Date on Master's Thesis/Doctoral Dissertation

12-2018

Document Type

Master's Thesis

Degree Name

M. Eng.

Department

Bioengineering

Committee Chair

Bertocci, Gina E.

Committee Member

Thompson, Angela K.

Committee Member

Bertocci, Karen L.

Author's Keywords

biomechanical study; child abuse; short-distance falls; video-recorded falls; pediatric head injury; biometric device

Abstract

Falls are commonly used as a false history by caregivers to conceal child abuse. Determining biomechanical compatibility is a key aspect in differentiating abuse from accident. Current forensic approaches are limited in assessing biomechanical compatibility of short-distance falls involving children due to a lack of reliable witnessed falls with known injury outcomes. The goals of this pilot study were to characterize biomechanical measures and to examine differences in biomechanical measures based on child and fall characteristics in reliable witnessed video-recorded falls involving children. The results of this study will serve as preliminary data for an on-going larger study with the aim of improving forensic investigations with a fall history. Children between the ages of 1-3 years in a video monitored childcare center were equipped with a biometric measuring device that collected head accelerations and velocities during falls. Additionally, Head Injury Criteria (HIC) values and impact durations were determined. Video surveillance was used to capture fall dynamics and to provide reliable witnessed falls. For each fall event, whole-body impact biomechanics were determined using fall characteristics, coefficient of restitution measurements, and child anthropometric measurements. The results of the study indicate that fall characteristics had an effect on biomechanical measures. Falls with head impact were associated with greater head accelerations and shorter impact durations and thus, would be associated with an increased likelihood of injury risk compared to falls without head impacts. Head biomechanical measures also increased for falls onto stiffer surfaces than falls onto less stiff surfaces. Falls from height resulted in an increase in whole-body biomechanical measures compared to ground based falls. Fall events that resulted in head impacts with objects prior to impacting the ground were associated with greater biomechanical measures and injury risk than any other falls. However, no injuries requiring medical care occurred to any child and biomechanical measures obtained indicated that there was a low level of injury risk. To our knowledge, this was the first study of video-recorded pediatric falls that included biometric measurement of head biomechanics. Findings from this study address the on-going question as to whether short-distance falls can cause severe or fatal injuries, and can potentially aid forensic investigations in determining if a fall history could account for a child’s presenting injuries. Future work will expand the fall sample size to further advance our understanding of fall biomechanics and injury risk in children.

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