Background Despite recent advances in the diagnosis and management of sports-related concussion (SRC) in the sports medicine community; as well as heightened recognition of the condition by the public and media, some sports, such as road cycling, appear to lack effective concussion assessment, diagnosis and management protocols.
Objectives Undertake a systematic review of the literature on SRC assessment in road cycling and from this evidence, suggest a model for the RoadsiIe heaD injury assessment (RIDE) as well model return to riding guidelines.
Design Systematic review.
Setting Elite Sport.
Patients (Or Participants) This systematic review is reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidance.
Interventions (Or Assessment Of Risk Factors) The Physiotherapy Evidence Database (PEDro) scale was used to assess the quality of included papers in the review.
Main Outcome Measurements From 94 studies identified, 65 studies were excluded after screening the titles and abstracts and two studies were included in the review.
Results 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of traumatic brain injuries that occurred during the 2011 road cycling season and,as a minimum, call for riders to be withdrawn from competition following loss of consciousness or amnesia. From this review, we then suggest a Roadside head injury assessment (RIDE) for assessing SRC in elite road cycling.
Conclusions The elite road cycling race environment poses a unique challenge to the identification of suspected SRC and this review illustrates the lack of published evidence to advise effective means of SRC assessment within road cycling. We are calling for The Union Cycliste Internationale (UCI) to host a consensus meeting to agree the operational detail required to implement a standardised RIDE - informed by the Berlin Consensus Guidelines, SCAT5 and return-to-riding protocol for road cycling.
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