The Role of Pre-participation Assessment and Screening in Basketball

Abstract

The pre-participation evaluation (PPE) is a complete history and physical exam performed by a medical professional on athletes of all ages. PPE origins come from the late 1800s, when British children were examined prior to the start of physical education classes. This exam was improved by the United States military physicians to determine if draftees were fit for duty. Now, governed by six medical societies, the main goal of a PPE is to allow athletes to compete and promote lifelong health and safety. The PPE is not evidence-based due to lack of outcome data and little to no change in overall morbidity and mortality. Despite lack of evidence, the PPE remains the standard of care for all athletes. PPEs are often performed prior to the start of the season to allow for evaluation, treatment, and rehabilitation on any provider concerns. Methodology for PPEs include a single provider, office-based setting, and team-based physicals. Historical forms should be completed prior to PPEs, and focus should remain on the cardiac, musculoskeletal, and neurological systems. Cardiac screening, with a thorough history review, is an essential portion of the PPE. Although currently screening EKGs during routine PPEs are not recommended by many governing societies, some evidence indicates that performing EKGs on high-risk populations may improve cardiac screening. Basketball players commonly have lower extremity musculoskeletal injuries. Sports-specific dynamic testing are adjuncts to the routine PPE musculoskeletal exam that may be beneficial. Physicality in basketball has been on the rise, thus injury, including concussions, has become more prevalent in basketball associations; baseline concussion testing is recommended by many sports organizations as a onetime screening tool which can also be used for return to play guides. Screening labs and tests may be great additions to the PPE but are not custom to the PPE. Lastly, athletes with physical and mental disabilities undergo the same PPE processes, except pathology-specific exams must be performed for medical eligibility.