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Heron N, Bigard X, Elliott N, Lunan E, Fallon T, Palmer D. Epidemiology of injuries at the 2023 UCI cycling world championships using the International Olympic Consensus: a protocol for a prospective cohort study. BMJ Open Sport Exerc Med 2024; 10:e001741. [PMID: 38617567 PMCID: PMC11015179 DOI: 10.1136/bmjsem-2023-001741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 04/16/2024] Open
Abstract
The sport of cycling consists of several individual sporting disciplines. Indeed, the world governing body for cycling, Union Cycliste Internationale (UCI), oversees the various cycling disciplines, with each of these disciplines having a number of subcategories. While several sports have undertaken prospective injury surveillance studies to understand the risks of their sport, plan event medical support and develop prevention programmes, limited high-quality studies have been undertaken within cycling. Indeed, this is the first prospective study of cycling injuries, particularly when considering the whole sport of cycling together. This current study will therefore aim to describe the incidence, severity, burden and nature of injuries within elite cycling in those athletes participating across 13 championship events at the inaugural World Championships, Glasgow, August 2023. Injury and exposure definitions will be in line with the IOC Consensus for injury surveillance in cycling. Injury incidence will be reported per 1000 athlete match hours or per number of athletes/cyclists and injury severity will be assessed via estimated median or mean days lost to training/competition. Meanwhile injury burden will be assessed via days of absence/1000 athlete match hours (or per number of athletes exposed) and all these results will be compared between male and female cyclists. This paper will also report the most common specific injuries for male and female cyclists (per 1000 hours of participation or per number of athletes exposed). Statistical differences will be tested for incidence or severity measures between sexes and will be compared to other sports.
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Affiliation(s)
- Neil Heron
- General Practice/Centre for Public Health, Queen's University Belfast, Belfast, UK
- School of Medicine, Keele University, Staffordshire, UK
| | | | - Niall Elliott
- Sports & Exercise Medicine, Sportscotland Institute of Sport, Stirling, UK
| | - Emma Lunan
- Scottish Institute of Sport, Stirling, UK
| | - Thomas Fallon
- General Practice/Centre for Public Health, Queen's University Belfast, Belfast, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport, Edinburgh, UK
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Course G, Sharman JE, Tran V. Health Service Impacts and Risk Factors for Severe Trauma in Mountain Biking: A Narrative Review. Healthcare (Basel) 2023; 11:3196. [PMID: 38132086 PMCID: PMC10871082 DOI: 10.3390/healthcare11243196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
Mountain biking is growing in participation but carries risk for severe injury and burden on health systems. Little is known about the impact of these injuries on emergency medical services, definitive healthcare, and factors contributing to accidents. This review aimed to determine the health service impacts of severe mountain bike trauma and risk factors, with a view to understanding critical gaps and needs. A systematic online search was conducted using the databases PubMed and MEDLINE complete and grey literature relating to mountain bike injury since the databases' inception to July 2023. The results show that although mountain biking has relatively high injury rates that are increasing, the impacts on health services were rarely documented, with some evidence indicating that even small increases in injuries from race events can overwhelm local health services. Severe injuries were more common in downhill disciplines. However, the definitions of what constitutes severe injury were variable. Severe injuries were more common in downhill disciplines, influenced by the rider skill level, demographics, participation in competitive events, trail design, environmental factors, and healthcare availability. Further research in these areas is needed, along with the more consistent reporting of injury severity.
