Reporting of Concussion-Like Symptoms After Cycling Crashes: A Survey of Competitive and Recreational Cyclists.

Context: Cycling crashes are common among recreational and competitive riders and may result in head and bodily trauma. Information is limited regarding the signs and symptoms of head injury (HI) after cycling crashes, medical treatment, and recovery.
Objectives: To evaluate concussion-like symptom reporting after cycling crashes with or without HI in recreational and competitive cyclists and to assess crash characteristics and follow-up medical care.
Design: Cross-sectional study.
Setting: Voluntary online survey.
Patients or Other Participants: A convenience sample of 780 cyclists residing in the United States: 528 males, 249 females, 2 gender queer/nonbinary, and 1 transgender female.
Main Outcome Measure(s): Survey-based, self-reported signs and symptoms of HI, including the third edition of the Sport Concussion Assessment Tool (SCAT3) symptom checklist, loss of consciousness, posttraumatic amnesia, and helmet damage.
Results: Of the participants, 403 reported crashes in the previous 2 years. Cyclists who self-reported no significant injury after their crash were excluded, leaving 77 HI reporters (HI group) and 260 trauma controls (TC group). The HI group more frequently reported experiencing 17 of the 22 symptoms on the SCAT3 symptom checklist. The HI group described a 4-fold higher incidence of loss of consciousness (HI = 13/77 [16.9%] versus TC = 11/2600 [4.2%]) and memory loss immediately after the crash (HI = 44/77 [57.1%] versus TC = 37/260 [14.2%]). The HI group reported major, noncosmetic helmet damage 2.5 times more frequently than the TC group (HI = 49/77 [63.6%] versus TC = 67/260 [25.8%]).
Conclusions: The findings suggest that a standardized concussion assessment is needed for cyclists who experience major trauma.