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The UCI announced Thursday new sports-related concussion (SRC) protocols aimed at increasing rider safety through rapid and early identification.
SRC increases the risk of neurocognitive impairments which may include effects on memory, speech, and reaction time — that need to be promptly identified and addressed.
Following several months of study which examined the effects of concussion on cyclists, a working group of seven specialists — doctors, scientists, and neurologists — made recommendations to the UCI.
This study was initially triggered following observations made during stage 13 of the 2020 Tour de France in which Romain Bardet lost consciousness in a high-speed crash.
The UCI indicated that the recommended SRC protocol was adapted from the 2017 Berlin Concussion Consensus Statement, a common set of rules that lays out a series of measures and tools for quickly identifying SRC and treating athletes according to sport-specific requirements.
The protocol sets out recommendations that are specific to cycling in which SRC may account for 1.3 percent to 9.1 percent of all injuries across the eight UCI-recognized disciplines of road cycling, track cycling, mountain bike, BMX Racing, BMX Freestyle, cyclocross, trials, and indoor cycling.
The UCI indicated that the main difficulty in addressing SRC in cycling is the ability of first responders to triage a cyclist in the field, confirm a diagnosis, and then make a rapid determination as to the safety and well being of a cyclist who has crashed and may have suffered a SRC — to allow them to continue on, or withdraw from competition. Road cycling, mountain bike (cross-country Olympic, and Marathon), and track cycling (Omnium) are disciplines that are most at-risk compared with BMX Racing, BMX Freestyle, track, trials, and indoor cycling in which access to riders is more easily gained.
The proposed protocol recommends non-medical professionals such as coaches, sport directors, soigneurs, mechanics, and even riders be trained in identifying SRC, which would allow proactive and early identification of a concussion. The protocol details the signs of SRC which can be used to assess the condition of an athlete (feeling stunned or dazed, trouble with balance, headaches, slurred speech, changes in vision) and allow quick and appropriate decisions in an optimal timeframe on the road or trail.
Cycling’s governing body indicates that if any signs of concussion are present, a diagnosis will need to be confirmed by a race doctor. In the absence of any initial signs of SRC, a rider should be monitored by the race medical service, which should administer a standard examination comprising of tests for rider orientation (Maddocks questions which commonly ask ‘Do you know what time it is? Do you know today’s date?’) and balance.
This protocol defines recommendations for a rider’s return to competition: Athletes suffering concussion should have a period of complete rest of between 24 and 48 hours and not return to competition for at least a week after their symptoms have cleared up. A compulsory notification of all SRC events to the UCI medical director is part of the recommendations that are made.
The UCI Medical Rules will be amended when the UCI Management Committee meets at the UCI Cyclocross World Championships in Ostend, Belgium, in January 2021, to include the recommendations made by the panel of medical experts.
The full Cycling-Specific Sport-Related Concussion document is available from the UCI’s web site.