Harrogate consensus agreement: Cycling-specific sport-related concussion

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.