The preparticipation physical examination (PPE) is ideally done as part of routine health screening examinations by an athlete’s primary physician and should be considered a part of the preventive health examination for all children and adolescents to encourage safe physical activity of any kind on a regular basis.
Preparticipation Physical Evaluation Working Group. Preparticipation physical evaluation monograph.
Sandy Hoffman and Erin Macri1
At a time when various elements of clinical practice are under appropriate scrutiny, the preparticipation physical evaluation (PPE)1 has gone from the routine to a part of sports and exercise medicine that is garnering a great deal of interest.
The most fundamental question is—what is the purpose of the PPE? In this chapter we begin by addressing that question and we then discuss:
who benefits from a PPE
who is best qualified and appropriate to conduct a PPE
ideal times for conducting the assessment
selecting a format and appropriate content
considerations for clearing a sportsperson for participation.
A PPE is often a mandatory administrative requirement of an athletic association for organized sports participation. There is enormous variation throughout the world in how these examinations are performed, including questions asked, physical examination components performed, and the level of training required of practitioners conducting these examinations. The ensuing discussion will clarify key components and considerations for developing and conducting evaluations that best meet the needs of specific sportspeople, teams, or leagues.
The reader is referred to Chapters 42, 43, 44, and 46 for details regarding special populations. such as the older and younger sportsperson, the female sportsperson, and the disabled sportsperson.
The physical, psychological, and social benefits of physical activity and sports participation for people of all ages and abilities are vast and well recognized. These benefits should serve as an underlying tenet guiding the development and implementation of PPEs. It is important that clinicians, coaches, and league administrators uphold the message that a PPE is designed to be valuable, enjoyable, and educational for the sportsperson.
The information gained from the PPE should encourage the sportsperson toward improved self-care, and should never feel like a “test” or make the sportsperson feel ill at ease about being evaluated. To facilitate this, the environment should be positive and the clinician should focus the evaluation around optimizing health, safety, performance, and participation for the sportsperson.
To summarize, the overall experience for both clinician and sportsperson should be constructive, motivating, and enjoyable.
Conducting pre-participation physical evaluations can achieve several key objectives (see box opposite).
Objectives of pre-participation physical evaluations
To provide an entry point for medical care
To screen for potentially life-threatening conditions
To review injury history and identify relevant ...
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