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McLarnon M, Boyce SH, Fisher N, Heron N. 'It's All Downhill from Here': A Scoping Review of Sports-Related Concussion (SRC) Protocols in Downhill Mountain Biking (DHI), with Recommendations for SRC Policy in Professional DMB. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12281. [PMID: 36231582 PMCID: PMC9566347 DOI: 10.3390/ijerph191912281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Downhill mountain biking (DHI) is a form of cycling and does not currently have a specific sports-related concussion (SRC) assessment. OBJECTIVE To review the extent, range and nature of research investigating SRC in DMB, provide a summary of key literature findings relating to its identification and management, and then develop a SRC protocol specific to DMB. DESIGN Scoping review as per recognised methods. SETTING Literature-based. The following databases were searched: MEDLINE, EMBASE, Scopus and Web of Science, with no restrictions on date. Results were limited to the English language. PARTICIPANTS Six articles were included in the review from 64 identified articles. The article had to specifically include an analysis of adult downhill riders for inclusion. OUTCOME MEASURES Study type, study group (amateur/professional), concussion incidence, concussion assessment and recommendations. MAIN RESULTS Concussion incidence was identified as between 5-23%. No study outlined a trackside assessment of cyclists or a protocol for return to play where SRC was identified. Several authors identified that riders often continued to participate despite the presence of a concussion. No sport-specific SRC assessment was determined for DHI, and a SRC assessment was therefore developed. CONCLUSIONS This review illustrates the lack of studies and formal protocol in SRC assessment for DHI. In light of this, we propose a three-stage framework specific to the sport to best identify a concussion and act where appropriate while minimising disruption to competition. This framework involves assessing the cyclist on the 'sideline', a second assessment post-event in the medical room and a third assessment the following day. A SRC consensus meeting specific for DHI is suggested with an identified need for updated guidance from UCI, requiring possible rule changes for the sport.
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Affiliation(s)
| | - Stephen H. Boyce
- Emergency Department, Glasgow Royal Infirmary, Glasgow G4 0SF, UK
- Scottish Institute of Sport, Stirling FK9 5PH, UK
| | - Neil Fisher
- UK Athletics, Birmingham B42 2BE, UK
- British Cycling, Manchester M11 4DQ, UK
| | - Neil Heron
- British Cycling, Manchester M11 4DQ, UK
- Centre for Public Health Research, Queen’s University, Belfast BT7 1NN, UK
- Department of General Practice, Keele University, Newcastle ST5 5BG, UK
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Gomes C, Jones N, Heron N. Sports-related concussion (SRC) in track cycling: SRC assessment protocol for elite track cycling. BMJ Open Sport Exerc Med 2022; 8:e001384. [PMID: 36071859 PMCID: PMC9386233 DOI: 10.1136/bmjsem-2022-001384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Track cycling is a fast, exciting sport and requires a specific sports-related concussion (SRC) assessment protocol. This paper proposes the first SRC assessment protocol for use in track cycling and proposes that this should occur in three stages. Stage 1 will occur at the trackside, whilst stage 2 occurs in the changing room immediately after the event and stage 3 the day following the suspected SRC. This SRC protocol is in its first iteration and we hope it stimulates debate to allow further refinement.
