at the moment of impact, the spine is exposed to motion that exceeds the normal physiological range. This can result in ligament tears or damage to the spinal nerve roots.2

Direction of impact. It has been known for years that a rear-end collision is more likely to result in injury than is a frontal collision. Pape et al.1 found in their study that rear-end collisions were a greater risk factor than frontal impacts.

Previous injuries. It’s not surprising that a pre-existing injury to the neck or shoulder could be worsened after an auto collision, and that’s what Pape et al.1 found. In fact, patients with a history of neck and/or shoulder pain were more than twice as likely to have chronic problems three years after the collision.

Muscular tension immediately after the crash. Pape et al.1 found that patients with increased muscular tension soon after the crash were 3.43 times as likely to develop long-term symptoms.

Reduced range of motion. Sterling et al.3 found, as have other studies, that reduced ROM predicts symptoms two to three years after the injury.

Immediate pain and/or numbness. Both Sterling3 and Berglund4 found that patients who reported symptoms immediately after the crash were more likely to develop chronic pain. Immediate numbness indicates that the patient suffered some kind of nerve injury in the collision, and unless these types of injuries are diagnosed and treated quickly, they could easily develop into chronic pain. Berglund4 found that these patients were 6.5 times as likely to develop long-term problems.

The issues of reduced ROM and increased muscular tension are related, and understanding this issue is critical in treating auto injury patients. Upon injury to the disk or ligaments of the spine, an immediate reflex reaction is instigated – causing surrounding muscles to contract. This muscular guarding can be palpated as tension or inflammation. The increased muscular activity has the result of restricting ROM. How do these symptoms predict chronic pain? If the underlying tissue damage – ligament or disk – does not heal properly, long-term pain and restricted motion can result.

These studies help us treat auto injury cases in two ways: first, they demonstrate the need to take a careful and thorough history of the collision. For instance, asking the patient if his or her head was turned at the moment of impact can help us diagnose the injury. Second, by being aware of risk factors, we can focus our attention on those patients more likely to suffer long-term consequences of their injury.

1. Pape E, Brox JI, Hagen KB, et al. Prognostic factors for chronic neck pain in persons with minor or moderate injuries in traffic accidents. Accident Analysis and Prevention 2007 Jan;39(1):135-46.
2. Panjabi MM, Ivancic PC, Maak TG, et al. Multiplanar cervical spine injury due to head-turned rear impact. Spine 2006;31(4):420-429.
3. Sterling M, Jull G, Kenardy J. Physical and psychological factors maintain long-term predictive capacity post-whiplash injury. Pain 2006;122:102-108.
4. Berglund A, Bodin L, Jensen I, et al. The influence of prognostic factors on neck pain intensity, disability, anxiety and depression over a 2-year period in subjects with acute whiplash injury. Pain 2006;125(3):244-56.