Key result
Clinical assessment and neurophysiology remain primary for evaluating cyclist nerve symptoms despite low-quality evidence.
Why the study?
Cyclists often report sensory and motor changes in the hands, and this review aimed to evaluate existing publications to determine areas for improvement in clinical management.
Clinical assessment and neurophysiology remain the standard for evaluating nerve injuries in cyclists, though musculoskeletal ultrasound may be a useful addition.
Identifies gaps in traditional assessment of cyclists' hand symptoms; leaves open standardized diagnostic protocols for clinical and research use.
Cycling is popular internationally as a mode of transport and sport. Cyclists often report sensory and motor changes in the hands during rides. In the past, assessment of these symptoms was based on clinical history, physical examination and neurophysiology. The aim of this narrative review was to evaluate existing publications and determine if there are areas for further improvement in the clinical setting. Methods: Searches were undertaken in accordance with the PRISMA guidelines using four online databases: PUBMED, OVID, CINAHL and WEB OF SCIENCE. Articles were evaluated using adapted versions of guidelines for case and cohort studies. Results: 2630 articles were found and 13 were included in the review. 2 considered median, 9 considered ulnar and 2 assessed both nerves. 11 were case and 2 were cohort studies. 7 discussed neurophysiology and 1 mentioned ultrasound as a modality of investigation. Interventions were described in 3 articles. Conclusion: The quality of evidence is generally low when considering this problem. Clinical assessment and neurophysiology are commonly regarded as the method for assessing nerve symptoms amongst cyclists. Advances in musculoskeletal ultrasound add to our early investigative repertoire and may help expedite management and limit future disability. In addition, further research is required into screening and preventative measures amongst cyclists. 2630 articles were found and 13 were included in the review. 2 considered median, 9 considered ulnar and 2 assessed both nerves. 11 were case and 2 were cohort studies. 7 discussed neurophysiology and 1 mentioned ultrasound as a modality of investigation. Interventions were described in 3 articles. Conclusion: Clinical assessment and neurophysiology are commonly reported as the method for assessing nerve symptoms amongst cyclists. Advances in musculoskeletal ultrasound mean we should consider this as part of the investigative repertoire. In addition, further research is required into screening and early interventions to limit the onset of more disabling symptoms.
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Sirisena et al. (2021) conducted a review in Median and Ulnar Nerve Injuries in Cyclists (n=13). Assessment of nerve symptoms was evaluated. A review of 13 articles found that clinical assessment and neurophysiology are the primary methods for evaluating nerve symptoms in cyclists, though the overall quality of evidence is low.
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