The use of a standardized pre-participation physical examination form in Turkish adolescent athletes

OBJECTIVE: The pre-participation physical examination (PPE) has become the standard of care for athletes of all ages. The PPE is generally intended to identify medical conditions that may affect safe and effective participation in organized sports. The aim of this study is to validate and to implement a standardized questionnaire in Turkish language, which might aid Turkish physicians during the PPE.

METHODS: A total of 1350 athletes visiting the yearly PPE of the Directorate of Sports and Youth in Isparta, Turkey were asked to participate in this study between October 2001 and November 2001. Eight hundred and ten (60%) students accepted to fill out the questionnaire. A self-reported questionnaire that includes 2 parts has been administered. The first part included questions on socio-demographics. Second part is a translated PPE evaluation form. The questionnaire has been piloted in 15 adolescent students. Athletes have been examined afterwards by one of the medical practitioner and he used the questionnaire (PPE Evaluation Form) to identify additional problems in each athlete.

RESULTS: Participants were predominantly male, with higher family income and social security, active at an amateur level, participated in team, and in contact sports. Internal consistency of the PPE form was Cronbach alpha=0.69. Thirty-one (3.8%) athletes had significant findings that needed further evaluation. No one was disqualified after follow-up. Eight items, which asked for certain cardiovascular risk factors, had significant relation to cardiovascular findings of PPE [Chi-Square (1) = 7.4-99.6, p<0.01]. An additional 132 (16.3%) athletes had significant problems that never had been adequately evaluated or treated but which were not likely to affect safe sports participation.

CONCLUSION: The Turkish PPE form seems to be promising tool to support the physician during PPE. Using a standardized and valid PPE tool might diminish the dependency of primary care physicians to technological equipment, which are mostly not available in developing countries' primary health care settings and would also reduce the costs of PPE, which might not be affordable for athletes without social security.