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Affiliation(s)
- Clint Gomes
- Department of Medicine, English Institute of Sport, Manchester, UK
| | - Nigel Jones
- Department of Medicine, British Cycling, Manchester, UK
| | - Neil Heron
- General Practice/Centre for Public Health, Queen's University Belfast, Belfast, UK
- School of Medicine, Keele University, Keele, England
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Jancaitis G, Snyder Valier AR, Bay C. A descriptive and comparative analysis of injuries reported in USA Cycling-sanctioned competitive road cycling events. Inj Epidemiol 2022; 9:22. [PMID: 35836302 PMCID: PMC9284847 DOI: 10.1186/s40621-022-00385-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/30/2022] [Indexed: 11/29/2022] Open
Abstract
Background Competition in road cycling events is common, yet little is known about the nature and disposition of injuries sustained in these events. The purpose of this study is to describe injured body regions and the disposition of injuries sustained by cyclists during competitive road cycling events. Methods Data regarding body region injured and injury disposition were retrospectively analyzed from a convenience sample of 1053 injury reports (male: n = 650 [61.7%], age = 33.4 ± 13.6 years; female: n = 116 [11.0%], age = 33.3 ± 13.9 years; missing: n = 284 [27.0%]) completed during the 2016 competitive season. Results A total of 1808 injuries were reported. Injured body regions included upper extremity (46.5%, n = 841), lower extremity (32.2%, n = 583), head/neck (10.4%, n = 189), torso/back (5.2%, n = 95), face (4%, n = 87), and internal/other (0.7%, n = 13). There were 1.37 ± 0.81 injuries recorded per report. Dispositions following injury were medical attention (34.1%, n = 316), ambulance/EMS (19.3%, n = 179), report only (15% n = 139), referred (13.0% n = 121), released to parent/personal vehicle (12.1% n = 112), refused care (4.1% n = 38), and continued riding (2.5% n = 23). Males (34.0%, n = 212) received medical attention more frequently than females (23.3%), p < 0.05. Females received EMS transport (29.1%, n = 30) more frequently than males (16.8%, n = 105), p < 0.05. Conclusions Upper extremity is the most injured body region in this data set. Following injury, racers often receive medical attention and a substantial percentage require transport by EMS. Clinical relevance Anticipating the nature of injuries sustained by cyclists may promote positive health outcomes by ensuring medical teams are prepared for the immediate medical needs of cyclists.
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Affiliation(s)
| | | | - Curt Bay
- A.T. Still University, 5850 E. Still Circle, Mesa, AZ, 85206, USA
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Goodlin GT, Steinbeck L, Bergfeld D, Haselhorst A. Adaptive Cycling: Injuries and Health Concerns. Phys Med Rehabil Clin N Am 2021; 33:45-60. [PMID: 34799002 DOI: 10.1016/j.pmr.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Para-cycling has high rates of acute injuries. The underlying medical conditions of para-athletes predispose these cyclists to injury patterns and sequelae different from those of their able-bodied counterparts. Such injuries include an increased incidence of upper-extremity and soft tissue injuries, along with predisposition for respiratory, skin, genitourinary, and heat-related illnesses. There are no validated sideline assessment tools or return-to-play protocols for sports-related concussion in wheelchair user para-athletes or those with balance deficits. Para-cyclists may be at increased risk for relative energy deficiency in sport due to competitive pressure to maintain certain weights and increased incidence of low bone mineral density.
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Affiliation(s)
- Gabrielle T Goodlin
- Physical Medicine & Rehabilitation, Department of Neurology, The University of Texas at Austin, Dell Medical School, 1400 North IH-35, Suite 2.230, Austin, TX 78701, USA. https://twitter.com/gabi_goodlin
| | - Lindsey Steinbeck
- Physical Medicine & Rehabilitation, Department of Neurology, The University of Texas at Austin, Dell Medical School, 1400 North IH-35, Suite 2.230, Austin, TX 78701, USA
| | - Deborah Bergfeld
- Physical Medicine & Rehabilitation, Department of Neurology, The University of Texas at Austin, Dell Medical School, 1400 North IH-35, Suite 2.230, Austin, TX 78701, USA
| | - Alexandria Haselhorst
- Physical Medicine & Rehabilitation, Department of Neurology, The University of Texas at Austin, Dell Medical School, 1400 North IH-35, Suite 2.230, Austin, TX 78701, USA.
