Taylor John Am, Burke Jeanmarie, Gavencak John, Panwar Pervinder
New York Chiropractic College, 2360 State Route 89, Seneca Falls, NY 13148.
J Can Chiropr Assoc. 2005 Mar;49(1):32-9.
Cervical spine injuries sustained in rear-end crashes cost at least $7 billion in insurance claims annually in the United States alone. When positioned correctly, head restraint systems have been proven effective in reducing the risk of whiplash associated disorders. Chiropractors should be knowledgeable about the correct use of head restraint systems to educate their patients and thereby prevent or minimize such injuries.
The primary objective of this study was to determine the prevalence of correct positioning of car seat head restraints among the interns at our institution. The secondary objective was to determine the same chiropractic interns' knowledge of the correct positioning of car seat head restraints. It was hypothesized that 100 percent of interns would have their head restraint correctly positioned within an acceptable range and that all interns would possess the knowledge to instruct patients in the correct positioning of head restraints.
Cross-sectional study of a convenient sample of 30 chiropractic interns from one institution.
Interns driving into the parking lot of our health center were asked to volunteer to have measurements taken and to complete a survey. Vertical and horizontal positions of the head restraint were measured using a beam compass. A survey was administered to determine knowledge of correct head restraint position. The results were recorded, entered into a spreadsheet, and analyzed.
13.3 percent of subjects knew the recommended vertical distance and only 20 percent of subjects knew the recommended horizontal distance. Chi Square analyses substantiated that the majority of subjects were unaware of guidelines set forth by the National Highway Traffic Safety Administration (NHTSA) for the correct positioning of the head restraint (chi(2) (vertical) = 16.13, chi(2) (horizontal) = 10.80, p <.05). Only 6.7 percent of the subjects positioned their head restraint at the vertical distance of 6 cm or less (p <.05). However, 60 percent of the subjects positioned their head restraint at the recommended horizontal distance of 7 cm or less, but this was no different than could be expected by chance alone (p >.05). Interestingly, the 13.3 percent of the subjects who were aware of the vertical plane recommendations did not correctly position their own head restraint in the vertical plane. Similarly, only half of the subjects who were aware of the horizontal plane recommendations correctly positioned their head restraint in the horizontal plane. The data suggest that chance alone could account for the correct positioning of the head restraint in our subjects.
The results of this cross-sectional study raise concerns about chiropractic intern knowledge and application of correct head restraint positioning. The importance of chiropractors informing patients of the correct head restraint position should be emphasized in chiropractic education to help minimize or prevent injury in patients involved in motor vehicle collisions.
仅在美国，每年因追尾事故导致的颈椎损伤所产生的保险理赔费用就至少达70亿美元。当正确放置时，头枕系统已被证明能有效降低挥鞭样损伤相关疾病的风险。脊椎按摩师应了解头枕系统的正确使用方法，以便对患者进行教育，从而预防或尽量减少此类损伤。
本研究的主要目的是确定我校实习生中汽车座椅头枕正确放置的普及率。次要目的是确定这些脊椎按摩实习生对头枕正确放置的知识掌握情况。研究假设是100%的实习生能将头枕正确放置在可接受范围内，且所有实习生都具备指导患者正确放置头枕的知识。
对来自一所院校的30名脊椎按摩实习生的便利样本进行横断面研究。
要求驾车驶入我校健康中心停车场的实习生自愿接受测量并完成一项调查。使用光束罗盘测量头枕的垂直和水平位置。通过一项调查来确定对头枕正确位置的知识掌握情况。记录结果，输入电子表格并进行分析。
13.3%的受试者知道推荐的垂直距离，只有20%的受试者知道推荐的水平距离。卡方分析证实，大多数受试者不知道美国国家公路交通安全管理局（NHTSA）规定的头枕正确放置指南（卡方（垂直）=16.13，卡方（水平）=10.80，p<.05）。只有6.7%的受试者将头枕放置在垂直距离6厘米或更小处（p<.05）。然而，60%的受试者将头枕放置在推荐的水平距离7厘米或更小处，但这与仅靠随机预期的情况并无差异（p>.05）。有趣的是，13.3%知道垂直平面建议的受试者并未在垂直平面上正确放置自己的头枕。同样，在知道水平平面建议的受试者中，只有一半在水平平面上正确放置了头枕。数据表明，受试者头枕的正确放置可能只是偶然。
这项横断面研究的结果引发了对脊椎按摩实习生对头枕正确放置知识及应用情况的担忧。在脊椎按摩教育中应强调脊椎按摩师告知患者头枕正确位置的重要性，以帮助尽量减少或预防机动车碰撞事故中患者的损伤。
