The Preparticipation Sports Evaluation

• In general, the evidence base for the PPE is limited. (5) • The clinician should coordinate and address the goals of parents, athletes, and organizations while promoting safe participation in physical activity. • Based on at least fair evidence, the PPE does little to prevent morbidity and mortality in athletes. (4) • Based on expert opinion, the PPE is best performed well in advance of the competitive season. (5) • Based on expert opinion, the office-based PPE is preferable to the station-based approach. (5) • Based on at least fair evidence, clinicians should focus on the medical and musculoskeletal history because most conditions that affect participation are elicited from that history. (5)(13)(14) • Based on expert opinion, athletes who have suffered a concussion should not be allowed to return to play while symptomatic and should follow a stepwise progression of graduated return to full activity. (17) • Based on expert opinion, screening echocardiography and electrocardiography should not be routine parts of the PPE. (13) • Based on expert opinion, athletes who have lost a paired organ may compete in any sport with proper protective equipment. (22)(26) • Based on expert opinion, most athletes who have chronic medical conditions can compete safely in most sports. (26).