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Harrogate consensus agreement: Cycling specific sport related concussion. SPORTS MEDICINE AND HEALTH SCIENCE 2021; 3:110-114. [PMID: 35782162 PMCID: PMC9219345 DOI: 10.1016/j.smhs.2021.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 12/04/2022] Open
Abstract
Sport-related concussion (SRC) is a common and increasingly recognised sport-related injury and accounts for between 1% and 9% of all cycling-specific injuries. Attention has been drawn to the difficulty in managing suspected SRC in a fast-paced sport such as road cycling, particularly the lack of an effective and time-efficient assessment protocol. A meeting on cycling SRC was convened in Harrogate, United Kingdom, in an attempt to resolve this problem. The aim was to agree on standard terminology, definitions, diagnostic protocols and return to play protocols for the various differing codes of cycle sport. Seven experts in the field of cycling medicine were invited to participate by the International Cycling Union and are the authors of this report. The panel recognised that the sport of cycling consists of varied disciplines, some of which provide a setting in which a sideline assessment is possible which is in line with the Berlin Consensus statement. However, other disciplines provide challenging circumstances where health care providers have limited access to participants and where participants are unable to discontinue participation and participate in sideline assessment. Consensus-based discipline-specific protocols and guidelines which recognise the limitations posed by these circumstances, but nevertheless, improve on the current situation specific to the sport of cycling are presented as a potential solution to the unique challenges posed by these cycling disciplines.
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A Novel mHealth Monitoring System during Cycling in Elite Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094788. [PMID: 33946166 PMCID: PMC8124243 DOI: 10.3390/ijerph18094788] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 04/24/2021] [Accepted: 04/26/2021] [Indexed: 02/04/2023]
Abstract
Background: Cycling is a very demanding physical activity that may create various health disorders during an athlete’s career. Recently, smart mobile and wearable technologies have been used to monitor physiological responses and possible disturbances during physical activity. Thus, the application of mHealth methods in sports poses a challenge today. This study used a novel mobile-Health method to monitor athletes’ physiological responses and to detect health disorders early during cycling in elite athletes. Methods: Sixteen high-level cyclists participated in this study, which included a series of measurements in the laboratory; health and performance assessments; and then application in the field of mHealth monitoring in two training seasons, at the beginning of their training period and in the race season. A field monitoring test took place during 30 min of uphill cycling with the participant’s heart rate at the ventilatory threshold. During monitoring periods, heart rate, oxygen saturation, respiratory rate, and electrocardiogram were monitored via the mHealth system. Moreover, the SpO2 was estimated continuously, and the symptoms during effort were reported. Results: A significant correlation was found between the symptoms reported by the athletes in the two field tests and the findings recorded with the application of the mHealth monitoring method. However, from the pre-participation screening in the laboratory and from the spiroergometric tests, no abnormal findings were detected that were to blame for the appearance of the symptoms. Conclusions: The application of mHealth monitoring during competitive cycling is a very useful method for the early recording of cardiac and other health disorders of athletes, whose untimely evaluation could lead to unforeseen events.
