Children and Exercise

Abstract

Children participate in sports all over the world and should have a pre-participation physical evaluation (PPE) before the season begins. The 2010 consensus guidelines suggest a PPE for children. The primary goal is to maximize safe participation for all, identify medical problems with risks of life-threatening complications during participation and conditions that require a treatment plan before or during participation, rehabilitate old musculoskeletal injuries, treat conditions that interfere with performance, and remove unnecessary restrictions on participation. The PPE should take place 4–6 weeks before the season starts. Most children with chronic medical conditions can participate in a sport at some level after appropriate evaluation and/or treatment. Sudden death in the young athlete occurs with prevalence of between 1:100,000. Most athletes who die suddenly have no symptoms of life-threatening cardiovascular disease, and the PPE is not efficient in detecting them. However, athletes suspected of having these conditions on the basis of historical or physical findings must not participate until further evaluation by a cardiologist. The European Society of Cardiology (ESC) has proposed guidelines for pre-participation screening for young athletes planning to begin competitive sports, which includes a standard 12-lead ECG.