1
|
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.
Collapse
Affiliation(s)
| | | | - Curt Bay
- A.T. Still University, 5850 E. Still Circle, Mesa, AZ, 85206, USA
| |
Collapse
|
2
|
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.
Collapse
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.
| |
Collapse
|
3
|
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.
Collapse
|
4
|
Rooney D, Sarriegui I, Heron N. 'As easy as riding a bike': a systematic review of injuries and illness in road cycling. BMJ Open Sport Exerc Med 2020; 6:e000840. [PMID: 34422283 PMCID: PMC8323466 DOI: 10.1136/bmjsem-2020-000840] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 10/12/2020] [Indexed: 12/20/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Dáire Rooney
- Medical School, Queen’s University Belfast, Belfast, UK
| | - Inigo Sarriegui
- Medical Department, Southampton Medicine, Southampton Football Club, Southampton, UK
| | - Neil Heron
- Department of Family Practice, Queen’s University Belfast, Belfast, UK
- Department of General Practice, Keele University, UK
| |
Collapse
|
5
|
Rix K, Demchur NJ, Zane DF, Brown LH. Injury rates per mile of travel for electric scooters versus motor vehicles. Am J Emerg Med 2020; 40:166-168. [PMID: 33139141 DOI: 10.1016/j.ajem.2020.10.048] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/20/2020] [Accepted: 10/23/2020] [Indexed: 10/23/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Kevin Rix
- Trauma Service/Injury Prevention, Dell-Seton Medical Center at the University of Texas, Austin, TX, USA
| | - Nora J Demchur
- Division of Emergency Medicine, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas, Austin, TX, USA
| | - David F Zane
- Epidemiology and Disease Surveillance Unit, Austin Public Health, Austin, TX, USA
| | - Lawrence H Brown
- Division of Emergency Medicine, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas, Austin, TX, USA; U.S. Acute Care Solutions, Canton, OH, USA.
| |
Collapse
|
6
|
Killops J, Sewry NA, Schwellnus M, Swanevelder S, Janse van Rensburg D, Jordaan E. 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. Inj Prev 2020; 27:338-343. [DOI: 10.1136/injuryprev-2020-043874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 11/03/2022]
Abstract
BackgroundThere are limited data on acute injury-related medical encounters (injuries) in endurance cycling events.ObjectiveTo determine the risk factors for injuries during a mass community-based endurance cycling event.DesignRetrospective, cross-sectional study.SettingCape Town Cycle Tour (109 km), South Africa.Participants102 251 race starters.MethodsAll 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.ResultsThe 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).ConclusionWomen, 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.
Collapse
|
7
|
Sillén K, Wallenius V. Rates and types of injuries during the three consecutive years 2016 to 2018 of the Vätternrundan-One of the world's largest and longest bicycle races. TRAFFIC INJURY PREVENTION 2019; 20:749-752. [PMID: 31381375 DOI: 10.1080/15389588.2019.1639681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/24/2019] [Accepted: 07/01/2019] [Indexed: 06/10/2023]
Abstract
Objective: The present study was performed during 3 consecutive years of the Vätternrundan in Sweden, one of the world's longest and largest bicycle races. The aim was to examine the rates and types of injuries to participating cyclists in order to identify the reasons and mechanisms for injury, with the purpose of decreasing the risk of injury. Method: A retrospective observational interference study was performed over 3 consecutive years. Data were collected from medical records of cyclists who were treated at hospital for traumatic injuries at the Vätternrundan 2016. Injured cyclists were asked to fill out questionnaires about the accidents. During the 2 consecutive years 2017 to 2018, a follow-up was performed in order to evaluate whether the precautions taken, based on the data from the previous year, could decrease rate of injuries during the consecutive race. Results: Sixty-nine (0.35%) of the 19,663 participants in the Vätternrundan in 2016 were included in the study, due to their need for hospital care. The corresponding numbers for 2017 and 2018 were 52 (0.27%) and 44 (0.22%), respectively. The most common injury was fracture to the clavicle (18-30%). In total, 68-74% of all injuries were to the upper body (above the hip; P < .001 compared to lower body). A crash with another cyclist caused by crowding was the most frequent mechanism of injury. A few risky "hot spots" for injuries were identified along the race track, and the mechanisms for accidents were hypothesized based on the responses of injured cyclists and the geographic clustering of accidents. These reasons were systematically targeted during the planning of the race in 2017 and 2018. Conclusion: We found that the overwhelming majority of traumatic injuries were to the upper body, with the most common injury being clavicular fracture. The most common mechanism for injury was interference between cyclists in the first year's race, mainly due to crowding because of the track being too narrow at certain locations. The interventions performed, based on these findings, resulted in a substantial decrease in injuries during the next 2 consecutive Vätternrundan races. Thus, systematic identification and elimination of hazards contributed to a reduction of the rate of injury by 37% (P = .0013, χ2) during the 3 years of the study.
