The preparticipation physical examination for athletics: a critical review of current recommendations

The preparticipation physical examination (PPE) has become the standard of care for the millions of high school students in the United States as they prepare for athletic participation. These assessments are intended to identify medical conditions that may affect safe and effective participation in organized sports. The PPE has become an integral aspect of the athletic and sports medicine system during the last three decades. Over time, the PPE has been revised, largely based upon the recommendations of large medical organizations. Several primary and secondary goals have been presented to be accomplished through the PPE. One particular goal of these assessments is to identify individuals with underlying cardiovascular disease, a significant cause of acute sudden cardiac death in high school and college athletes. While current research continues to demonstrate that the PPE has no effect on the overall morbidity and mortality rates in athletes, other objectives may be fulfilled by these examinations. In order to improve the ability of these examinations in fulfilling their primary objectives, instruments that have better results in preventing the injuries and deaths associated with athletic participation should be developed and investigate.