Whiplash-Associated Disorders

Ferrara, S. D.; Ananian, Viviana; Baccino, É.; Banczerowski, Péter; Daniele, Bruno; Boscolo‐Berto, Rafael; Domenici, Ranieri; Quevedo, Javier Gorriz; Graw, Matthias; Hell, Wolfram; Cueto, Claudio Hernández; Knudsen, Peter Juel Thiis; Masiero, Stefano; Montisci, Massimo; Norelli, Gian Aristide; Pinchi, Vilma; Raudys, Romas; Raul, Jean Sébastien; Sterzik, Vera; Tessitore, Enrico; Tuusov, Jana; Vanezis, Peter; Vermylen, Yvo; Vieira, Duarte Nuno; Viel, Guido; Viero, Alessia; Villanueva, Enrique; Zoia, R.

doi:10.1007/s00414-015-1243-x

Cited by 17 publications

(5 citation statements)

References 12 publications

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“…Notably, in the cases in which torture acts with kicks and fists are reported, we did not find any scars, while beatings with the rifle butt or falls on the ground or against hard floors almost always leave scars. In about one-third of cases (28%), we did not find skin scars but the after effect of fractures, painful limitation of movement, or functional impairment [28,29]. Some blunt instrument injuries can be considered more specific.…”

Section: Discussionmentioning

confidence: 98%

Tortures alleged by migrants in Italy: compatibility and other medicolegal challenges

et al. 2021

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Background Illegal immigration to Europe is a well-known phenomenon whose numbers are being steadily increasing in recent years. Most of the immigrants in Italy come from war zones, and many of them submit an asylum application supported by the complaint to have been victims of persecutory acts in their home countries. Material and methods One hundred ninety-six medicolegal reports are analyzed considering the different country of origin, the type of the lesions claimed, tools used, evidenced effects, location of the perpetration of the physical abuses, and the possible motivation of the alleged torture. Results Greater than 80% of the assessed asylum seekers are over 18-year males coming from African countries. Fifty-eight percent of migrants were tortured or abused in countries of transit, 95% in Libya. Economic, familial, politic, and ethnic reasons prevail in some countries of origin, while tortures or abuses perpetrated in transit countries are mainly linked to forced labor and detention. In the 42.2% of cases, no physical evidence of tortures was detected. The Istanbul Protocol resulted to have been only partly applicable and about 40% of the medicolegal reports are “inconclusive” about the compatibility of physical evidence with the alleged tortures. Conclusions The medicolegal and forensic experts involved in torture and ill-treatment cases should seek specific education and training to lower the risks of underestimation and the rate of inconclusive reports. More extensive implementation of the Istanbul Protocol in daily practice should be pursued by the authorities in charge of asylum or protection releasement.

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Section: Discussionmentioning

confidence: 98%

Tortures alleged by migrants in Italy: compatibility and other medicolegal challenges

et al. 2021

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“…Insurance claims related to injuries following whiplash-related accidents are substantial, associated with high costs, and have a significant impact on healthcare, legal, and economic systems worldwide [ 3 , 4 ]. Possible symptoms related to whiplash are numerous and heterogeneous, and the absence of demonstrable pathoanatomical signs that characterise chronic WAD makes its diagnosis largely based on self-reported symptoms, hence, particularly vulnerable to malingering [ 11 ]. Indeed, the need for accurate assessment methods that take into account the wide range of symptom manifestations was recognised long ago [ 12 ], and suspicious symptom presentations among whiplash claimants represent a well-known and longstanding problem [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, current medical diagnostic techniques are unable to detect soft tissue injuries accurately, which are predominant in minor WAD [ 1 , 10 ]. For this reason, these disorders are difficult to diagnose and objectify and, at the same time, easy to simulate [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

The detection of malingering in whiplash-related injuries: a targeted literature review of the available strategies

et al. 2021

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Objective The present review is intended to provide an up-to-date overview of the strategies available to detect malingered symptoms following whiplash. Whiplash-associated disorders (WADs) represent the most common traffic injuries, having a major impact on economic and healthcare systems worldwide. Heterogeneous symptoms that may arise following whiplash injuries are difficult to objectify and are normally determined based on self-reported complaints. These elements, together with the litigation context, make fraudulent claims particularly likely. Crucially, at present, there is no clear evidence of the instruments available to detect malingered WADs. Methods We conducted a targeted literature review of the methodologies adopted to detect malingered WADs. Relevant studies were identified via Medline (PubMed) and Scopus databases published up to September 2020. Results Twenty-two methodologies are included in the review, grouped into biomechanical techniques, clinical tools applied to forensic settings, and cognitive-based lie detection techniques. Strengths and weaknesses of each methodology are presented, and future directions are discussed. Conclusions Despite the variety of techniques that have been developed to identify malingering in forensic contexts, the present work highlights the current lack of rigorous methodologies for the assessment of WADs that take into account both the heterogeneous nature of the syndrome and the possibility of malingering. We conclude that it is pivotal to promote awareness about the presence of malingering in whiplash cases and highlight the need for novel, high-quality research in this field, with the potential to contribute to the development of standardised procedures for the evaluation of WADs and the detection of malingering.

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“…The way the patients are diagnosed in each country affects the global consideration of the pathology and, therefore, might predispose health professionals to face the patient with mistrust [36]. Guidelines for the assessment of the WAD advise to objectively quantify the signs of the patient with the objective of correctly staging them and proposing the best therapeutic options [37]. It seems, however, that the staging of the patient according to objective signs is not done on a basis in the gathered sample of cases.…”

Section: Plos Onementioning

confidence: 99%

Improving the staging of neck injuries using a new index, the Neck Functional Holistic Analysis Score: Clustering approach to determine degrees of impairment

Fidalgo-Herrera¹,

Jové-Blanco²,

Martínez-Beltrán

et al. 2020

PLoS ONE

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Background Traumatic cervical spine injuries are amongst the traffic injuries that can cause most harm to a person. Classifying subtypes of clinical presentations has been a method used in other pathologies to diagnose more efficiently and to address the appropriate treatment and the prognosis. The management of patients suffering from cervical injuries could be improved by classifying the severity of the impairment. This will allow clinicians to propose better treatment modalities according to the severity of the injury. Materials and methods The present study is a retrospective cohort study performed with the clinical data from 772 patients stored at Fisi-(ON) Health Group. All the patients treated for cervical spine injuries are evaluated using the EBI-5 ® system, which is based on inertial measurement unit (IMU) technology. The normalized range of motion of each patient was incorporated into a single index, the Neck Functional Holistic Analysis Score (NFHAS). Results Clustering analysis of the patients according to their NFHAS resulted in five groups. The Kruskal-Wallis H test showed that there were statistically relevant differences in the ROM values and NFHAS of the patients depending on the cluster they were assigned to: FE X 2 (4) = 551.59, p = 0.0005; LB ROM X 2 (4) = 484.58, p = 0.0005; RT ROM X 2 (4) = 557.14, p = 0.0005; NFHAS X 2 (4) = 737.41, p = 0.0005. Effect size with ηp 2 for the comparison of groups were: FE = 0.76, LB = 0.68, RT = 0.76 and NFHAS = 0.96.

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Whiplash-Associated Disorders

Cited by 17 publications

References 12 publications

Tortures alleged by migrants in Italy: compatibility and other medicolegal challenges

Tortures alleged by migrants in Italy: compatibility and other medicolegal challenges

The detection of malingering in whiplash-related injuries: a targeted literature review of the available strategies

Improving the staging of neck injuries using a new index, the Neck Functional Holistic Analysis Score: Clustering approach to determine degrees of impairment

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