Preparticipation screening of children for sports. Current recommendations

Every year physicians all over the world are asked to perform preparticipation physical evaluations (PPE) for children involved in sports. The PPE should be brief yet comprehensive enough to determine which athletes are at risk. In addition, the examination may help determine the athlete's general health and maturity level, uncover any disqualifying conditions and may also help establish a doctor-patient relationship. PPEs should be performed 4 to 6 weeks prior to initiation of the sport and be repeated every 1 to 3 years. A station-based exam may help evaluate large numbers of athletes within a limited time period. The history is the most important aspect of the PPE and should focus on prior cardiovascular complications, a family history of cardiovascular death before 50 years of age and any other limiting medical problems. A general physical examination should be performed to focus on areas involved in sports participation. Laboratory tests are not usually necessary. Disqualifying conditions may be determined based on the physical abnormality present and the amount of contact or energy involved in the sport to be played. Throughout the world, sports participation is growing rapidly. Although these guidelines have been drafted by a consortium of sports-related and general practice groups in the US, they can easily be applied worldwide. Unfortunately the health of young adults in developing countries may not be as good as that of those residing in more industrialised countries, therefore each athlete must be considered individually. With this type of individualised approach the examining physician can make informed and intelligent decisions concerning the athlete's participation.