مدل شبیه سازی کامپیوتری سقوط اطفال از تخت خواب: تجزیه و تحلیل حساسیت پارامتری

Falls from beds and other household furniture are common scenarios that may result in injury and may also be stated to conceal child abuse. Knowledge of the biomechanics associated with short-distance falls may aid clinicians in distinguishing between abusive and accidental injuries. In this study, a validated bed fall computer simulation model of an anthropomorphic test device representing a 12-month-old child was used to investigate the effect of altering fall environment parameters (fall height, impact surface stiffness, initial force used to initiate the fall) and child surrogate parameters (overall mass, head stiffness, neck stiffness, stiffness for other body segments) on fall dynamics and outcomes related to injury potential. The sensitivity of head and neck injury outcome measures to model parameters was determined. Parameters associated with the greatest sensitivity values (fall height, initiating force, and surrogate mass) altered fall dynamics and impact orientation. This suggests that fall dynamics and impact orientation play a key role in head and neck injury potential. With the exception of surrogate mass, injury outcome measures tended to be more sensitive to changes in environmental parameters (bed height, impact surface stiffness, initiating force) than surrogate parameters (head stiffness, neck stiffness, body segment stiffness).

Falls from beds and other household furniture are common scenarios that may result in injury and may also be stated to conceal child abuse [1], [2], [3] and [4]. Identification of important factors related to injury potential in short-distance falls may aid clinicians in history-taking and improve assessments of injury and history compatibility when distinguishing between abusive and accidental injuries. Fall environment and child (fall victim) factors have been shown in previous studies to be related to injury potential in short falls [5], [6], [7], [8], [9], [10] and [11]. However, many of these studies have been limited by the biofidelity of anthropomorphic surrogates used to represent the fall victim [5], [7], [8], [9], [10] and [11]. Mechanical response requirements for pediatric surrogates are often based on scaled adult cadaver or primate data and may not accurately represent a human child. Computer simulation modeling is a tool that can be used to investigate injury-producing events, and to study the effect of changing event parameters on injury potential. Within the model, parameters that can be altered include fall environment parameters (such as fall height and impact surface) and child surrogate parameters (such as mass and mechanical properties of joints and tissues) which are difficult to alter experimentally. Computer simulation has been widely used by the automotive industry to study motor vehicle crash events, and has also been used in a few studies to investigate falls [12], [13], [14], [15], [16], [17] and [18]. A computer simulation model of a 12-month-old child surrogate falling from an elevated horizontal surface such as a bed was previously developed and validated [19]. The purpose of this study was to use the validated model to investigate the effect of altering fall environment and surrogate parameters on biomechanical measures related to injury potential. This will serve to identify key factors that may increase a child's risk of injury in a given fall scenario.