Collapse
Affiliation(s)
- Karin Sillén
- Department of Gastrosurgical Research and Education, Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg , Gothenburg , Sweden
| | - Ville Wallenius
- Department of Gastrosurgical Research and Education, Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg , Gothenburg , Sweden
| |
Collapse
|
8
|
Killops J, Schwellnus M, Janse van Rensburg DC, Swanevelder S, Jordaan E. Medical encounters, cardiac arrests and deaths during a 109 km community-based mass-participation cycling event: a 3-year study in 102 251 race starters-SAFER IX. Br J Sports Med 2019; 54:605-611. [PMID: 31371337 DOI: 10.1136/bjsports-2018-100417] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND There are few data on medical encounters, including deaths during mass-participation cycling events. OBJECTIVE To determine the incidence and nature of medical encounters during a community-based mass-participation cycling event. DESIGN Cross-sectional study across three annual events. SETTING 2012-2014 Cape Town Cycle Tour (109 km), South Africa. PARTICIPANTS 102 251 race starters (male=80 354, female=21 897). METHODS Medical encounters (moderate, serious life-threatening, sudden cardiac arrest/death), using the 2019 international consensus definitions, were recorded on race day for 3 years as incidence rates (IR per 1000 starters; 95% CI). Overall illness-related (by organ system) or injury-related (by anatomical region) encounters, and severity were recorded. RESULTS We recorded 539 medical encounters (IR 5.3; 4.8 to 5.7). The IR was 3.2 for injuries (2.9 to 3.6), 2.1 for illnesses (1.0 to 2.4) and 0.5 for serious life-threatening medical encounters (0.4 to 0.7). In the 3-year study, we encountered three cardiac arrests and one death (2.9 and 1.0 per 100 000 starters, respectively). Injury IRs included upper limb (1.9; 1.6 to 2.1), lower limb (1.0; 0.8 to 1.0) and head/neck (0.8; 0.6 to 1.0). Illness IRs included fluid/electrolyte abnormalities (0.6; 0.5 to 0.8) and the cardiovascular system (0.5; 0.4 to 0.6). CONCLUSION In a 109 km community-based mass-participation cycling event, medical encounters (moderate to severe) occurred in about 1 in 200 cyclists. Injury-related (1/300 cyclists) encounters were higher than illness-related medical encounters (1 in about 500). Serious life-threatening medical encounters occurred in 1/2000 cyclists. These data allow race organisers to anticipate the medical services required and the approximate extent of demand.
Collapse
Affiliation(s)
- Jannelene Killops
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI) and Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI) and Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa .,Research Centre, International Olympic Committee (IOC), Pretoria, South Africa
| | - Dina Christina Janse van Rensburg
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI) and Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Sonja Swanevelder
- Biostatistics Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Esme Jordaan
- Biostatistics Unit, South African Medical Research Council, Tygerberg, South Africa.,Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa
| |
Collapse
|
9
|
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.
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Helmich I, von Götz D, Emsermann C, Xuanjin F, Griese A, Lauterbach I, Lausberg H. Not just contact sports: significant numbers of sports-related concussions in cycling. J Sports Med Phys Fitness 2019; 59:496-501. [DOI: 10.23736/s0022-4707.18.08329-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
12
|
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.
