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For this issue of BJSM, we were charged with crafting a systematic review of how well the preparticipation physical evaluation (PPE) meets its objectives in paediatric athletes. According to the fourth edition PPE monograph, the primary objectives for the PPE are to screen for conditions that may be life-threatening, disabling or predispose to injury or illness.1 While substantial literature has emerged on cardiac and musculoskeletal screening in this group, there was insufficient information on the remainder of the evaluation, particularly in preadolescents, to produce a meaningful systematic review. This lack of evidence, and the evolution of the healthcare landscape, raises concern about resources currently used to conduct PPEs as a discrete clinical service, particularly when separated from broader preventive and screening services delivered by primary care providers (PCPs).
Current recommendations are for children and adolescents to accumulate 60 min of moderate to vigorous physical activity per day, with an emphasis on the need to include vigorous levels of exertion. Therefore, assessments to enhance safety during high-intensity physical activity and sport should …