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Affiliation(s)
- Gillian Course
- School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia;
- Department of Emergency Medicine, Royal Hobart Hospital, Hobart, TAS 7000, Australia
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia;
| | - James E. Sharman
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia;
| | - Viet Tran
- School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia;
- Department of Emergency Medicine, Royal Hobart Hospital, Hobart, TAS 7000, Australia
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia;
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Chilton EP, Robinovitch SN. Perceived risk for falls and decision-making in riding raised ramps in mountain biking: a pilot study. Front Psychol 2023; 14:1243536. [PMID: 38192391 PMCID: PMC10773584 DOI: 10.3389/fpsyg.2023.1243536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/28/2023] [Indexed: 01/10/2024] Open
Abstract
Mountain biking (MTB) is a challenging activity where riders face constant decisions on whether to attempt technical paths or features (e.g., wooden ramps and jumps) that pose risk for falls and injuries. Risk homeostasis theory posits that riders pursue an optimal non-zero level of risk that balances the rewards of attempting challenging features with the need to avoid unreasonable risk for injury. Little is known on how riders judge risk, and the level of risk that riders deem unacceptable. We conducted experiments with experienced MTB riders (n = 17) to examine how their willingness to ride raised wooden ramps depended on their perceived probability for falling (Pf) and their perceived probability for injury in the event of a fall (Pi) while riding the ramp. In one experiment, participants viewed ramps of varying widths and heights and described their willingness to ride each ramp, along with Pf and Pi. We found that Pf and Pi were independent predictors of willingness to attempt ramps. Moreover, the product Pf*Pi (the perceived risk for injury in attempting the ramp) was a stronger predictor than Pf or Pi alone. In a second experiment, participants viewed ramps of different widths, and reported the maximum (threshold) height where they would ride each ramp, along with Pf and Pi. We found that Pf*Pi at the threshold height, averaging 13%, did not vary with ramp width. We conclude that decisions on riding ramps are based on the product Pf*Pi. On average, riders refused to ride ramps when Pf*Pi exceeded 13%.
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Affiliation(s)
| | - Stephen N. Robinovitch
- Injury Prevention and Mobility Laboratory, Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
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Braybrook PJ, Tohira H, Birnie T, Brink D, Finn J, Buzzacott P. Types and anatomical locations of injuries among mountain bikers and hikers: A systematic review. PLoS One 2023; 18:e0285614. [PMID: 37647303 PMCID: PMC10468092 DOI: 10.1371/journal.pone.0285614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 04/26/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Mountain biking and hiking continue to grow in popularity. With new participants to these sports, it is likely the number of injuries will increase. To assist medical personnel in the management of these patients we attempted to quantify the types and locations of injuries sustained by mountain bikers and hikers. Objective The objective of this systematic review is to identify the type and anatomical location of injuries for both mountain bikers and hikers. METHODS A systematic search was undertaken using CINAHL, Cochrane, ProQuest, PubMed and Scopus databases. Reviewers assessed the eligibility of articles by a title/abstract review and final full-text review. Studies were included if the types of injuries were reported by medical personnel and contained anatomical locations. Studies were excluded if it did not take place on a trail or if the injuries were self-reported. Risk of bias was assessed utilising the Joanna Briggs Institute (JBI) checklists for study quality. No meta-analysis or comparison between mountain bikers and hikers was possible due to the high heterogeneity of the definition of injury. RESULTS A total of 24 studies met the inclusion criteria, 17 covering mountain biking and 7 hiking. This represented 220,935 injured mountain bikers and 17,757 injured hikers. The most common type of injuries sustained by mountain bikers included contusions, abrasions and minor lacerations, which made up between 45-74% of reported injuries in studies on competitive racing and 8-67% in non-competitive studies. Fractures represented between 1.5-43% of all reported injuries. The most injured region was the upper limbs reported in 10 of 17 studies. For hikers the most common injuries included blisters and ankle sprains with blisters representing 8-33% of all reported injuries. The most common body location to be injured by hikers was a lower limb in all 7 studies. CONCLUSIONS This is the first systematic review to report on the injury epidemiology of the two most common trail users; mountain bikers and hikers. For participants in both activities the majority of injuries were of minor severity. Despite this, the high proportions of upper limb fractures in mountain bikers and ankle sprains in hikers cannot be ignored. TRIAL REGISTRATION Registration: This systematic review was prospectively registered with the University of York PROSPERO database on the 12/4/2021 (CRD42021229623) https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021229623.
