Preventive medicine in elite sport: The role of the periodic health evaluation
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Health problems are an occupational hazard for elite athletes. Medical surveillance by the International Olympic Committee reveals that up to one in six athletes are injured and one in ten experience an illness during the period of an Olympic Games. These health problems range from the common cold to catastrophic, disabling injuries, and death. In addition to health consequences, the financial and performance impacts of injury and illness can be significant to both the athlete and their team. Protecting athletes from injury and illness is an important task for all sport organizations. Preventive medicine reduces the impact of health problems by stopping them from occurring and reducing their burden. In elite sport, one aspect of preventive medicine is the periodic health evaluation (PHE). The objectives of the PHE are to comprehensively review of an athlete’s health status, assess for risk of future health problems, serve as an entry point into the healthcare system, and to monitor health over time. Several approaches to the PHE have been described, with varying levels of clinician-patient engagement, necessary resources, and clinical complexity. Despite widespread adoption, whether PHEs improve the health and wellness of athletes is unknown. Better understanding of the PHE can result in improved health for athletes, more efficient resource allocation for sport organizations, and will guide other areas of athlete health promotion research and practice. The aim of this dissertation is to describe current PHE practices in elite athlete populations and assess the value of specific elements of the PHE: the health history, iron screening, and screening for conditions that are difficult to diagnose in primary care (sleep, mental health, and allergies).
Avhandling (doktorgrad) - Norges idrettshøgskole, 2022
Has partsPaper I: Nabhan D, Taylor D, Lewis M, Bahr R. Protecting the world’s finest athletes: periodic health evaluation practices of the top performing National Olympic Committees from the 2016 Rio or 2018 PyeongChang Olympic Games. Br J Sports Med 2021:bjsports-2020-103481.
Paper II: Nabhan D, Taylor D, Hedges A, Bahr R. The value of the patient history in the periodic health evaluation: Patient interviews capture 4 times more injuries than electronic questionnaires. J Orthop Sports Phys Ther; 2021;51:46–51.
Paper III: Nabhan D, Lewis M, Taylor D, Bahr R. Expanding the screening toolbox to promote athlete health: how the US Olympic & Paralympic Committee screened for health problems in 940 elite athletes. Br J Sports Med 2021;55:226–30.
Paper IV: Nabhan D, Bielko S, Sinex JA, Surhoff K, Moreau WJ, Schumacher YO, Bahr R, Chapman R. Serum ferritin distribution in elite athletes. J Sci Med Sport 2020;23:554–8.