Introduction and Context
Physical activity is one of the most effective interventions for preventing chronic disease, yet a small risk of serious adverse events—mainly cardiovascular and musculoskeletal—accompanies higher-intensity or new exercise. In response to gaps in guidance for non‑elite adults who plan to start or resume intensive exercise, the German Society for Sports Medicine and Prevention (DGSP) led a multi‑society consensus to produce the S2k guideline “Sports Preparticipation Evaluation for Healthy Adults” (Joisten et al., Sports Med 2025) [Joisten 2025].
Why now? Existing PPE guidance mostly targets elite athletes or provides divergent recommendations for middle‑aged adults (ACSM, EFSMA, EACPR). The German panel sought to fill a practical gap: how to screen apparently healthy adults (≥18 years) who intend to begin or increase the intensity/volume of exercise while balancing feasibility, cost, and the harms from overtesting. The guideline is consensus (S2k) rather than a full systematic evidence review—reflecting limited primary trial data—but it draws on 35 prior guidelines and 55 cited primary studies.
