• Low Speed Rear Impact Crashes (LOSRIC) don't cause injuries.
• Injuries heal in 6-12 weeks.
• Litigation has an effect on the patient's recovery.
• The patient's pre-injury psychological makeup affects recovery.
• Greater vehicle damage=greater occupant injury.
• Accident reconsctructionists can predict injury potential.

• In a series of recent human volunteer crash tests of low speed rear impact collisions, it was reported that the threshold for cervical spine soft tissue injury was 5 mph (delta V) (17).
• Most injuries occur at speeds below 12 mph.
• The peak acceleration of the head is greater than the peak acceleration of the vehicle.
• A 5 mph delta V crash typically produces about 10-12 g of acceleration of the occupant's head.
• Other reports have shown that crashed cars can often withstand collision speeds of 10 mph or more without sustaining damage (13-15,26,41). Thus: the concept of "no crush, no cash" is simply not valid.
• Recent epidemiological studies have shown that most injury rear impact accidents occur at crash speeds of 6 mph to 12 mph (19,20)--the majority at speeds below the threshold for property damage to the vehicle.
• A number of risk factors in rear impact accident injury have now been verified including: rear (vs. other vector) impact (5,8,45, 47,48,51,1 54,155,166-174), loss of cervical lordotic curve (55,68), preexisting degenerative changes (50,53,55,155,164), the use of seat belts and shoulder harness (165,167,171,175), poor head restraint geometry (7,19,176), non-awareness of the impending collision (6,9,15,174), female gender (40,43-46,50), and head rotation at impact (23,49).
• The notion of litigation neurosis has been rather definitively dispelled (23,44,45,50-63).
• Once thought to suggest minimal injury, a delay in onset of symptoms has been shown to be the norm, rather than the exception (8,15,21,23,63,81,82,84,92,10,147,148,1).
• Mild traumatic brain injury can result from whiplash trauma. Often the symptoms are referred as the post concussion syndrome. This condition, often maligned in the past, has now been well-validated in recent medical literature (88,159-161).
• A recent outcome study of whiplash patients reported in the European Spine Journal found that between one and two years post injury, 22% of patients' conditions deteriorated (153). This second wave of symptoms has been observed by others as well (81).
• Radanov et al. (23) followed whiplash patients through time and reported that 45% remained symptomatic at 12 weeks, and 25% were symptomatic at 6 months. Other researchers have reported time to recovery in the most minor of cases at 8 weeks; time to stabilization in the more severe cases at 17 weeks; and time to plateau in the most severe categories as 20.5 weeks (153). Thus, the notion that whiplash injuries heal in 6-12 weeks is challenged. (Incidentally, there never has been any real support for this common myth.)
• Each year, 1.99 million Americans are injured in whiplash accidents (1,35).
• Of the 31 important whiplash outcome studies published since 1956 (19 published since 1990 pooling patients from all vectors of collision (i. e., rear, frontal, and side impacts), a mean of 40% still symptomatic is found. For rear impact only, a mean of 59% remain symptomatic at long-term follow-up.
• Although estimates vary, about 10% of all whiplash victims becomes disabled (79).
• The Quebec Task Force on Whiplash-Associated Disorders (2) has been criticized on the basis of potential bias, study design, the use of ambiguous and misleading terminology, and for developing conclusions that are not supported by the literature.
• The chiropractic profession has developed its own guidelines for management of whiplash patients.

[In essence, these are the guidelines that Dr. Croft developed several years ago and the ones demonstrated in Slide 59 of his program. The chiropractic profession has not universally adopted these guidelines, but they have been widely published and are accepted by many chiropractors. It is my hope further research will allow us to refine and modify these guidelines.]  Module 3 Arthur C. Croft, M.S., D.C. Page 95

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