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Affiliation(s)
- Paul John Braybrook
- Prehospital Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, Bentley, Western Australia
- St John Western Australia, Belmont, Western Australia
| | - Hideo Tohira
- Prehospital Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, Bentley, Western Australia
- Discipline of Emergency Medicine, Medical School, University of Western Australia, Crawley, Western Australia
| | - Tanya Birnie
- Prehospital Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, Bentley, Western Australia
| | - Deon Brink
- Prehospital Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, Bentley, Western Australia
- St John Western Australia, Belmont, Western Australia
| | - Judith Finn
- Prehospital Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, Bentley, Western Australia
- St John Western Australia, Belmont, Western Australia
- Discipline of Emergency Medicine, Medical School, University of Western Australia, Crawley, Western Australia
| | - Peter Buzzacott
- Prehospital Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, Bentley, Western Australia
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Edler C, Droste JN, Anemüller R, Pietsch A, Gebhardt M, Riepenhof H. Injuries in elite road cyclists during competition in one UCI WorldTour season: a prospective epidemiological study of incidence and injury burden. PHYSICIAN SPORTSMED 2023; 51:129-138. [PMID: 34808064 DOI: 10.1080/00913847.2021.2009744] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
METHODS Fifty-four male athletes from two different teams were involved. Accidents and injuries were recorded immediately after the incident by a team physician present at every race. Exposure, location, type and cause of injury have been recorded. Incidence was calculated. Severity was measured as a cumulative severity score and burden depicted in a risk matrix. RESULTS Total time of exposure was 12537 hours over 3524 athlete days and 544002 kilometers of racing. 98 accidents were recorded, with 83 leading to injury. The total number of recorded injuries was 193. Injury incidence for all injuries was 54,8 (±SD 47,7-62,8) /1000 athlete days, 15,4 (±SD 13,4-17,7) /1000 athlete hours and 35,5 (±SD 30,8-40,8) /100.000 km raced. By far the most frequent types of injury were hematomas, contusions and bruising (n = 141, 73%) followed by lacerations (n = 22; 11,4%). Most injuries affected the arm and elbow (n = 34, 17,6%) followed by the shoulder and clavicle (n = 28, 14,5%) and occurred with contact (79%). Fractures pose a high injury burden due to long time loss, whereas hematomas, contusions and bruising showed the highest incidence numbers but comparably less time loss. CONCLUSION Road cyclists' injuries have been underestimated in previous studies. Hematomas, contusions and bruising pose the highest number of injuries with a broad degree of severity and range of injury burden. Fractures are less common but show the highest injury burden. The upper extremities are involved the most.
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Affiliation(s)
- Christopher Edler
- Department of Prevention, Rehabilitation and Interdisciplinary Sports Medicine, Bg Hospital Hamburg - Teaching Hospital of the University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jan-Niklas Droste
- Department of Prevention, Rehabilitation and Interdisciplinary Sports Medicine, Bg Hospital Hamburg - Teaching Hospital of the University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Medicine and Sports Science RB Leipzig Football Club, Leipzig Germany
| | - Ruben Anemüller
- Department of Trauma, Orthopedic Surgery and Sports Traumatology, BG Hospital Hamburg - Teaching Hospital of the University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Aki Pietsch
- Department of Prevention, Rehabilitation and Interdisciplinary Sports Medicine, Bg Hospital Hamburg - Teaching Hospital of the University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias Gebhardt
- Department of Surgery and Sports Traumatology, Park Clinic Manhagen, Großhansdorf, Germany
| | - Helge Riepenhof
- Department of Prevention, Rehabilitation and Interdisciplinary Sports Medicine, Bg Hospital Hamburg - Teaching Hospital of the University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Medicine and Sports Science RB Leipzig Football Club, Leipzig Germany
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Bigdon SF, Hecht V, Fairhurst PG, Deml MC, Exadaktylos AK, Albers CE. Injuries in alpine summer sports - types, frequency and prevention: a systematic review. BMC Sports Sci Med Rehabil 2022; 14:79. [PMID: 35501847 PMCID: PMC9063189 DOI: 10.1186/s13102-022-00468-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 04/18/2022] [Indexed: 01/03/2023]