Collapse
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
| |
Collapse
|
13
|
Pommering TL, Manos DC, Singichetti B, Brown CR, Yang J. Injuries and Illnesses Occurring on a Recreational Bicycle Tour: The Great Ohio Bicycle Adventure. Wilderness Environ Med 2017; 28:299-306. [PMID: 28781179 DOI: 10.1016/j.wem.2017.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 06/02/2017] [Accepted: 06/02/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Recreational multiday cycling events have grown popular in the United States; however, little has been published regarding the injuries and illnesses that occur during these events. The objective of this study was to describe injuries and illnesses that occur in the Great Ohio Bicycle Adventure (GOBA) and to examine associated risk factors. METHODS Injury and illness data collected from an on-site medical clinic during the 2013 and 2014 GOBA tours were merged with rider registration data for analysis. Diagnoses were classified as acute injury, overuse injury, or medical illness. The odds ratios of sustaining at least 1 injury/illness, as well as sustaining an acute injury, were assessed adjusting for riders' demographics. RESULTS A total of 4005 (2172 in 2013 and 1833 in 2014) cyclists participated in GOBA, with an an age of 50.7±17.6 (2-86) years (mean±SD [range]), of whom 59.8% were male. During the tours, 143 (3.6%) riders reported at least 1 injury/illness, which resulted in 220 clinical diagnoses, including 114 (51.8%) acute injuries, 27 (12.3 %) overuse injuries, and 79 (35.9%) medical illnesses. The lower extremities were the most commonly injured body site (n=71, 50.4%). "Superficial/Abrasions/Contusions" was the most common injury/illness type (n=68, 30.9%). Riders who had no previous tour experience or who were at least 50 years old had a greater risk of injury/illness than their counterparts. CONCLUSIONS The prevalence of injury and illness is relatively low in multiday recreational cycling events. Our findings provide important data for planning and preparing for medical coverage at mass recreational cycling events.
Collapse
Affiliation(s)
- Thomas L Pommering
- College of Medicine, The Ohio State University, Columbus, OH; Division of Sports Medicine, Nationwide Children's Hospital, Columbus, OH.
| | - Diane C Manos
- College of Medicine, The Ohio State University, Columbus, OH
| | - Bhavna Singichetti
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH
| | - Chelsea R Brown
- College of Medicine, The Ohio State University, Columbus, OH
| | - Jingzhen Yang
- College of Medicine, The Ohio State University, Columbus, OH; Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH
| |
Collapse
|
14
|
Decock M, De Wilde L, Vanden Bossche L, Steyaert A, Van Tongel A. Incidence and aetiology of acute injuries during competitive road cycling. Br J Sports Med 2016; 50:669-72. [PMID: 26968218 DOI: 10.1136/bjsports-2015-095612] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2016] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Despite the ever-increasing popularity of bicycle racing, the high perceived risk of acute injuries and the recent media attention, studies of acute injuries in road cyclists are rather scarce. The goal of this study is to evaluate the incidence, aetiology and patterns of acute injuries in non-professional competitive road cyclists during cycling races in Flanders. MATERIAL AND METHODS All acute injuries that occurred during competition in Flanders in 2002 and 2012, collected in the injury registry, were analysed. The incidence, injury rate, diagnosis, circumstances and level of performance were evaluated. RESULTS A total of 777 documented reports of accidents (1230 injuries) were retrieved for the years 2002 and 2012. There was no significant difference between incidence and injury rate between 2002 and 2012. There was a strong significant difference in the incidence between the different levels of performance in both seasons. Severe injuries were seen in 29.5% in 2002 and in 30.1% in 2012. The most common location of a severe injury was the hand. Collision with another rider was the most common cause of injury. CONCLUSIONS Almost 1 out of 6 non-professional competitive road cyclists had an accident during cycling races in 2002 and 2012 in Flanders and collision with other riders was the most important cause of a crash. The most common lesion was abrasion, but almost one out of three riders had a severe injury.
