The Preparticipation Physical Examination: Mayo Clinic Experience With 2,739 Examinations

Abstract

To report the results of preparticipation physical examination (PPE) performed on 2,739 high school athletes and present a model for providing PPEs in similar practice settings. We analyzed 2,739 PPEs performed on high school athletes by means of a station examination approach in our Sports Medicine Center during a 3-year period. Personnel from the Departments of Physical Medicine and Rehabilitation, Orthopedics, Family Medicine, and Internal Medicine participated in performance of a comprehensive station-based physical examination of high school athletes. The final reviewing physician assigned one of three dispositions to each athlete: cleared for participation in sports, not cleared, or cleared with follow-up recommended. On the basis of PPE findings, 53 athletes (1.9%) were disqualified from participation in sports. Abnormalities that did not preclude participation but necessitated follow-up were identified in another 327 athletes (11.9%). Musculoskeletal problems were the leading cause of restriction from sports activities (43.4%) and the second leading cause for recommended follow-up (27.8%). Clinically significant cardiac abnormalities were noted in only 10 athletes (0.37% of the overall group of students). Our methods and results are discussed in relationship to previous PPE studies. On the basis of this study, we conclude that (1) a Sports Medicine Clinic can efficiently administer PPEs to a large number of athletes by using an adaptable station approach, (2) the musculoskeletal component of a PPE is an important part of the process that often reveals abnormalities and should be performed by qualified personnel, and (3) each practice must refine its delivery of PPEs on the basis of its particular environment.