Preparticipation physical evaluations in youth sports: a systematic review of current recommendations
Background:
Participation in youth sports is on the rise in America, and discourse exists regarding frequency and content of the preparticipation examination (PPE) to best identify risk factors and prevent injury. Our objective was to review current recommendations for PPEs proposed by the specialties that most commonly perform PPEs: the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Sports Medicine, and the National Athletic Trainers' Association.
Methods:
The evidence basis for the recommendations in PPE Campaign and Coalition for Youth Sports Health and Safety Fourth Edition and the National Athletic Trainers' Association (NATA) position statement on PPEs were reviewed. Recommendations with a strong empirical basis (Category A and B) were distinguished from those which were opinion-based.
Results:
A thorough review of all recommendations revealed only one Category A and three Category B recommendations. These recommendations were in the categories of orthopedic screening, medical/family history and general health screenings.
Conclusions:
There is little evidence supporting the effectiveness of current recommendations in preventing primary and secondary injury in youth sports. The few recommendations which are evidence-based speak to the importance of a complete review of medical and family history and performing a thorough musculoskeletal exam.
