References

1. Rubin A: Team physician or athlete's doctor? Physician Sportsmedicine 1998;26:27-29.

2. Madden CC, Walsh WM, Mellion MB: The team physician: The prepar-ticipation examination and on-field emergencies. In DeLee JD, Drez DD, Miller MM (eds): Orthopaedic Sports Medicine: Principles and Practice, 2nd ed. Philadelphia, Saunders, 2003, pp 737-768.

3. American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, American Osteopathic Academy of Sports Medicine: Preparticipation Physical Evaluation, 3rd ed. Overland Park, KS, American Medical Society for Sports Medicine, 2005, pp 93-98.

4. Jacobson KE: Jack C. Hughston, MD—Orthopaedist and pioneer of sports medicine. Am J Sports Med 2004;32:1816-1817.

5. Johnston L: From orthopaedics to sports medicine—One man's vision. M.D. News, Western Georgia Edition 2003;3:6-10.

CHAPTER 2

The Preparticipation Physical Examination

Robert Hosey and Kenneth Cayce IV

In This Chapter

Timing and frequency

Methods of conducting preparticipation exams History Physical exam The special-needs athlete Determination of clearance Future of the preparticipation exam

In 1992, the first standardized preparticipation examination form was introduced to the sports medicine community.2 Despite the availability of standardized examination forms, there has not been widespread use of a common form. Ninety-seven percent of colleges and universities require the preparticipation examination process, and all 50 states and the District of Columbia require a preparticipation examination to be completed for high school athletes.3,4 When preparticipation examinations are used in colleges and universities, only 51% required it to be done annually. These examinations have often been performed by various health care providers, including athletic trainers and nurse practitioners.5

The primary objectives of the preparticipation examination are to screen for conditions that may be life threatening or disabling or that may predispose to injury or illness and to meet administrative requirements. Secondary objectives include determining general health, serving as an entry point to the health care system for adolescents, and providing opportunity to discuss health-related topics.6 Recently, a consensus panel made up of practitioners from the American Academy of Family Physicians, American Academy of Pediatrics, American Medical

Society of Sports Medicine, American College of Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine has evaluated and updated the preparticipation sports examination.6 The resulting monograph, published in 2004, was designed to help physicians identify specific and relative contraindications to participate in certain sports and to attempt to produce a standardized preparticipation examination.

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