Collapse
Affiliation(s)
- Mathieu Decock
- Department of Orthopedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium
| | - Lieven De Wilde
- Department of Orthopedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium
| | - Luc Vanden Bossche
- Physical and Rehabilitation Medicine, Sports Medicine Centre, Ghent University Hospital, Belgium
| | - Adelheid Steyaert
- Physical and Rehabilitation Medicine, Sports Medicine Centre, Ghent University Hospital, Belgium
| | - Alexander Van Tongel
- Department of Orthopedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium
| |
Collapse
|
15
|
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.
Collapse
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
| |
Collapse
|
16
|
Roi GS, Tinti R. Requests for medical assistance during an amateur road cycling race. ACCIDENT; ANALYSIS AND PREVENTION 2014; 73:170-173. [PMID: 25240133 DOI: 10.1016/j.aap.2014.08.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 06/11/2014] [Accepted: 08/11/2014] [Indexed: 06/03/2023]
Abstract
Requests for medical assistance during an amateur road cycling race, which included 56,700 cyclists over 6 consecutive races between 2006 and 2011, were analysed with the aim of improving injury prevention and medical coverage. Medical assistance was requested by a small percentage of participants (1.7 ± 1.0%), but the actual number seeking assistance was quite high due to the large total number of participants (162 ± 51). 0.17% of all participants did not finish the race for medical reasons. No fatal injuries were recorded. The incidence rate of requests for medical assistance was 0.108/1,000 km, and the incidence of withdrawal was 0.011/1,000 km of the race. Of all medical requests, those due to direct trauma caused by falls accounted for 63%, requests for overload injuries accounted for 4% and requests for non-traumatic complaints accounted for 22% of the total; 11% of requests were not classified. Weather conditions may affect the type and the incidence of requests: requests for traumatic injuries increase if raining; requests for heat-related illnesses if hot. Prevention techniques are aimed at guaranteeing and promoting health and safety and should be implemented by both the race organisers and the cyclists.
Collapse
Affiliation(s)
- Giulio Sergio Roi
- Isokinetic Medical Group, Education & Research Department, Via Casteldebole 8/4, Bologna, 40132, Italy.
| | - Riccardo Tinti
- Isokinetic Medical Group, Education & Research Department, Via Casteldebole 8/4, Bologna, 40132, Italy.
| |
Collapse
|
17
|
An Analysis of Patient Presentations at a 2-Day Mass-participation Cycling Event: The Ride to Conquer Cancer Case Series, 2010-2012. Prehosp Disaster Med 2014; 29:429-36. [DOI: 10.1017/s1049023x14000776] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTo analyze the unique factors involved in providing medical support for a long-distance, cross-border, cycling event, and to describe patient presentations and event characteristics for the British Columbia (BC) Ride to Conquer Cancer from 2010 through 2012.MethodsThis study was a 3-year, descriptive case series report. Medical encounters were documented, prospectively, from 2010-2012 using an online registry. Data for event-related variables also were reported.ResultsProviding medical support for participants during the 2-day ride was complicated by communication challenges, weather conditions, and cross-border issues. The total number of participants for the ride increased from 2,252 in 2010 to 2,879 in 2011, and 3,011 in 2012. Patient presentation rates (PPRs) of 125.66, 155.26, and 198.93 (per 1,000 participants) were documented from 2010 through 2012. Over the course of three years, and not included in the PPR, an additional 3,840 encounters for “self-treatment” were documented.ConclusionsThe Ride to Conquer Cancer Series has shown that medical coverage at multi-day, cross-national cycling events must be planned carefully to face a unique set of circumstances, including legislative issues, long-distance communication capabilities, and highly mobile participants. This combination of factors leads to potentially higher PPRs than have been reported for noncycling events. This study also illuminates the additional workload “self-treatment” visits place on the medical team.LundA, TurrisSA, WangP, MuiJ, LewisK, GutmanSJ. An analysis of patient presentations at a 2-day mass-participation cycling event: The Ride to Conquer Cancer Case Series, 2010-2012. Prehosp Disaster Med. 2014;29(4):1-8.
