Comprehensive Overview of Pre-Participation Physical Examination

2. Chapter 6 The Pre-Participation Physical Examination

3. Objectives • Upon completion of this chapter, you should be able to: • Discuss the needs and overall goals of the pre-participation physical examination • Distinguish between office-based and station-based exams • List the important components of the pre-participation physical examination

4. Objectives (cont’d.) • Upon completion of this chapter, you should be able to (cont’d.): • Describe the clearance process for athletic examinations • Discuss confidentiality concerns with recordkeeping

5. The Pre-Participation Physical Examination (PPE) • Originally consisted of a short physical, often less than five minutes • Today, it can be a comprehensive assessment of an athlete’s overall health and ability to perform • Goal is to maintain health and safety of the athlete

6. The PPE (cont’d.) • Timing • Should take place at least six weeks prior to the beginning of the athlete's sport season • End of school year through mid-summer • Any athlete rehabilitating over the summer must be reevaluated

7. The PPE (cont’d.) • Station-based PPE • Examination by several different specialists • Each responsible for one aspect • Includes medical history and basic measurements of blood pressure, height, weight, and eyesight

8. The PPE (cont’d.) • Station-based PPE (cont’d.) • Specialists often include: • Family physicians • Orthopedic specialists • Physical therapists • Athletic trainers • Podiatrists • Pediatrician

9. The PPE (cont’d.) • Station-based PPE (cont’d.) • Advantages: • Low cost • Athlete will see several different sports medicine specialists throughout the exam process • Disadvantages: • Difficulty of recruiting volunteer physicians • Finding a facility

10. The PPE (cont’d.) • Office-based PPE • Traditional doctor’s office • Family physician usually has patient's complete medical history as a basis • Quiet setting

11. Components of the PPE • Medical history is the cornerstone • Identifies about 75% of problems affecting athletes • Recommended baseline: • Medical conditions and diseases • Surgeries and hospitalizations • Medications • Allergies

12. Components of the PPE (cont’d.) • Recommended baseline (cont’d.): • Immunization status • Menstrual history • Pulmonary status • Neurological status • Musculoskeletal status • Injuries or illness since last exam

13. Components of the PPE (cont’d.) • Standard components: • Height • Weight • Pulse • Blood pressure • Eyes, ear/nose/throat, heart, abdomen, genitalia (males only), skin, and musculoskeletal

14. Clearance for Participation in Sports • Three categories: • Unrestricted clearance • Clearance after completion of further evaluation or rehabilitation • No clearance for certain types of sports or for all sports

15. Clearance for Participation in Sports (cont’d.) • Sports are classified based on degree or level of contact and strenuousness • Contact or collision sports • Limited contact sports • Noncontact sports

16. Recordkeeping • Managing resulting information is crucial • Information must be made available to coaches, trainers, and the athletic director • All information contained on the PPE form must be kept strictly confidential • Secured in the office or under lock and key • Should be kept for a minimum of seven years

17. Conclusion • The PPE has evolved to become a comprehensive approach to medical assessment • Can be either office-based or station-based • Determining clearance is the most important PPE result • The ultimate goal of the PPE is to allow athletes to compete safely