Injuries and Illnesses Occurring on a Recreational Bicycle Tour: The Great Ohio Bicycle Adventure

Epidemiology of adverse events related to sports among community people: a scoping review

OBJECTIVES

Numerous reports have described injuries and illnesses in competitive athletes, but studies on leisure-time physical activity and associated adverse events in the general population have not been adequately reviewed. This study aimed to summarise the previous findings on this topic.

DESIGN

Scoping review.

DATA SOURCES

PubMed and Ichushi-Web for articles in English and Japanese, respectively (13 April 2023).

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Articles on adverse events related to sports performed by 'individuals and groups active in the community' were included, whereas those on elite athletes, exercise therapy and rehabilitation, and school sports were excluded. Terms related to physical activity, exercise, sports and adverse events were used for the search strategies.

RESULTS

The literature search yielded 67 eligible articles. Most articles were from the USA, Japan and Australia. Running, scuba diving, rugby and soccer were the most commonly reported sports. Adults were the most common age category in the samples. The most commonly reported adverse events were injuries; only 10 articles reported diseases. 13 longitudinal studies reported the frequency of adverse events based on the number of events/participants×exposure.

CONCLUSION

Adverse events such as sports trauma, disability and certain diseases occur sometimes during sporting activities by residents; however, the articles identified in this review showed biases related to the countries and regions where they were published and the sports disciplines and types of adverse events reported, and articles reporting the frequency of adverse events were also limited. This highlights the need for more high-quality observational studies on diverse populations in the future.

Effects of cycling on the morphology and spinal posture in professional and recreational cyclists: a systematic review

The aim was to know if cycling affects spinal morphology in postures off the bicycle, such as adapting the spinal curvatures on the bicycle depending on the handlebar type and position on the handlebars. A systematic review was conducted following the PRISMA guidelines. The studies selected met the following criteria: a) the study design was cross-sectional or longitudinal (experimental or cohorts); b) the study evaluated the sagittal morphology of the spine on the bicycle; c) the study included healthy and trained participants without injuries or cyclists reporting low back pain. Fifteen studies reported that a greater pelvic tilt was observed that when the handlebar was in a lower position. Sixteen studies found that lumbar kyphosis was greater when the handlebar grip was lower and farther from the saddle. Twelve studies reported that a tendency towards greater thoracic flexion as the time spent pedalling on the bicycle increased. In conclusion, the practice of cycling produces adaptations in the morphology of the spine of the cyclist compared to non-cyclists, such as an increase in pelvic tilt and a greater capacity for lumbar flexion in trunk flexion positions, and a greater thoracic kyphosis in the standing position.

Factors associated with patellofemoral pain in recreational road cyclists: A cross-sectional study in 59953 cyclists - SAFER XXXIII

OBJECTIVE

Patellofemoral pain (PFP) is a common cycling-related injury, and independent factors need to be identified to enable effective injury prevention strategies. We aim to determine factors associated with PFP in cyclists entering mass community-based events.

DESIGN

Cross-sectional study.

SETTING

2016-2020 Cape Town Cycle Tour.

PARTICIPANTS

Consenting race entrants.

MAIN OUTCOME MEASURES

62758 consenting race entrants completed a pre-race medical questionnaire, and 323 reported PFP. Selected factors associated with PFP (demographics, cycling experience and training, chronic disease history) were explored using multivariate analyses.

RESULTS

Prevalence ratio (PR) of PFP was similar for sex and age groups. Independent factors associated with PFP (adjusted for sex and age) were history of chronic disease [Composite Chronic Disease Score (0-10)(PR = 2.0, p < 0.0001) and any allergies (PR = 2.0, p < 0.0001)].

CONCLUSION

A history of chronic diseases and allergies is associated with PFP in cyclists. Practical clinical recommendations are: 1) that prevention programs for PFP be considered when cycling is prescribed as a physical activity intervention for patients with chronic disease, and 2) that older cyclists presenting with PFP be assessed for the presence of risk factors or existing chronic disease.

Infrastructure and Injury Prevention in Cycling

The focus of this article centers on bicycle injury prevention and related infrastructure. The article discusses the current epidemiology of cycling injuries, and known prevention strategies, specifically individual recommended practices related to helmet use in both adult and pediatric populations. The article also discusses different ways in which the environment plays a role in protecting cyclists from injuries, and what environmental changes have been adopted to reduce the likelihood for cycling injuries.

'As easy as riding a bike': a systematic review of injuries and illness in road cycling

Objectives

To allow the implementation of effective injury and illness prevention programmes for road cyclists, we wanted to first identify the injury/illness burden to this group of athletes. We, therefore, undertook a systematic review of all reported injuries/illness in road cycling.

Design

Systematic review.

Data sources

Identification of articles was achieved through a comprehensive search of: MEDLINE, Embase, PsycINFO, Web of Science and Cochrane Library from inception until January 2020.

Eligibility criteria for selecting studies

Studies reporting injuries/illness in adults participating in road cycling. Cycling commuter studies were excluded from the analysis.

Method

Two review authors independently screened titles and abstracts for eligibility and trial quality. Initial search criteria returned 52 titles and abstracts to be reviewed, with 12 studies included after reviewing the full text articles.

