Pre-Participation Examination in Children

Increasing numbers of children and adolescents annually participate in the sports competitions, in which the pre-participation evaluation (PPE) is a necessity. Unfortunately, no proper outcome is attainable in our country despite the huge volume and significant costs. The primary goals of the PPE are to detect conditions that may predispose to injury, disability, or death and to meet legal and insurance requirements. It is recommended that PPE be performed 4-6 weeks prior to an athlete starting practice. There are 3 types of PPE: office based, assembly line, and station. Medical history and physical examination are two essential components of PPE. In this regard, family history and special attention to cardiovascular, pulmonary, musculoskeletal and neurologic systems are particularly important. Most guidelines do not recommend any further paraclinical testing including ECG. At the end of examination, the physician should determine the level of contact and intensity of the given sport and finally decide regarding the safe clearance of the athlete. Due to the importance of PPE as a valuable preventive method, national standardization of the PPE, endorsement of these standards by all organizations and performing the PPE by only appropriately trained physicians are the main strategies to improve the quality of evaluations.