Week 7 - Pre-participation evaluation (PPE) Flashcards
Justification for pre-participation evaluation/what is it
Well established within elite sport (McCall, 2015; Target 2013)
Recommended by the international olympic committee (Ljungqvist, 2009)
Main goals are to decrease the potential for injury, prevent re-injruy, enhance performance, improve QoL (Cook 2014 p398)
To be effective must include intervention that is specific to the individual and goal specific follow up (Mycklbust 2013; Silvrs-Granelli, 2017)
Criticisms of PPE
Bahr 2016:
Currently no adequate screening full-filing three criteria
1) string relationship demonstrated in prospective studies between marker and risk
2) marker must be validated in relevant population
3) an intervention programme targeted at “high risk” should be more beneficial than targeting “all”
Many sport-specific group interventions have good prevention though (eg NMT)
When are PPE tests done?
Starting a programme, quarterly/biannual/annual, once only with ongoing monitoring (Cook, 2014; Moran 2016; Ljungqvist 2009; Targett 2013)
What tests might PPE include and who implements?
FMS, MSK evaluation, body composition testing, fitness/agility/plyometric/strength training, pre-competition medical assessment (Cook, 2014; Moran 2016; Ljungqvist 2009; Targett 2013)
Physio/doctors etc (name MDT) and may be linked to S&C coaching, technical coaches (Moran 2016)
Benefits of PPE
Establish trends, progression of individuals and groups, development of targeted performance nhafcmenet and injury prevention programmes, identifying and excluding underlaing health risks, establishing a performance baseline of the athlete in a health state
(Barh 2016; Cook 2014; Ljungqvist 2009; Targett 2013)
Additionally:
Comprehensive review of current health status, educational tool, prevention of inadvertent doping (by reviewing medication), improved athlete self management, medico-legal duties (Bahr 2016; Cook 2014; Moran 2016)
Drawbacks
Resources, inter-rater reliability, timing in season, management support, impact on mental health, collating data, lack of specific evidence linking tests to subgroups of injury type, sport and athlete gender/age/level of competition (Bahr 2016; Finch 2016; McCall 2014; Targett 2013)
Discuss functional movement screening (FMS)
AKA dynamic profiling of which FMS is one (Cook 2014)
Debate on injury prevention effectiveness (Moran 2015).
Scored and used to identify beneficial/non beneficial movement, over/underactivity of muscle groups, joint hypomobility/possible hypermobility, control/balance issues.
Eg back squat, single hop
(Cook 2014; Chimera 2016; Moran 2015)
Discuss MSK evaluation
Most effective alongside prev medical and injury history - previous injury is biggest predictor of future injury (Brinkman 2011; Haggland 2013)
Subject of debate (Pontillo 2004, Bahr 2016)
Assess posture+biomechanics, muscle length testing eg knee to wall, joint mobility tests (hip internal/external rotation), muscle strength and function tests (repeated calf raise), balance and control tests (Y-balance) (Chimera 2016)
Discuss types of physical and fitness assessment
Biometrics, plyometrics, agility testing, CVS testing (Cook 2014; Target 2013)
Aims of PPE (Week 6)
Environment to maintain health and safety
Detection of life threatening or disabling conditions
Screening for predisposition to illness or injury
Entry point to health care
Opportunity to build rapport
Whats included in a medical PPE (week 6)
History
Chronic Illness
Musculoskeletal
Cardiac
Respiratory
Other Systems
Risk Takers
Allergies And Immunisations
Esp: Particular attention to syncope and pre syncope during exercise
Drug history - WADA List
Family History- particularly premature cardiac deaths
What is epilepsy and absolute/relative CI for
Absolute C/I for rock climbing flying scuba motor racing archery shooting
Relative C/I swimming cross country skiing cycling
