Whiplash-associated disorders in frontal impacts: influencing factors and consequences.

This multidisciplinary in-depth investigation of accidents using 24 occupants with neck symptoms shows the complexity of whiplash-associated disorders (WAD) in frontal impacts with respect to factors that influence occurrence as well as duration of symptoms. Several different occupant kinematics have been identified, all resulting in symptoms classified as WAD. Compared to occupants restrained only by a seat belt, occupants with arm resistance influence showed a greater representation of symmetrical neck symptoms. Two cases of unbelted occupants with a neck compression mechanism far from conventional "whiplash" motion were found. Posture as well as physical and psychosocial factors such as strong negative reactions, bad prognosis expectation, and stressed daily activities influenced the duration of symptoms. Occupant characteristics and sitting posture and behavior at the time of impact are important factors when analyzing and understanding WAD.