Clearing athletes for participation in sports. The North Carolina Medical Society Sports Medicine Committee's recommended examination.

The North Carolina Medical Society's Medicine Committee has reviewed current U.S. literature on preparticipation examinations and adopted a documentation form that fits the specific needs of our state. In spite of a recently published comprehensive monograph on preparticipation physical evaluation, no national consensus exists about whether comprehensive preparticipation exams or brief, focused examinations are better. With this in mind, we limited medical history questions to those determined by previous studies to identify specific problems. Also included are evaluations of blood pressure, musculoskeletal, and cardiovascular systems since studies have shown significant yield from these. The same studies find little benefit from the remainder of a comprehensive physical assessment. The recommended evaluation represents a minimal standard and addresses the core areas likely to prevent athletes from participating safely in sports. No recommended exam could cover all issues that affect school-age athletes--health prevention, adolescent development, general medical care, and psychological stresses--but physicians can use the recording form as a starting point and incorporate a more extensive evaluation into the assessment of athletes found to be at increased risk. Consistent use of this examination should promote better detection of sport-specific risks related to cardiovascular disorders, asthma, musculoskeletal problems, concussions, heat-related problems, and general medical problems. The Sports Medicine Committee wants to promote physical activity. Before disqualifying athletes physicians should remember that the disqualification rate in published studies averages only 1%. When questions about the need for disqualification arise, consultation may be advisable.(ABSTRACT TRUNCATED AT 250 WORDS)