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Advancing the preparticipation physical evaluation: an ACSM and FIMS joint consensus statement
William O Roberts1, Herbert Löllgen, Gordon O Matheson
1*Department of Family Medicine and Community Health, Phalen Village Family Medicine Clinic, University of Minnesota, St Paul, Minnesota; †Hon.Pres.German Fed.Sports Medicine, Bermesgasse, Remscheid, Germany; ‡Department of Orthopaedic Surgery, Stanford School of Medicine, Stanford, California; §Department of Economics, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana; ¶Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada; ‖Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; **University of Illinois at Chicago, Chicago, Illinois; ††The Goldberg Center for Community Pediatric Health, Children's National Medical Center, Washington, District of Columbia; ‡‡University of Chicago, Chicago, Illinois; §§Institute of Sports Medicine and Science, Rome, Italy; ¶¶FIMS, EFSMA, Kiewitstraat, Hasselt, Belgium; ‖‖Department of Sports and Physiological Performance, Centre for Sports Science and University Sports, of the University of Vienna, Vienna, Austria; and ***University of Rome "Foro Italico," Piazza Lauro de Bosis, Roma.
Abstract:
: While the preparticipation physical evaluation (PPE) is widely accepted, its usage and content are not standardized. Implementation is affected by cost, access, level of participation, participant age/sex, and local/regional/national mandate. Preparticipation physical evaluation screening costs are generally borne by the athlete, family, or club. Screening involves generally agreed-upon questions based on expert opinion and tested over decades of use. No large-scale prospective controlled tracking programs have examined PPE outcomes. While the panel did not reach consensus on electrocardiogram (ECG) screening as a routine part of PPE, all agreed that a history and physical exam focusing on cardiac risk is essential, and an ECG should be used where risk is increased. The many areas of consensus should help the American College of Sports Medicine and Fédération Internationale du Médicine du Sport in developing a universally accepted PPE. An electronic PPE, using human-centered design, would be comprehensive, would provide a database given that PPE is mandatory in many locations, would simplify PPE administration, would allow remote access to clinical data, and would provide the much-needed data for prospective studies in this area.