Reporting of Concussion-Like Symptoms After Cycling Crashes: A Survey of Competitive and Recreational Cyclists

Abstract

Context Cycling crashes are common among recreational and competitive riders and may result in head and bodily trauma. Information is limited regarding the signs and symptoms of head injury (HI) after cycling crashes, medical treatment, and recovery. Objectives To evaluate concussion-like symptom reporting after cycling crashes with or without HI in recreational and competitive cyclists and to assess crash characteristics and follow-up medical care. Design Cross-sectional study. Setting Voluntary online survey. Patients or Other Participants A convenience sample of 780 cyclists residing in the United States: 528 males, 249 females, 2 gender queer/nonbinary, and 1 transgender female. Main Outcome Measure(s) Survey-based, self-reported signs and symptoms of HI, including the third edition of the Sport Concussion Assessment Tool (SCAT3) symptom checklist, loss of consciousness, posttraumatic amnesia, and helmet damage. Results Of the participants, 403 reported crashes in the previous 2 years. Cyclists who self-reported no significant injury after their crash were excluded, leaving 77 HI reporters (HI group) and 260 trauma controls (TC group). The HI group more frequently reported experiencing 17 of the 22 symptoms on the SCAT3 symptom checklist. The HI group described a 4-fold higher incidence of loss of consciousness (HI = 13/77 [16.9%] versus TC = 11/2600 [4.2%]) and memory loss immediately after the crash (HI = 44/77 [57.1%] versus TC = 37/260 [14.2%]). The HI group reported major, noncosmetic helmet damage 2.5 times more frequently than the TC group (HI = 49/77 [63.6%] versus TC = 67/260 [25.8%]). Conclusions The findings suggest that a standardized concussion assessment is needed for cyclists who experience major trauma.

Twitter discourse around competitive cycling and sports-related concussion

“…The lack of injury surveillance in cycling (Rooney et al, 2020), paired with the difficulties in concussion diagnosis (McCory et al, 2017), makes understanding the true rates and frequency of the injury in competitive cycling a difficult task. However, there is literature that shows competitive cyclists have high rates of crashes, traumatic injuries, and self-reported concussions (Silberman, 2013;Rice et al, 2020;Hurst et al, 2018;.…”

Methods for epidemiological studies in competitive cycling: an extension of the IOC consensus statement on methods for recording and reporting of epidemiological data on injury and illness in sport 2020

“…Sport-related concussions remain a poorly quantified yet high priority injury problem in cycling. [33][34][35][36][37] The potential shortterm and longer term repercussions of cyclists riding soon after suffering a concussion, before having made a full recovery, may be significant. To increase the recognition and sensitivity of the diagnosis of concussion, the UCI recently published a cyclingspecific adaptation of the Sports Concussion Assessment Tool, version 5.…”

An Investigation into Helmet Use, Perceptions of Sports-Related Concussion, and Seeking Medical Care for Head Injury amongst Competitive Cyclists

“…In recent years, there have been concerns raised in road cycling disciplines regarding concussion incidence, policy, and attitudes amongst athletes [ 9 ]; however, research remains somewhat limited in this area [ 10 , 19 , 20 , 21 ]. In mountain biking and bicycle motocross (BMX), Hurst and colleagues [ 12 , 22 , 23 ] report that these athletes may be at risk of sub-concussive brain trauma due to the uneven terrain encountered.…”