title: Biomechanical Response of the Infant Head to Shaking: An Experimental Investigation.
abstract: Controversy exists regarding whether violent shaking is harmful to infants in the absence of impact. In this study, our objective was to characterize the biomechanical response of the infant head during shaking through use of an instrumented anthropomorphic test device (commonly referred to as a "crash test dummy" or surrogate) representing a human infant and having improved biofidelity. A series of tests were conducted to simulate violent shaking of an infant surrogate. The Aprica 2.5 infant surrogate represented a 5th percentile Japanese newborn. A 50th percentile Japanese adult male was recruited to shake the infant surrogate in the sagittal plane. Triaxial linear accelerometers positioned at the center of mass and apex of the head recorded accelerations during shaking. Five shaking test series, each 3-4 sec in duration, were conducted. Outcome measures derived from accelerometer recordings were examined for trends. Head/neck kinematics were characterized during shaking events; mean peak neck flexion was 1.98 radians (113 degrees) and mean peak neck extension was 2.16 radians (123 degrees). The maximum angular acceleration across all test series was 13,260 radians/sec2(during chin-to-chest contact). Peak angular velocity was 105.7 radians/sec (during chin-to-chest contact). Acceleration pulse durations ranged from 72.1 to 168.2 ms. Using an infant surrogate with improved biofidelity, we found higher angular acceleration and higher angular velocity than previously reported during infant surrogate shaking experiments. Findings highlight the importance of surrogate biofidelity when investigating shaking.
authors.affiliation: 1 Department of Pediatrics, University of Washington School of Medicine , Seattle, Washington.
authors.forename: Carole A
authors.initials: CA
authors.lastname: Jenny
authors.affiliation: 2 Department of Bioengineering, University of Louisville , Louisville, Kentucky.
authors.forename: Gina
authors.initials: G
authors.lastname: Bertocci
authors.forename: Tsuguhiro
authors.initials: T
authors.lastname: Fukuda
authors.affiliation: 3 GESAC, Inc. , Silver Spring, Maryland.
authors.forename: Nagarajan
authors.initials: N
authors.lastname: Rangarajan
authors.affiliation: 3 GESAC, Inc. , Silver Spring, Maryland.
authors.forename: Tariq
authors.initials: T
authors.lastname: Shams
mesh_terms: D061725:Accelerometry; D001696:Biomechanical Phenomena; D000070642:Brain Injuries, Traumatic / Q000209:etiology*; D006259:Craniocerebral Trauma / Q000209:etiology*; D006801:Humans; D007223:Infant; D008953:Models, Anatomic; D019838:Neck Injuries / Q000209:etiology; D038642:Shaken Baby Syndrome / Q000209:etiology*
keywords: biomechanics; child abuse; pediatric injury; shaking; traumatic brain injury