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History of chronic disease is a novel intrinsic risk factor associated with gradual onset injuries in recreational road cyclists: A cross-sectional study in 21,824 cyclists - SAFER XIV. Phys Ther Sport 2020; 46:137-144. [DOI: 10.1016/j.ptsp.2020.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 12/25/2022]
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Heron N, Elliott J, Jones N, Loosemore M, Kemp S. Sports-related concussion (SRC) in road cycling: the RoadsIde heaD Injury assEssment (RIDE) for elite road cycling. Br J Sports Med 2019; 54:127-128. [DOI: 10.1136/bjsports-2019-101455] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2019] [Indexed: 11/04/2022]
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The Injury and Illness Profile of Male and Female Participants in a 94.7 km Cycle Race: A Cross-Sectional Study. Clin J Sport Med 2019; 29:306-311. [PMID: 31241533 DOI: 10.1097/jsm.0000000000000517] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the incidence and patterns of injury and illness of male and female participants during a 94.7 km distance cycling event. DESIGN Descriptive study. SETTING Momentum 94.7 Cycle Challenge 2014. PARTICIPANTS All 23 055 race starters (males = 17 520, females = 5236, not specified = 299). MAIN OUTCOME MEASURES The incidence and type of all medical complaints and difference between sexes. RESULTS Incidence (per 1000 race starters) of all medical complaints was 38.69 (males = 36.52, females = 38.39), adverse medical events 11.88 (males = 10.73, females = 16.42) and serious adverse events 1.3 (males = 0.86, females = 2.67). The incidence of nontraumatic medical complaints was 32.49 (males = 33.39, females = 31.32) and of traumatic injuries was 3.99 (males = 3.14, females = 7.07). Females compared to males had a higher risk of sustaining traumatic injuries (P < 0.001), central nervous system, (P = 0.0062) and eye complaints (P = 0.0107). Most complaints (80.6%) were reported for the musculoskeletal system. Males 10-15 years (P = 0.0013) and females 23-39 years (P = 0.0336), and older than 50 years (P = 0.0002) had a higher than expected risk for traumatic injuries. CONCLUSIONS Medical complaints ratio reported was 1:26 (males = 1:28, females = 1:26) in all starters during the cycling event. Cyclists that did not finish the race (adverse events) were 1:84 (males = 1:93, females = 1:61). Serious adverse events that required hospitalization were 1:769 (males = 1:1163, females = 1:374). The majority of admissions were for traumatic injuries, followed by cardiovascular complaints. Results from this study indicated that a wide spectrum of medical complaints can be expected during such an event with a higher risk for females to sustain traumatic injuries and to encounter central nervous system and eye complaints. Information regarding the pattern and type of medical encounters can prove useful during planning and management of similar future events.
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Elliott J, Anderson R, Collins S, Heron N. Sports-related concussion (SRC) assessment in road cycling: a systematic review and call to action. BMJ Open Sport Exerc Med 2019; 5:e000525. [PMID: 31205745 PMCID: PMC6540321 DOI: 10.1136/bmjsem-2019-000525] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2019] [Indexed: 12/14/2022] Open
Abstract
Background Sports-related concussion (SRC) is a recognised risk in road cycling and can have serious health consequences. Recent high-profile cases of professional road cyclists continuing to participate in races despite suffering obvious SRC have highlighted the difficulties in assessing SRC within road cycling. Purpose To undertake a systematic review of the literature on SRC assessment in road cycling. Study design Systematic review. Methods Literature describing SRC assessment in road cycling was identified by searching MEDLINE, EMBASE, PsycINFO and Web of Science. Two reviewers independently screened titles and abstracts for eligibility and a qualitative analysis was undertaken of included studies. Results From 94 studies identified, two were included for review. Gordon et al describe the presentation of a single case of paediatric concussion following a cycling crash. They highlight the utility of SRC evaluation using the Sport Concussion Assessment Tool (SCAT) as well as the importance of a stepwise return-to-play protocol. Greve and Modabber discuss a number of traumatic brain injuries that occurred during the 2011 road cycling season and, as a minimum, call for riders to be withdrawn from competition following loss of consciousness or amnesia. Both studies are at high risk of bias and of low quality. Conclusion Road cycling poses unique challenges for the assessment of SRC. This review illustrates the lack of published evidence to advise effective means of SRC assessment within road cycling. The Union Cycliste Internationale (UCI) regulations advise the use of SCAT-5 for concussion assessment but this tool is impractical, requiring modification for use in road cycling. We would like to call on the UCI to hold a consensus meeting to establish an evidence-based SRC assessment protocol and return-to-riding protocol for road cycling.
