Biomechanical Evaluation of Head Kinematics During Infant Shaking Versus Pediatric Activities of Daily Living.

Abstract

Abusive shaking of infants has been asserted as a primary cause of subdural bleeding, cerebral edema/brain swelling, and retinal hemorrhages. Manual shaking of biofidelic mannequins, however, has failed to generate the rotational accelerations believed necessary to cause these intracranial symptoms in the human infant. This study examines the apparent contradiction between the accepted model and reported biomechanical results. Researchers collected linear and angular motion data from an infant anthropomorphic test device during shaking and during various activities of daily life, as well as from a 7-monthold boy at play in a commercial jumping toy. Results were compared among the experimental conditions and against accepted injury thresholds. Rotational accelerations during shaking of a biofidelic mannequin were consistent with previous published studies and also statistically indistinguishable from the accelerations endured by a normal 7-month-old boy at play. The rotational accelerations during non-contact shaking appear to be tolerated by normal infants, even when repetitive.