Screening in Sport

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Introduction

In the endeavours to optimize effects of sports participation and training, unfortunate side-effects should be minimized. Indeed, the devastating impact of cardiac arrest (CA) or sudden death (SD) in athletes has shocked societies and sports spectators all over the world. Preventive measures, specifically pre-participation screening have been advocated by the European Society of Cardioloy (ESC) and have subsequently been implemented in some sporting communities. The EACPR Sports Cardiology section answers below our key questions on pre-participation screening.

Sports participation and athletics can be a positive experience for all age groups – by boosting fitness, enhancing self‐esteem, enhancing coordination and providing an opportunity for creative cooperation and competition. Participation in sports and athletic activities has continued to increase at all levels of society from the very young youth sports activities, to high school and college, and finally to the baby boomer generation. More high school students are playing sports than ever before; more than 7.6 million (55.5%) of all high school students participate.5 For the ninth consecutive year, there has been a marked increase in athletics participation at the collegiate level with more than 444,000 student athletes competing on more than 18,000 teams.

Aim of Screening

The primary aim of the PPE as performed in other countries would appear to be the detection of cardiovascular abnormalities to prevent sudden death among young athletes. The Australian medical screening program has a broader perspective and is aimed at improving the health of the athlete. The medical screening of these high performance athletes has a number of aims:
(1) Prevent sudden death
(2) Ensure optimal medical health (asthma, diabetes, menstrual,
depression)
(3) Ensure optimal musculoskeletal health

(4) Optimize performance (nutrition, psychology, biomechanics)
(5) Prevent injury
(6) Review medications and vaccinations
(7) Collect baseline data (blood tests, neuropsychological
testing in contact sports)
(8) Develop professional relationship with athlete
(9) Educate

Screening Protocol

Medical Screening

With the help of sports medical screening examinations, early recognition of risks and diseases is possible. It is perfectly clear that this can contribute towards a considerable reduction in health risk, particularly of sudden cardiac death.The German Society for Sports Medicine and Prevention (DGSP) has issued a new S1 guideline "Guideline for Sports Medical Screening Examination", which, for the first time, specifies evidence-based recommendations and quality standards for sports medical screening examinations outside professional sport or elite teams. The aim is to detect latent or present disease which might be a risk to the sportsman or sportswoman. These checkups are intended for beginners and returnees in all age groups and for ambitious hobby or high performance sportsmen and women. The checkup includes questions on the personal medical history, the family history, sporting activities and internal and orthopedic investigations.

a good estimate of the acceptance and use of sports medical screening investigations can be obtained with the current PACE study (PACE: Performance, Age, Competition, Exercise), which has already analyzed the marathon and half-marathon performances of more than 300 000 sportsmen aged between 20 and 80 (18). As part of this project, a scaled online questionnaire has been developed and translated into six languages. This puts questions about performance, training planning, habits and sports medical screening examinations. The present study has evaluated information from about 10 000 long distance runners about the use and performance of sports medical screening examinations.

Musculoskeletal Screening

Time constraints do not allow a full comprehensive assessment of all joints and muscles. Therefore, the aim of musculoskeletal screening is to assess recovery from any previous injury and to assess the presence of proven (very few) or suspected risk factors for future injury. Athletes involved in sports associated with high risk of specific joint or muscle injuries, such as, swimmers’ shoulders and pitchers’ elbows, should
have specific assessments performed on these areas.

A full injury history should be taken, and any deficits remaining postinjury should be fully assessed with a view to designing a rehabilitation program to restore full function. Frequently, athletes will have resumed full athletic participation following a significant injury and yet still have considerable limitations in strength, range of movement, proprioception,and so forth.The questionnaire asks the athlete to describe the nature
and date of any previous injury and to list any residual problems.Athletes are asked to describe the nature, date, and symptoms of any current injury.

Performance Screening

Athletes require a strong foundation in a diverse range of athletic qualities in order to tolerate the progressively advanced training loads and competitive demands of their chosen sport. The improvement of foundation movements that underpin these athletic qualities early in the athletes' development pathway is one of the key recommendations of long term athlete development models.1,2 The foundation movements typically involve variations of squatting, lunging, jumping, pushing, pulling and bracing.3‐6 Typically these movements are objectively assessed using some form of functional movement assessment criteria in order to screen athletes for dysfunctional movement patterns in an attempt to alleviate injury risk through addressing incorrect movement patterns.7 The Functional Movement Screen (FMS™) by Cook7 is by far the most popular screening tool used to provide an objective assessment of movement in sports performance research and is typically synonymous with the term “functional movement.

 the AAA can be used as an assessment tool for athlete profiling, as well as be used to assess changes in functional movement ability over time (by making multiple measurements on the same athlete following a training intervention). In order to confidently assess changes in an individual it is necessary to obtain an estimate of the measurement error that might arise solely from the tester(s). The specific objectives of this study were to determine the absolute error with one tester rating the same movements one week apart (intra‐tester reliability) as well as determining the error associated with different testers scoring the same performance (inter‐tester reliability).

Resources

/The-ESC/Communities/European-Association-for-Cardiovascular

Pre-Participation and Follow-Up Screening of Athletes for Endurance Sport

References

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