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Affiliation(s)
- Jonathan Elliott
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Richard Anderson
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Stephen Collins
- Department of Medicine and Surgery, Northern Health and Social Care Trust, Coleraine, United Kingdom
| | - Neil Heron
- General Practice/Centre for Public Health, Queen's University Belfast, Belfast, UK.,Department of General Practice, Keele University, Keele, Staffordshire, United Kingdom
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Priego Quesada JI, Kerr ZY, Bertucci WM, Carpes FP. A retrospective international study on factors associated with injury, discomfort and pain perception among cyclists. PLoS One 2019; 14:e0211197. [PMID: 30682136 PMCID: PMC6347182 DOI: 10.1371/journal.pone.0211197] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/09/2019] [Indexed: 12/21/2022] Open
Abstract
Although cycling has been associated with overuse/fatigue and acute injuries, there is lack of information regarding associated risk factors and prevention factors. The objective of the study was to determine the factors associated with injury, and perceptions of discomfort and pain in cyclists. A total of 739 cyclists completed an online questionnaire between February and October 2016. The questionnaire acquired information on participant demographics, characteristics related to cycling profile and fitness training, bike components and cycling posture, self-reported perceptions of comfort and pain, and injuries sustained in the last 12 months. Logistic regression models estimated odds ratios (OR) and 95% confidence intervals (95%CI) that examined factors associated with reporting overuse/fatigue injury, acute injury, body discomfort, saddle discomfort, and pain while cycling. Odds of reporting an overuse/fatigue injury increased when the cyclists complemented training with running (OR = 1.74; 95%CI = 1.03–2.91) or swimming (OR = 2.17; 95%CI = 1.19–3.88), and with reported pain while cycling (OR = 1.17; 95%CI = 1.05–3.69) and not cycling (OR = 1.76; 95%CI = 1.07–2.90). Odds of reporting an acute injury increased when biking to work (OR = 1.79; 95%CI = 1.07–2.86), and decreased with increased average cycling speed (1-km/h decrease OR = 0.93; 95%CI = 0.88–0.97), and compared to low-end bike, with the use of mid-range (OR = 0.25; 95%CI = 0.09–0.72) and high-end bike (OR = 0.34; 95%CI = 0.13–0.96). Although body discomfort was only associated with saddle discomfort and the presence of pain during cycling, saddle discomfort was also associated with biking to work (OR = 0.46; 95%CI = 0.22–0.88). Finally, pain perception was associated with a number of factors such as ride to work, core training, cycling experience, saddle discomfort, pain while not cycling. Numerous factors are associated with injury, and perceptions of discomfort and pain in cyclists. Such factors should be considered when developing training routines, bicycle maintenance best practices, and injury prevention programs.
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Affiliation(s)
- Jose Ignacio Priego Quesada
- Research Group in Sports Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
- Biophysics and Medical Physics Group, Department of Physiology, University of Valencia, Valencia, Spain
- * E-mail:
| | - Zachary Y. Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - William M. Bertucci
- Laboratory of Performance, Health, Metrology, and Society (PSMS, EA 7507), UFR STAPS, University of Reims Champagne-Ardenne, Reims, France
| | - Felipe P. Carpes
- Applied Neuromechanics Research Group, Laboratory of Neuromechanics, Federal University of Pampa, Uruguaiana, Brazil
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Laskowski-Jones L, Caudell MJ, Hawkins SC, Jones LJ, Dymond CA, Cushing T, Gupta S, Young DS, Starling JM, Bounds R. Extreme event medicine: considerations for the organisation of out-of-hospital care during obstacle, adventure and endurance competitions. Emerg Med J 2017; 34:680-685. [PMID: 28784607 DOI: 10.1136/emermed-2017-206695] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 04/28/2017] [Accepted: 06/04/2017] [Indexed: 11/03/2022]
Abstract
Obstacle, adventure and endurance competitions in challenging or remote settings are increasing in popularity. A literature search indicates a dearth of evidence-based research on the organisation of medical care for wilderness competitions. The organisation of medical care for each event is best tailored to specific race components, participant characteristics, geography, risk assessments, legal requirements, and the availability of both local and outside resources. Considering the health risks and logistical complexities inherent in these events, there is a compelling need for guiding principles that bridge the fields of wilderness medicine and sports medicine in providing a framework for the organisation of medical care delivery during wilderness and remote obstacle, adventure and endurance competitions. This narrative review, authored by experts in wilderness and operational medicine, provides such a framework. The primary goal is to assist organisers and medical providers in planning for sporting events in which participants are in situations or locations that exceed the capacity of local emergency medical services resources.