Collapse
|
18
|
De Bernardo N, Barrios C, Vera P, Laíz C, Hadala M. Incidence and risk for traumatic and overuse injuries in top-level road cyclists. J Sports Sci 2012; 30:1047-53. [DOI: 10.1080/02640414.2012.687112] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
19
|
Gosling CM, Forbes AB, McGivern J, Gabbe BJ. A profile of injuries in athletes seeking treatment during a triathlon race series. Am J Sports Med 2010; 38:1007-14. [PMID: 20436054 DOI: 10.1177/0363546509356979] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Triathlon combines swimming, cycling, and running into a single event. With increasing popularity of this sport, there has been a rise in the number of participants, particularly in shorter distance races. However, the risks of participating in short-distance races have not been reported. PURPOSE To describe the rate and profile of injuries seen for medical assistance during a triathlon race series. STUDY DESIGN Descriptive epidemiology study. METHODS A standardized injury reporting form was used to collect information from race entrants seeking medical aid at each of the races comprising a combination of Sprint, Olympic, and Fun race distances in a triathlon series in Victoria, Australia over the 2006-2007 race season. Injury rates and risk factors were assessed via regression analysis. RESULTS There were 10,197 individual starters who took part. There were 235 presentations for medical assistance (n = 322 injuries) over the series. The presentation rate was 20.1 per 1000 hours of competition (2.3% of total race starts). Injuries were predominantly sustained during the run (38.4%) and cycle (14.3%) legs. Lower limb injuries (59.5%) and abrasions (28.6%) were the most common site and nature of injury, respectively. There were 9 severe injuries: 5 fractures, 3 probable heat stroke cases, and 1 deep laceration. Elite/Junior Elite, Olympic distance, and 12- to 19-year-old competitors were at higher risk of injury, especially during running and cycling. CONCLUSION The level and age of triathlon competitors, and the race distance, influenced the risk of injury over a race series. These results provide timely information for triathlon race event organizers and could be incorporated into a review of practices for the provision of medical services to triathlon events, especially the common sprint distance competitions. CLINICAL RELEVANCE Shorter distance triathlons have lower injury rates and relatively minor injuries, but medical teams and race organizers should be prepared for serious injuries.
Collapse
Affiliation(s)
- Cameron M Gosling
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | | | | |
Collapse
|
20
|
Injury incidence and predictors on a multiday recreational bicycle tour: The Register's Annual Great Bike Ride Across Iowa, 2004 to 2008. Wilderness Environ Med 2010; 21:202-7. [PMID: 20832697 DOI: 10.1016/j.wem.2010.04.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The "Register's Annual Great Bike Ride Across Iowa" (RAGBRAI) is a 7-day recreational bicycle ride with more than 10,000 participants covering 500 miles. The heat and humidity of late July in Iowa, the prevalence of amateur riders, and the consumption of alcohol can combine creating the potential for a significant number of injuries. The purpose of this study is to determine the type, quantity, and severity of injuries on RAGBRAI and gather data on the factors related to these incidents. METHODS This retrospective chart review examined ambulance "run sheets" for patients requiring transport to the hospital from the bike route between 2004 and 2008. These run sheets included name, age, chief complaint, anatomic location of injuries, medications administered, procedures performed, and a full narrative describing the initial scene, patient's account of the incident, services provided, and ongoing condition of the patient while en route to the hospital. Chi-square tests, Pearson's correlation tests, and t tests were applied to determine significant statistical outcomes. RESULTS From 2004 to 2008, Care Ambulance Inc provided on-route medical services for 419 RAGBRAI participants. Of these participants, 190 (45.3%) required transport to a local hospital by Care Ambulance Inc. Females were more likely to require transport, as they comprised 46.3% of transported patients while only representing 35% of all RAGBRAI participants (P = .001). For men, increasing age was a significant predictor of transport, particularly males between the ages of 60 and 69 years old (P = .01). Of the 148 run sheets where mechanism of incident was documented, 114 incidents were caused by rider factors (77.0%), 29 by road factors (19.6%), and 5 by bicycle factors (3.4%). Higher heat indexes were correlated with an increased number of dehydration cases (r = 0.979, P = .02). Of participants who reported with minor injuries to a mobile first aid station and did not require transport, 90.1% had not imbibed any alcohol. Bony injuries were more common above the waistline as 39/45 (86.7%) fractures occurred to the clavicle, shoulder/proximal humerus, hand, or head. The most common bony injury each year of RAGBRAI was a clavicle fracture, which represented 44.4% of all recorded fractures from 2004 to 2008. Lacerations and abrasions were also more common above the waist, as 63.5% (127/200) of soft tissue injuries requiring treatment were either to the head or upper extremities. No specific event day showed any correlation with increased injury (P >.05). CONCLUSIONS This study suggests that females and older males are more likely to require transport for injuries sustained on RAGBRAI, the majority of injuries occur around the head and upper extremities, dehydration case load is correlated with heat index, and that incidents are usually caused by rider factors. This research could be used by multiday recreational bicycle tour organizers to continue educating riders on riding carelessness and etiquette and prepare medical services for certain quantities and types of injuries.
