Development of a Best-practice Guideline to Support the Implementation of the Preparticipation Physical Examinations in Canada

Canadian sport lacks a solid foundation related to guidelines or laws requiring athletes to undergo a pre-participation physical examination as a minimum entry requirement to sport. As a result, athletes participating in sports in Canada are at risk of sudden death, or preventable injury. The purpose of this project was to develop a best practice guideline to direct Canadian health care providers in the implementation of a preparticipation physical examination (PPE), and to validate the best practice guideline through both public and peer review. A draft of the guideline was distributed to a group of 13 community stakeholders for initial review, edits were made and the guideline was then distributed to 10 medical professionals for an additional assessment utilizing the AGREE II tool. The results were then analyzed utilizing the formula provided with the tool to assess the 6 domains of: scope and purpose, stakeholder involvement, rigor of development, clarity and presentation, application and editorial independence, as well as overall quality. Based on responses from both evaluations, the guideline demonstrated a high level of evidence and currency in practice, and was recommended by both groups for adoption as a guide PPE in Canadian sport. Through the use of this best practice guideline, health care providers will have an evidence-based tool to reduce the number of preventable injuries and illnesses in sport through comprehensive assessment. The implications for social change are an increase in safety and protection for Canadian athletes through an effective, and consistent PPE process, evaluating not only physical complaints, but the psychological and social aspects of their health in order to provide a holistic assessment of the athlete.