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Affiliation(s)
- Linda Laskowski-Jones
- Department of Emergency Medicine, Christiana Care Health System, Newark, Delaware, USA
| | - Michael J Caudell
- Augusta University Medical College of Georgia, Center of Operational Medicine, Augusta, Georgia, USA
| | - Seth C Hawkins
- Department of Emergency Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Lawrence J Jones
- Appalachian Center for Wilderness Medicine, Morganton, North Carolina, USA
| | - Chelsea A Dymond
- University of Queensland Ochsner Clinical Foundation New Orleans, Los Angeles, California, USA
| | - Tracy Cushing
- University of Colorado Denver School of Medicine, Aurora, Colorado, USA
| | - Sanjey Gupta
- Long Island Jewish Medical Center, Emergency Medicine, New Hyde Park, New York, USA
| | - David S Young
- Rush University Medical Center, Chicago, Illinois, USA
| | - Jennifer M Starling
- Department of Emergency Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
| | - Richard Bounds
- Department of Emergency Medicine, Christiana Care Health System, Newark, Delaware, USA
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Yanturali S, Canacik O, Karsli E, Suner S. Injury and illness among athletes during a multi-day elite cycling road race. PHYSICIAN SPORTSMED 2015; 43:348-54. [PMID: 26468912 DOI: 10.1080/00913847.2015.1096182] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Although road bicycle races have been held for more than a century, injury and illness patterns during multi-day bicycle events have not been widely studied. The aim of this study was to determine the incidence of injury and illness among riders and describe the medical care interventions provided to participants of cycling road races. METHODS A prospective observational study was conducted on the Presidential Cycling Tour of Turkey, which was held between April 26 and May 3, 2015. The race lasted 8 days and covered 1258 km of road. There were 166 elite cycling athletes representing 21 teams from various countries. Data collected pertaining to incidents involving injury or illness included the following: type of injury; anatomical location of injury; details of the medical encounter; location of the intervention; treatment provided; medication administered and disposition of the rider. An injury was defined as a physical complaint or observable damage to the body produced by the transfer of energy of the rider. An illness was defined as a physical complaint or presentation not related to injury. RESULTS The overall incidence (injury and illness) was 5.83 per 1000 cycling hours. (Injury incidence was 2.82 vs illness incidence of 3.01 per 1000 hours cycling). A total of 31 incidents occurred. Of these, 15 were injuries, while 16 were complaints of a non-traumatic nature. A total of 43 interventions were made in the 15 cases of injury. The most commonly injured body regions were limbs; the majority of injuries involved the skin and soft tissue. The most common medical intervention was wound care (64% of all interventions). Two riders had to withdraw from the race, and one was hospitalized due to a traumatic pneumothorax. None of the non-traumatic cases resulted in withdrawal from the race. CONCLUSIONS A broad spectrum of illness and injury occurs during elite multi-day road races, ranging from simple skin injuries to serious injuries requiring hospital admission. Most injuries and illnesses are minor; however, medical teams must be prepared to treat life-threatening trauma.
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Affiliation(s)
- Sedat Yanturali
- a Department of Emergency Medicine , Dokuz Eylül University Hospital , Izmir , Turkey
| | - Omer Canacik
- a Department of Emergency Medicine , Dokuz Eylül University Hospital , Izmir , Turkey
| | - Emre Karsli
- a Department of Emergency Medicine , Dokuz Eylül University Hospital , Izmir , Turkey
| | - Selim Suner
- b Department of Emergency Medicine , The Warren Alpert Medical School of Brown University , Providence , Rhode Island , USA
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