Harrogate consensus agreement: Cycling specific sport related concussion

Swart, Jeroen; Bigard, Xavier; Fladischer, Thomas; Palfreeman, Roger; Riepenhof, Helge; Jones, Nigel; Heron, Neil

doi:10.1016/j.smhs.2021.05.002

Cited by 7 publications

(10 citation statements)

References 13 publications

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“…There is also a trend of increasing the mandatory time out of competition following a concussion, with World Rugby increasing this period to 12 days for the 2022/23 season unless specific criteria are met [ 26 ]. Thus, from reviewing our median time to return to competition of 16 days following a concussion, the UCI may need to reconsider their concussion policy [ 25 ] and increase the minimum time out of competition following a SRC beyond the current 6 days.…”

Section: Discussionmentioning

confidence: 99%

“…For each recorded episode of concussion, we calculated the number of days taken (from the day of injury) for the athlete to be medically cleared for a return to competition. The medical record for each concussion episode was created and updated by two medical doctors caring for the GBCT athletes, NJ and CG, with the SRCs diagnosed and managed as per international guidelines [ 12 , 25 ]. Data were anonymously plotted in Excel sheets and then analysed in the statistical package, SPSS (IBM SPSS 29).…”

Section: Methodsmentioning

confidence: 99%

“…The English Football Association state that the earliest a player aged 20 years or older can return to play is 6 days in an ‘enhanced care setting’ [ 23 ] and this approach is supported by the world governing body of football, FIFA [ 24 ]. It is also echoed by the governing body for cycling, the Union Cycliste International (UCI) [ 25 ]. However, in professional rugby, the period out of competition is now 12 days for players not meeting set criteria [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

‘If in Doubt, Sit Them Out’: How Long to Return to Elite Cycling Competition following a Sports-Related Concussion (SRC)?

Heron

Jones

Cardwell

et al. 2023

IJERPH

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Introduction: A concussion or sports-related concussion (SRC) is a traumatic brain injury induced by biomechanical forces. After a SRC diagnosis is made, a concussed individual must undergo a period away from competition while they return to their baseline level of functioning. The Union Cycliste Internationale (UCI) currently recommend a minimum of 6 days restriction from competitive cycling following a SRC but there is a growing feeling amongst those involved in brain injury research that this period is too short. Therefore, how much time should cyclists be removed from competitive sporting action following a SRC? Aims: To review the time out of competition following the diagnosis of a SRC for elite cyclists within British Cycling (BC). Methods: All medical records for elite cyclists within BC were audited for diagnoses of “concussion” or “sports-related concussions” from January 2017 until September 2022. The days out of competition following the concussion until ready to compete again (that is, returned to full training) was then calculated. All diagnoses and management of SRC were undertaken by the medical team at BC and in-keeping with current international guidelines. Results: Between January 2017 and September 2022, there were 88 concussions diagnosed, 54 being males and 8 in para-athletes. The median duration for time out of competition for all concussions was 16 days. There was no statistical difference between males (median 15.5 days) and females (median 17.5 days) for time out of competition (p-value 0.25). The median duration out of competition following a concussion for able-bodied athletes was 16 (80 athletes) compared to 51 days (8 athletes) in para-cyclists, which was not statistically different (p-value 0.39). Conclusions: This is the first study to report SRC concussion recovery times in elite cycling, including para-athletes. Between January 2017 and September 2022, there were 88 concussions diagnosed at BC and the median duration for time out of competition for all concussions was 16 days. There was no statistically significant difference in recovery times between male and females and para- and able-bodied athletes. This data should be used to help establish minimum withdrawal times post-SRC for elite cycling participation and we call on the UCI to review this data when establishing SRC protocols for cycling, with further research required in para-cyclists.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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‘If in Doubt, Sit Them Out’: How Long to Return to Elite Cycling Competition following a Sports-Related Concussion (SRC)?

Heron

Jones

Cardwell

et al. 2023

IJERPH

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“…While these assessment tools do not replace the medical decision, their use certainly assists the medical practitioner with clinical decision making as well as guidance for return to play clinical decisions for athletes post-concussion. Previous systematic literature reviews have evaluated the sensitivity of sideline screening tools and assessment protocols [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

An assessment of current concussion identification and diagnosis methods in sports settings: a systematic review

Daly

Pearce

Finnegan

et al. 2022

BMC Sports Sci Med Rehabil

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Background Concussion in sport is an ongoing global concern. The head injury assessment (HIA) by the field of play is acknowledged as the first step in recognising and identifying concussion. While previous systematic literature reviews have evaluated the sensitivity of side-line screening tools and assessment protocols, no systematic review has evaluated the research designs and assessments used in a field setting. This systematic review investigated existing screening and diagnostic tools used in research as part of the HIA protocol to identify concussion that are currently used in professional, semi-professional and amateur (club) sports settings. Methods A systematic searching of relevant databases was undertaken for peer-reviewed literature between 2015 and 2020. Results Twenty-six studies met the inclusion criteria. Studies were of moderate to good quality, reporting a variety of designs. The majority of studies were undertaken in professional/elite environments with medical doctors and allied health practitioners (e.g., physical therapists) involved in 88% of concussion assessments. While gender was reported in 24 of the 26 studies, the majority of participants were male (77%). There was also a variety of concussion assessments (n = 20) with the sports concussion assessment tool (SCAT) used in less than half of the included studies. Conclusion The majority of studies investigating concussion HIAs are focused on professional/elite sport. With concussion an issue at all levels of sport, future research should be directed at non-elite sport. Further, for research purposes, the SCAT assessment should also be used more widely to allow for consistency across studies.

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“…Despite this, limited tools aid its diagnosis or management [1]. A concussion is a growing concern from a public health perspective and accounts for many injuries within both amateur and professional cycling [2,3] Recent tools have been developed to identify and manage SRC in road [4][5][6][7] and track cycling [8] However, downhill racing is an arguably higher risk sport with regards to traumatic injury and indeed head injury [9,10] but does not have any formal concussion policy.…”

Section: Introductionmentioning

confidence: 99%

‘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

McLarnon

Boyce

Fisher

et al. 2022

IJERPH

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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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Harrogate consensus agreement: Cycling specific sport related concussion

Cited by 7 publications

References 13 publications

‘If in Doubt, Sit Them Out’: How Long to Return to Elite Cycling Competition following a Sports-Related Concussion (SRC)?

‘If in Doubt, Sit Them Out’: How Long to Return to Elite Cycling Competition following a Sports-Related Concussion (SRC)?

An assessment of current concussion identification and diagnosis methods in sports settings: a systematic review

‘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

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