Impact of knowledge and attitude on inappropriate post-concussion behaviors in competitive cyclists

To measure epidemiological data on concussions and examine the association between knowledge and attitudes about concussions and inappropriate post-injury behavior. Descriptive, cross-sectional study. Online survey. A total of 365 competitive cyclists in Japan. Survey items included participant information, the experience of concussion-like symptoms, concussion knowledge index (CKI) score, concussion attitude index (CAI) score, and inappropriate behavior post-concussion injury. The prevalence of concussion-like symptoms among all competitive cyclists was 45.8%. CKI and CAI scores for all participants were 21.7 ± 3.4 and 10.5 ± 3.4, respectively. No significant differences were identified in CKI and CAI scores based on concussion-like symptom experience. After adjusting for covariates, we found that the risk of 'returning to training without rest after injury' decreased by 20% for each 1-point increase in CKI score. In contrast, the risk of 'returning to training with symptoms remaining' decreased by 13% for each 1-point increase in CAI. An association was found between concussion knowledge and return to competition without a period of rest post-injury, as well as between attitude toward concussion and return to competition with symptoms. Therefore, these findings can contribute to concussion education among cyclists.