Results

The most common injuries sustained were abrasions, lacerations and haematomas accounting for 40–60% of the total injuries recorded. Fractures (6–15%) were the second most frequent type of injury. Head injuries (including concussions) accounted for 5–15% of injuries with musculotendinous injuries accounting for 2–17.5%. The upper limb was more frequently affected by injuries than the lower limb, with amateurs appearing to be at higher risk of injury/illness than professionals. Clavicle was the prevalent fracture, with patellofemoral syndrome the number one overuse diagnosis. No meta-analysis of the results was undertaken due to the inconsistent methods of reporting.

Conclusion

This is the first systematic review of road cycling injuries. Injuries most often affected the upper limb, with clavicle being the most prevalent fracture and the most common overuse injury being patellofemoral syndrome.

A Novel mHealth Monitoring System during Cycling in Elite Athletes

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.

Risk Factors for Illness-related Medical Encounters during Cycling: A Study in 102,251 Race Starters-SAFER XI

PURPOSE

There are limited data on risk factors associated with illness-related medical encounters (illME) in cycling events. The aim of this study was to determine risk factors associated with illME in mass community-based endurance cycling events.

METHODS

This is a retrospective cross-sectional study in the Cape Town Cycle Tour (109 km), South Africa, with 102,251 race starters. All medical encounters for 3 yr were recorded by race medical doctors and nurses. illME were grouped into common illnesses by final diagnosis. A Poisson regression model was used to determine whether specific risk factors (age, sex, cycling speed, and average individual cyclist wet-bulb globe temperature [aiWBGT]) are associated with illME, serious and life-threatening or death ME, and specific common illME.

RESULTS

Independent risk factors associated with all illME during an endurance cycling event were slow cycling speed (P = 0.009) and higher aiWBGT (P < 0.001). Risk factors associated with serious and life-threatening or death ME were older age (P = 0.007) and slower cycling speed (P = 0.016). Risk factors associated with specific common illME were fluid and electrolyte disorders (females, older age, and higher aiWBGT) and cardiovascular illness (older age).

CONCLUSION

Females, older age, slower cycling speed, and higher aiWBGT were associated with illME in endurance cycling. These data could be used to design and implement future prevention programs for illME in mass community-based endurance cycling events.

Injury rates per mile of travel for electric scooters versus motor vehicles

OBJECTIVE

This study determined the vehicle-miles-traveled (VMT)-based injury rate for stand-up, dockless electric rental scooters (e-scooters), and compare it with the VMT-based injury rate for motor vehicle travel.

METHODS

In this secondary analysis of existing data, the e-scooter injury rate was calculated based on e-scooter injuries presenting to an emergency department or the emergency medical services system in Austin, TX between September and November 2018. Injuries were identified by Austin Public Health through a targeted e-scooter epidemiological injury investigation; e-scooter VMT data were reported by e-scooter vendors as a condition of their city licensing. Comparative injury rates for motor vehicle travel in Texas, and specifically in Travis County were calculated using annual motor vehicle crash (MVC) injury and VMT data reported by the Texas Department of Transportation.

RESULTS

There were 160 confirmed e-scooter injuries identified by the e-scooter injury investigation, with 891,121 reported miles of e-scooter travel during the study period. This produces an injury rate estimate of 180 injuries/million VMT (MVMT). The injury rates for motor vehicle travel for Texas and for Travis County were 0.9 injuries/MVMT and 1.0 injuries/MVMT, respectively.

CONCLUSION

The observed VMT-based e-scooter injury rate was approximately 175 to 200 times higher than statewide or county specific injury rates for motor vehicle travel. These findings raise concerns about the potential higher injury rate associated with e-scooters, and highlight the need for further injury surveillance, research and prevention activities addressing this emerging transportation technology.

Women, older age, faster cycling speed and increased wind speeds are independent risk factors for acute injury-related medical encounters during a 109 km mass community-based participation cycling event: a 3-year study in 102251 race starters—SAFER XII

Background

There are limited data on acute injury-related medical encounters (injuries) in endurance cycling events.

Objective

To determine the risk factors for injuries during a mass community-based endurance cycling event.

Design

Retrospective, cross-sectional study.

Setting

Cape Town Cycle Tour (109 km), South Africa.

Participants

102 251 race starters.

Methods

All injuries for 3 years were recorded by race medical doctors and nurses. Injuries were grouped into main anatomical area of injury, and a Poisson regression model was used to determine the risk factors associated with injuries.

Results

The four injury risk factors associated with all injuries during an endurance cycling event were sex (women vs men, p<0.0001), older age (p=0.0005), faster cycling speed (p<0.0001) and higher average individualised Wind Speed (aiWindSpeed, p<0.0001). The only risk factor for serious/life-threatening injuries was women (p=0.0413). For specific main anatomical areas: head/neck (women), upper limb (women, older age, faster cyclists), trunk (women, higher aiWindSpeed), and lower limb (higher aiWindSpeed).

Conclusion

Women, older age, faster cycling speed and higher aiWindSpeed were all risk factors for acute injuries during a mass community-based endurance cycling event. These risk factors should help inform race organisers and medical teams on race day to ensure the best medical care is given, and effective acute injury prevention programmes are disseminated.