The Preparticipation Sports Evaluation

Andrew R. Peterson, MD, MSPH* 2. David T. Bernhardt, MD† 1. *Department of Pediatrics, University of Iowa, Iowa City, IA. 2. †Departments of Pediatrics and Orthopedics and Rehabilitation, University of Wisconsin, Madison, WI. After completing this article, readers should be able to: 1. Perform a preparticipation history and physical examination and identify children and adolescents who may be at increased risk of morbidity or mortality from sports participation. 2. Recognize that many adolescents make infrequent contact with the medical system and that the mandatory preparticipation evaluation serves as an opportunity to address medical issues not necessarily associated with sports participation. 3. Know the conditions that should be evaluated by a cardiologist before sports participation. 4. Discuss the importance of assessing and documenting neurocognitive function in a preparticipation sports examination. 5. Understand that disqualification from one sport does not imply disqualification from all sports. Sports participation among people of all ages has increased steadily over the past 4 decades. This trend generally has been considered to be a positive development, with conventional wisdom asserting that sports participation teaches leadership and cooperative skills that have a lifelong impact. In addition, as the obesity pandemic worsens, organized sports participation and unstructured play or physical exercise can be a source of needed physical activity for children and adolescents. The pediatrician often is asked to evaluate a child's or adolescent's suitability for sports participation. The purpose of this evaluation has remained constant since it was first described in 1978. (1)(2) The goals are to fulfill the institution's legal and liability requirements, provide some assurance to coaches that athletes will start the season at an acceptable level of health and fitness, provide an opportunity to discover treatable conditions, and aid in predicting and preventing future injuries. The evaluation should be practical and applicable to all sports. The specific objectives of the evaluation …