Table 1 General descriptions of the included studies
Reference, yearCountryCyclist populationDesignDefinition of correct helmet use
Finch et al,14 1993AustraliaAll rider agesObservational surveyHelmet’s chin strap fastened
Forjuoh et al,9 2002USAAll childrenCross-sectional, direct observationPositioned on head in a straight, horizontal line, strapped visibly below chin
Hall et al,13 2004AustraliaElementary schoolsRandomised controlled trial evaluating interventionFastened straps, positioned squarely on the head, cap not worn under helmet, correct helmet size
Harlos et al,11 1999CanadaAll rider agesObservational surveyVisual assessment of fit, positioning on head, and appropriate strap use
Nykolyshyn et al,1 2003CanadaAll rider agesObservational cohort surveySit level with rest of head, bottom of helmet ∼2 finger widths away from top of rider’s eyebrows, helmet straps fastened with ∼1 finger width space between chin and straps
Parkinson et al,10 2003USAAll childrenQuestionnaire/helmet fit and condition assessmentCondition, room, strap, stability
Rivara et al,7 1999USAHelmeted subjectsCase–control (questionnaire, head/helmet measurement)N/A
Rowe et al,3 1995CanadaAll rider ages who stopped and agreed to participateProspective roadside surveyHelmets should sit on forehead (not over eyebrow, should not expose forehead); straps should be “snug”; should remain in place when movement is attempted
Thompson et al,15 1997USAInjured cyclistsCase–control (self-report/expert evaluation)Incorrect: poor fit, improper helmet placement because of style or fit, helmet failure when energy exceeds the threshold of ultimate protective capacity, impact occurring outside of covered head area
Twomey et al,8 2001USAAll rider agesObservational surveyIncorrect: helmet worn too far back on the head (forehead not covered) or without buckle fastened
Van Houten et al,16 2007USAElementary schoolObservational survey of baseline and treatment conditionsHelmet buckled snugly, level (forehead or back of head not exposed)
  • N/A, not applicable.