PM1074: Evaluating Consistency in Preparticipation Sports Physicals for High School Athletes

Purpose/Objectives: Currently, high school students are required to complete a physical examination prior to participation in sports. This physical examination includes a health history and a physical assessment completed by a healthcare professional. Consistency in screening is of importance in identifying pre-existing factors that could place the child at higher risk for sudden cardiac arrest or death. However, with guidelines that allow each state flexibility in their screening, assessment of student athletes is inconsistent. The purpose of this study is to evaluate the consistency of preparticipation sports physicals based on current recommendations.

Design/Methods: Evaluation of State High School Association guidelines for all fifty states and the District of Columbia was completed. Specific guidelines evaluated include: 1). if the state requires a physical and how often, 2). if the state uses the recommended PPE-4 form, 3). if the PPE-4 form is the most recent version, and 4). who can perform the pre-participation physical.
Data collection came by review of State High School Association online handbooks, bylaws and policies.

Results: All states evaluated, except one, required a physical examination prior to participation in sports. An annual physical exam was required by 68% (n=35) while the remaining states varied in requirement from every two or three years or the requirement determined by each school. A review of physical forms revealed that 52% (n=26) of states use the PPE-4, while 47% (n=24) use a variation of the form and 0.02% (n=1) did not have a stated preferred form. Additionally, of those states using the recommended PPE-4, 27% (n=7) are not using the most recent version.
Review of who can complete the pre-physical screening found that 90% (n=46) of states determined that a “qualified medical professional” (QMP) must complete the pre-participation physical.

Conclusion/Discussion: Providing high school students with consistent and thorough pre-participation screening is essential to identifying risk factors for sudden cardiac death. Pre-participation physicals need to be completed annually and only by an MD or DO. Additionally, preparticipation physicals should include the use of the recommended form by professional pediatric organizations. This provides consistency in screening for a students’ risk for SCD and minimizes the chances of a student participating in sports when they qualify for further evaluation. Continued education to State High School Associations regarding the importance of consistent screening is needed to emphasize the importance of consistency and thorough screening.