Optimizing the collegiate preparticipation physical evaluation.

BACKGROUND

Today's collegiate student athlete is a highly diverse individual and as such is at higher risk for many health problems both on and off the field.

OBJECTIVE

To determine if a preparticipation evaluation (PPE) can be optimized to help the collegiate team physician and athletic trainer assess both current and past health issues of student athletes.

DATA SOURCES: Utilizing MEDLINE and other medical literature database search engines, the authors conducted detailed literature searches on this subject. Key words used in these searches included preparticipation physical evaluation, collegiate, athlete, cardiovascular, preventive healthcare, high risk, alcohol, tobacco, sexually transmitted disease, motor vehicle accident, adolescent, and female.

METHODS

Approximately 35 articles were selected for review for this report. Authors reviewed articles within their particular area of content responsibility. Personal communications with several sports medicine experts were also conducted.

RESULTS

Twenty-three articles were selected for inclusion, in addition to information obtained from the American College of Sports Medicine and National Collegiate Athletic Association (NCAA) Web sites. Utilizing these sources, as well as guidance and suggestions from other sports medicine physicians, the authors determined that the NCAA-mandated PPE should deliver an overview of the athlete's entire health status.

CONCLUSIONS

As detailed in this report, it is recommended that the NCAA PPE serve as a tool in tracking and assessing both current and past health issues of student athletes. These health issues would include (1) on-field health concerns such as cardiac and musculoskeletal conditions, (2) off-field health concerns (that may adversely impact on-field performance) such as sexual activity and substance abuse, and (3) health issues unique to the female student athlete, such as eating habits, nutritional record, and menstrual history. Primary care physicians should be involved in all PPEs as they have the necessary expertise to recognize potential problems in these areas.