Abstract
Introduction Summer alpine sports, including mountain biking, hiking and airborne pursuits, have experienced a recent surge in popularity. Accordingly, trauma associated with these activities has increased. There is a scarcity of literature exploring clinical aspects surrounding injuries. Specifically, no single article provides a general overview, as individual studies tend to focus on one particular sport. In the present study, we performed a systematic literature review to summarize existing knowledge and explore the potential for prevention and clinical decision making in this group. Method Literature searches were performed using the PubMed and Scopus database for the most commonly ventured sports associated with injury: mountain biking, climbing, airborne sports, paragliding, and base jumping. From this search, studies were identified for qualitative and quantitative analyses. These searches were done according to PRISMA guidelines for systematic reviews. Studies were then analyzed regarding epidemiology of injuries, relevant anatomical considerations and prevention strategies were discussed. Results A broad spectrum of injury sites and mechanisms are seen in mountain biking, climbing or airborne sports. Mountain biking related injuries commonly involve the upper extremity, with fractures of the clavicle being the most common injury, followed by fractures of the hand and wrist. Scaphoid fractures remain of paramount importance in a differential diagnosis, given their often subtle clinical and radiological appearance. Paragliding, skydiving, and base jumping particularly affect transition areas of the spine, such as the thoracolumbar and the spinopelvic regions. Lower limb injuries were seen in equal frequency to spinal injuries. Regarding relative risk, mountain biking has the lowest risk for injuries, followed by climbing and airborne sports. Male alpinists are reported to be more susceptible to injuries than female alpinists. Generally, the literature surrounding hiking and water-related mountain sports is insufficient, and further work is required to elucidate injury mechanisms and effective preventative measures. A helmet seems to decrease the likelihood of face and head injuries in mountain sports and be a meaningful preventive measurement.
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Affiliation(s)
- Sebastian Frederick Bigdon
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
| | - Verena Hecht
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Paul Gilbert Fairhurst
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Moritz C Deml
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Aristomenis K Exadaktylos
- Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, Freiburgstrasse 16C, 3010, Bern, Switzerland
| | - Christoph E Albers
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
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Enduro-Mountainbiking: Ursachen, Häufigkeit und Folgen von Verletzungen. SPORTVERLETZUNG-SPORTSCHADEN 2022. [DOI: 10.1055/a-1693-2125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Trail Use, Motivations, and Environmental Attitudes of 3780 European Mountain Bikers: What Is Sustainable? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412971. [PMID: 34948581 PMCID: PMC8702103 DOI: 10.3390/ijerph182412971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/26/2021] [Accepted: 12/06/2021] [Indexed: 11/25/2022]
Abstract
Background: The extent to which mountain biking impacts upon the environment is largely determined by rider behaviours. The purpose of this study was to gain a better understanding of how mountain bikers interact with the natural environment and explore their attitudes towards sustainability. Methods: 3780 European mountain bikers completed an online cross-sectional survey. Results: Connection to nature was an important source of motivation and the use of mountain bike trails has increased rider’s appreciation of and willingness to protect nature, with a large majority having taken direct action to do so. Mountain bikers are prepared to contribute towards trail maintenance through the provision of labour or financially. Although most mountain bikers make use of wet trails and illegal trails, incidence of conflict is relatively low. A range of characteristics were identified as being fundamental elements of sustainable trails, both in relation to the sustainability of the trail itself and in terms of wider environmental sustainability. Conclusions: European mountain bikers care about the sustainability of the natural environment. Self-reported attitudes and behaviours suggest a willingness to reduce environmental impact and actively protect nature.
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