AAP: Update on medical conditions affecting sports participation

Stephen G. Rice, MD, PhD, provided an overview of the major changes in the American Academy of Pediatrics (AAP)'s new clinical report on medical conditions affecting sports participation, at the AAP 2008 National Conference and Exhibition in Boston.

The key changes to the AAP's report include:

• Revised/updated text portion
• Modifications to Table 1 (sports categories)
• Major additions and revisions to Table 2 (this section features the most significant changes to the report, Rice said)
• Used latest version of Figure 1 from the 36th Bethesda conference
• Expanded references 22 to 68

Rice said that in updating the report, he and the Council on Sports Medicine and Fitness devised more specific judgment criteria for assessing whether a student athlete can participate in a sport, clarified the previous distinction made between contact and collision sports, and increased overall precision of the report's wording. There were new consensus statements on concussions as well, Rice said. In addition, clarifications were made to various case scenarios, which sometimes dealt with controversial topics.

"Probably the biggest controversy of all [in updating the report] was in sickle cell trait and sickle cell disease," Rice said. This was due to negotiating over what language to use.

In addition, the wording for a case scenario involving an athlete with one functioning eye was clarified, a condition which is now defined as someone whose acuity in the poorer eye is worse than 20/40.

The full updated report can be accessed here.