Wilderness Preparticipation Evaluation and Considerations for Special Populations

Elizabeth Joy*, Karin Van Baak, Katherine L. Dec, Barbara Semakula, Ashlea D. Cardin, Jay Lemery, George C. Wortley, Michael Yaron, Christopher Madden

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Children, older adults, disabled and special needs athletes, and female athletes who participate in outdoor and wilderness sports and activities each face unique risks. For children and adolescents traveling to high altitude, the preparticipation physical evaluation should focus on risk assessment, prevention strategies, early recognition of altitude-related symptoms, management plans, and appropriate follow-up. As the risk and prevalence of chronic disease increases with age, both older patients and providers need to be aware of disease and medication-specific risks relative to wilderness sport and activity participation. Disabled and special needs athletes benefit from careful pre-event planning for the potential medical issues and equipment modifications that may affect their health in wilderness environments. Issues that demand special consideration for female adventurers include pregnancy, contraceptive use, menses, and ferritin levels at altitude. A careful preparticipation evaluation that factors in unique, population- specific risks will help special populations stay healthy and safe on wilderness adventures. The PubMed and SportDiscus databases were searched in 2014 using both MeSH terms and text words and include peer-reviewed English language articles from 1977 to 2014. Additional information was accessed from Web-based sources to produce this narrative review on preparticipation evaluation for special populations undertaking wilderness adventures. Key words include children, adolescent, pediatric, seniors, elderly, disabled, special needs, female, athlete, preparticipiation examination, wilderness medicine, and sports.

Original languageEnglish
Pages (from-to)76-91
Number of pages16
JournalWilderness and Environmental Medicine
Issue number4
StatePublished - Dec 2015
Externally publishedYes


  • altitude
  • disabled and special needs athlete
  • older adult
  • pediatrics
  • pregnancy
  • preparticipation evaluation


Dive into the research topics of 'Wilderness Preparticipation Evaluation and Considerations for Special Populations'. Together they form a unique fingerprint.

Cite this