The Sports Preparticipation Evaluation

Abstract

1. Shane M. Miller, MD, FAAP*\n2. Andrew R. Peterson, MD, MSPH, FAAP†\n\n\n \n\n1. *Departments of Orthopaedics and Pediatrics, UT Southwestern, and Texas Scottish Rite Hospital for Children Sports Medicine Center, Dallas, TX\n\n2. †Departments of Pediatrics and Orthopaedics/Rehabilitation, University of Iowa, Iowa City, IA\n\n* Abbreviations:\n AAP: : American Academy of Pediatrics\n AAS: : anabolic-androgenic steroid\n AHA: : American Heart Association\n BP: : blood pressure\n CDC: : Centers for Disease Control and Prevention\n DM: : diabetes mellitus\n ECG: : electrocardiography\n FDA: : Food and Drug Administration\n LVH: : left ventricular hypertrophy\n PES: : performance-enhancing substance\n PPE: : preparticipation physical evaluation\n SCAT5: : Sports Concussion Assessment Tool, Version 5\n SCD: : sickle cell disease\n SCT: : sickle cell trait\n\nLack of familiarity with current recommendations diminishes the confidence to perform a preparticipation physical evaluation (PPE). In a 2014 survey, Madsen et al (1) reported, “Only 37% of physicians reported an awareness of the PPE Monograph.” (2) Clinicians should be aware of current guidelines for performing a PPE and identify children who may be at increased risk from sport participation.\n\nAfter completing this article, readers should be able to:\n\n1. Perform a preparticipation history and physical examination and identify children and adolescents who may be at increased risk for morbidity or mortality from sport participation.\n\n2. Recognize that the mandatory preparticipation physical evaluation serves as an opportunity to address medical and psychosocial issues not necessarily associated with sport participation and as an entry point for healthy adolescents into the health-care system.\n\n3. Recognize the cardiac risks associated with sport participation and when additional cardiac evaluation is required.\n\n4. Understand the importance of assessing and documenting neurocognitive function before sport participation.\n\n5. Identify which sports are appropriate for athletes with some common medical conditions.\n\n6. Recognize the effect of a febrile illness on sport participation.\n\nIn the United States, sport participation is increasing, with more than 60 million children and adolescents competing in organized sports every year. The number of high school athletes has increased from 7.2 million to 7.9 million during the past 10 years. (3) The physical and psychosocial benefits of sport participation are well-documented, and pediatricians serve a vital role …