Objective: To determine if health outcomes and demographics differ according to helmet status between persons with cycling-related traumatic brain injuries (TBI). Methods: This is a retrospective study of 128 patients admitted to the Montreal General Hospital following a TBI that occurred while cycling from 2007-2011. Information was collected from the Quebec trauma registry and the coroner's office in cases of death from cycling accidents. The independent variables collected were socio-demographic, helmet status, clinical and neurological patient information. The dependent variables evaluated were length of stay (LOS), extended Glasgow outcome scale (GOS-E), injury severity scale (ISS), discharge destination and death. Results: 25% of cyclists wore a helmet. The helmet group was older, more likely to be university educated, married and retired. Unemployment, longer intensive care unit (ICU) stay, severe intracranial bleeding and neurosurgical interventions were more common in the no helmet group. There was no significant association between the severity of the TBI, ISS scores, GOS-E or death and helmet wearing. The median age of the subjects who died was higher than those who survived. Conclusion: Cyclists without helmets were younger, less educated, single and unemployed. They had more severe TBIs on imaging, longer LOS in ICU and more neurosurgical interventions. Elderly cyclists admitted to the hospital appear to be at higher risk of dying in the event of a TBI. Les variables indépendantes recueillies étaient les données sociodémographiques, le port du casque, l'information clinique et neurologique. Les variables indépendantes étaient la durée du séjour hospitalier, le score à l'échelle de devenir de Glasgow étendue (GOS-E), le score à l'ISS (injury severity scale), la destination au moment du congé hospitalier et le décès. Résultats: Vingt-cinq pour cent des cyclistes portaient un casque. Le groupe de patients qui portaient un casque était plus âgé, plus susceptible d'avoir un niveau de scolarité universitaire, d'être marié et d'être à la retraite. Le chômage, un séjour prolongé à l'unité de soins intensifs (USI), un saignement intracrânien plus sévère et un traitement neurochirurgical étaient plus fréquemment présents dans le groupe de cyclistes qui ne portaient pas de casque. Il n'y avait pas d'association significative entre la sévérité du TC, les scores ISS, GOS-E ou le décès et le port du casque. L'âge médian des sujets qui sont décédés était plus élevé que celui des survivants. Conclusion: Les cyclistes qui ne portaient pas de casque étaient plus jeunes, moins instruits, plus fréquemment célibataires et sans emploi. Ils avaient un TC plus sévère à l'imagerie, ils ont été hospitalisés à l'USI plus longtemps et ils ont subi plus d'interventions neurochirurgicales. Le risque de décès était plus élevé chez cyclistes plus âgés qui ont été hospitalisés suite à un TC.

Cyclists sustaining TBIs who did not wear helmets in this study were found to cost society nearly double that of helmeted cyclists.

Objectives: The purpose of this review is to describe the current scientific literature on the prevalence of metabolic syndrome in children with myelomeningocele and to gain insight into the baseline levels of aerobic fitness, endurance, and strength in this population in order to identify gaps in knowledge, suggest potential primary prevention strategies, and provide recommendations for future studies. Methods: A literature review of articles published in English and French between 1990 and April 2020 was conducted. Results: Obese adolescents with myelomeningocele have an increased prevalence of components of the metabolic syndrome. Children and adolescents with myelomeningocele have decreased aerobic fitness and muscular strength, decreased lean mass, and increased fat mass, all of which, when combined with higher levels of physical inactivity, put them at higher risk of developing metabolic syndrome and cardiovascular diseases. Conclusion: Until more research is conducted, addressing weight-related challenges and promoting healthy habits (such as optimal activity levels) could be easily integrated into yearly myelomeningocele clinics. An actionable suggestion might be to systematically weigh and measure children in these clinics and utilize the results and trends as a talking point with the parents and children. The follow-up appointments could also be used to develop physical activity goals and monitor progress. We recommend that the health care practitioner tasked with this intervention (physician, nurse, etc.) should be aware of locally available accessible sports platforms and have knowledge of motivational interviewing to facilitate removal of perceived barriers to physical activity.