2023-10-07 05:18:00
Alongside the start of the school year, thousands of children have also returned to sports in recent weeks. A resumption of activities which also concerns more and more young people, and that is good news. Indeed, in the Wallonia-Brussels Federation, a positive development in the sporting practice of children and adolescents has been noted: 76% of 6-18 year olds practice a sporting activity, i.e. 10% more than in 1991, and 6% more than in 2006.
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But when it comes to requesting a certificate of fitness for sport or carrying out medical monitoring, each discipline decides on its own rules. It happens that some clubs request exercise tests before registering for competitions, others do not. And in certain disciplines, nothing is required before starting a sporting activity.
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Parents also have their share of responsibility to push their child to participate in as many competitions as possible.
“For the little ones, we would prefer a return of the medical record”
“Today, there is almost no control, it’s a jungle,” laments Pascal Eeckhout, international cycling race commissioner and very active within the Belgian cycling federation. We don’t always know if children can ride, how many races they have done, etc. Parents also have their share of responsibility in pushing their child to participate in as many competitions as possible. The most important thing is that when they come to ride for the first time, there is a medical check-up, which is rarely the case. Furthermore, sports federations do not dictate strict enough rules and clubs do what they want.”
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We have more and more parents who demand a document so that their child can start playing sport without any exam.”
According to him, implementing tests twice a year would make it possible to detect possible heart problems or other pathologies that would be undetectable during a simple visit to the doctor. “With systematic screening, we might avoid certain accidents,” he emphasizes. For the little ones, we would prefer a return of the medical record as was the case before when it was compulsory. Anyone who didn’t have it mightn’t ride. When they grow up, we notice certain incidents because there was no prior control. We therefore prefer to limit participation in order to preserve their health. In this sense, an exercise control at the start of the season and at the end would be interesting from a preventive point of view”.
The other phenomenon is the multiplication of certificates of convenience. To be clear, certificates are too easily issued to parents. In a Schaerbeek medical center, the practice is common. “We have more and more parents who arrive on Monday at 8 a.m. and demand a paper so that their child can start sports without any exam,” says Sabine (not her real name), medical secretary. They explain that their child is healthy, that they don’t have time for an appointment and are often aggressive in getting a stamp from our doctors. The problem is that we see some issuing them without going through the examination, under pressure from families”.
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“The opportunity to do a complete clinical examination”
If carrying out a comprehensive cardiac screening is not considered relevant, doctors advise families to have a health check-up before registration.
In Belgium, no law requires federations to impose a medical certificate on children who wish to start practicing a sporting activity. However, some of them ask families for a medical certificate.
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“We do not issue a certificate of fitness for sport as a doctor, we rather talk regarding a certificate of non-contraindication to the practice of a sport,” recalls Jimmy Fontaine, general practitioner and member of the Scientific Society of Medicine. general (SSMG). If there is no obligation with us, we still advise parents to come because it is an opportunity to see if the patient is in good health or not, to do a complete clinical examination, which sometimes allows us to put shed light on certain things. For example, I happened to discover that a teenager whom I had not seen for years suffered from high blood pressure or problems because of his weight. It is an appointment which allows us to update the state of health of the child so it is still of interest”.
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Unfortunately, many brutal pathologies might not have been avoided thanks to screening medicine”
In Belgium, it is estimated that every year, between 3 and 10 young people die due to a cardiac accident occurring during a sporting activity or competition. In 2013, despite a certain number of reservations, the Higher Health Council considered that it made sense to offer systematic cardiac screening for all young athletes. But in a report published in 2015, experts from the KCE (Federal Center of Expertise for Health Care) favored another position. According to them, no reliable scientific data demonstrates that such systematic screening would prevent sudden deaths among young athletes (aged 14 to 34).
“This would not be manageable for us, for example if we had to carry out an electrocardiogram for all children, this would increase demand and risk short-circuiting other care which might be more useful,” he underlines. This should not impact the people who need it most, especially as the population is aging with more and more chronic illnesses to treat. Mass screening of the population at this level would not make sense. Unfortunately, many of the brutal pathologies that occur in the world of sport might not have been avoided thanks to screening medicine.”
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