Collapse
|
21
|
Bowles HR, Rissel C, Bauman A. Mass community cycling events: who participates and is their behaviour influenced by participation? Int J Behav Nutr Phys Act 2006; 3:39. [PMID: 17090328 PMCID: PMC1647288 DOI: 10.1186/1479-5868-3-39] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2006] [Accepted: 11/07/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Participation in mass physical activity events may be a novel approach for encouraging inactive or low active adults to trial an active behaviour. The public health applicability of this strategy has not been investigated thoroughly. The purpose of this study to was describe participants in a mass cycling event and examine the subsequent effect on cycling behaviour. METHODS A sample of men and women aged 16 years and older (n = 918) who registered online for a mass cycling event reported cycling ability and number of times they rode a bicycle during the month before the event. One month after the event participants completed an online follow-up questionnaire and reported cycling ability, lifestyle physical activity, and number of times they rode a bicycle during the month after the event. McNemar's test was used to examine changes in self-rated cycling ability, and repeated measures mixed linear modeling was used to determine whether average number of monthly bicycle rides changed between pre-event and post-event assessment. RESULTS Participants in the cycling event were predominantly male (72%), 83% rated themselves as competent or regular cyclists, and 68% rated themselves as more active than others of the same sex and age. Half of the survey respondents that rated their cycling ability as low before the event subsequently rated themselves as high one month after the event. Respondents with low pre-event self-rated cycling ability reported an average 4 sessions of bicycle riding the month before the event and an average 6.8 sessions of bicycle riding a month after the event. This increase in average sessions of bicycle riding was significant (p < .0001). Similarly, first-time participants in this particular cycling event significantly increased average sessions of cycling from 7.2 pre-event to 8.9 sessions one month after the event. CONCLUSION Participants who were novice riders or first time participants significantly increased their number of bicycle rides in the month after the event. Further knowledge about the public health applicability of mass events is needed, and methods for attracting less active and novice individuals to participate remain to be developed.
Collapse
Affiliation(s)
- Heather R Bowles
- Centre for Physical Activity and Health, University of Sydney Medical Foundation Building (K25) Level 2, 94 Parramatta Road, Camperdown NSW 2050, Australia
| | - Chris Rissel
- Health Promotion Service, Sydney South West Area Health Service and School of Public Health, University of Sydney. Level 9, King George V, Missenden Road, Camperdown NSW 2050, Australia
| | - Adrian Bauman
- Centre for Physical Activity and Health, University of Sydney Medical Foundation Building (K25) Level 2, 94 Parramatta Road, Camperdown NSW 2050, Australia
| |
Collapse
|
22
|
Abstract
Medical coverage of recreational and competitive cycling events requires significant planning and cooperation among the race and medical directors, race officials, and local emergency medical services. The medical team should be proficient in treating minor and self-limiting injuries such as abrasions and minor trauma. The medical team should also have contingency plans for medical emergencies, such as cardiac events and major trauma, that ensure rapid stabilization and transport of the athlete to the appropriate medical facility. Stationary and mobile medical teams may be necessary for proper coverage of the event. Event day communication systems between individual medical staff as well as race officials and local emergency medical services is important to the success of the event.
Collapse
Affiliation(s)
- John M Martinez
- Coastal Sports and Wellness Medical Center, 4010 Sorrento Valley Boulevard, Suite C, San Diego, CA 92121, USA.
| |
Collapse
|