On approval of the rules for medical examination of sportsmen for participation in sports competitions

Order of the Minister of Culture and Sport of the Republic of Kazakhstan dated December 24, 2020 No. 356. Registered in the Ministry of Justice of the Republic of Kazakhstan on December 25, 2020 No. 21902.

Unofficial translation

In accordance with paragraph 2 of Article 144 of the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”, I HEREBY ORDER:

Footnote. Preamble – as amended by Order № 127 of the Minister of Tourism and Sports of the Republic of Kazakhstan dated July 8, 2025 (shall enter into force ten calendar days after its first official publication).

1. To approve the attached rules for medical examination of sportsmen for participation in sports competitions.

2. To declare invalid:

1) order of the Minister of Culture and Sport of the Republic of Kazakhstan dated November 24, 2014 № 110 "On Approval of the Rules for Medical Examination of Sportsmen for Participation in Sports Competitions" (registered in the Register of state registration of regulatory legal acts under № 10009, published in the Legal information system “Adilet” on March 11, 2015);

2) subparagraph 2) of paragraph 1 of the order of the Minister of Culture and Sport of the Republic of Kazakhstan dated October 23, 2019 № 280 "On amendments and additions to some orders of the Minister of Culture and Sport of the Republic of Kazakhstan" (registered in the Register of state registration of regulatory legal acts under № 19513, published in the Standard control bank of regulatory legal acts of the Republic of Kazakhstan on October 28, 2019).

3. The Committee for the affairs of Sport and Physical Culture of the Ministry of Culture and Sport of the Republic of Kazakhstan, in accordance with the procedure established by the legislation of the Republic of Kazakhstan, shall ensure:

1) state registration of this order in the Ministry of Justice of the Republic of Kazakhstan;

2) placement of this order on the Internet resource of the Ministry of Culture and Sport of the Republic of Kazakhstan;

3) submission of information on implementation of measures to the Department of legal service of the Ministry of Culture and Sport of the Republic of Kazakhstan within two working days after the implementation of measures provided for by this order.

4. Control over execution of this order shall be entrusted to the supervising Vice-Minister of Culture and Sport of the Republic of Kazakhstan.

5. This order shall be enforced upon the expiration of ten calendar days after its first official publication.

Minister of Culture and Sport of the Republic of Kazakhstan

A. Raimkulova

"AGREED"
Ministry of Healthcare
of the Republic of Kazakhstan

Approved by the order of the Minister of Culture and Sport of the Republic of Kazakhstan dated December 24, 2020 № 356

Rules for medical examination of sportsmen for participation in sports competitions

Chapter 1. General provisions

1. These Rules for the medical examination of athletes for participation in sports competitions (hereinafter referred to as the Rules) have been developed in accordance with paragraph 2 of Article 144 of the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System” and shall determine the procedure for carrying out the medical examination of athletes for participation in sports competitions.

Footnote. Paragraph 1 – as amended by Order № 127 of the Minister of Tourism and Sports of the Republic of Kazakhstan dated July 8, 2025 (shall enter into force ten calendar days after its first official publication).

Chapter 2. Types of medical examination of sportsmen

2. Medical examination of sportsmen consists of:

1) in-depth medical examination;

2) staged medical examination;

3) current medical examination and medical-pedagogical supervision;

4) comprehensive functional testing;

5) pre-competition examination.

3. In-depth medical examination of athletes shall be carried out by sports medicine and rehabilitation organizations to obtain the most complete and comprehensive information about the physical development and health status of the athlete, early detection of deviations in health, therapy and prevention of somatic diseases and injuries of athletes, psychological preparation, including the functional state and indicators of his/her physical performance in dynamics.

Footnote. Paragraph 3 – as amended by Order № 127 of the Minister of Tourism and Sports of the Republic of Kazakhstan dated July 8, 2025 (shall enter into force ten calendar days after its first official publication).

4. The program of in-depth medical examination depends on the contingent of persons involved in physical culture and sport, the stage of sports training, sports specialization and shall be carried out in accordance with Appendix to these Rules.

5.Taking into account sports specialization, in addition to sportsmen:

1) ophthalmological examinations are carried out: fields of view, fundus, intraocular pressure, angle of fields of view, cycloscopy;

2) audiometry is carried out: of shooters (bullet shooting, trap shooting, archery), biathlonists, show jumpers, fencers, track and field athletes, swimmers, pentathletes, combatants and weightlifters;

3) as prescribed by a sports doctor, the following are carried out:

ultrasound examination of blood vessels, soft tissues and joints, pelvic organs, thyroid gland;

electroencephalography with functional tests, electroneuromyography;

electrocardiography (hereinafter - ECG) in orthostasis, ECG with a load on a treadmill (bicycle ergometry), daily ECG monitoring (Holter monitoring), 24-hour blood pressure monitoring, a straining test in weightlifting sportsmen (Valsalva test);

X-ray radiography;

CT scanning;

magnetic resonance imaging;

additional clinical laboratory examinations.

4) an additional examination is carried out by specialized specialists as prescribed by a sports medicine doctor (therapist, pediatrician and (or) general practitioner): cardiologist, pulmonologist, gastroenterologist, endocrinologist, dermatologist, allergist, cardiac surgeon, neurosurgeon, urologist and specialists in the field.

6. A staged medical examination shall be carried out by a sports medicine doctor in order to determine the level of health, physical performance and fitness of sportsmen after completing a certain stage of preparation for a sports competition.

A staged medical examination includes the following examinations:

1) examination by a sports medicine doctor, examination of other specialized specialists according to indications;

2) laboratory researches of biological materials;

3) functional diagnostic and anthropometric studies:

ECG at rest;

testing to determine the PWC-170 submaximal power (Physical Working Capacity) or maximum

power (until refusal to work), testing to determine the maximum alactate power (hereinafter - MAP);

anthropometry, body composition analysis.

7. A current medical examination and medical-pedagogical supervision shall be carried out for the purpose of operational control over the state of health and dynamics of adaptation of a sportsman’s body to training loads, individualization and increasing the efficiency of preparation process and recovery measures and include:

1) examination of a sportsman by a sports medicine doctor, conducting functional tests to determine the general physical performance in training sessions in accordance with Appendix to these rules;

2) functional and laboratory examinations of sportsman and examination of specialized specialists in the presence of medical indications.

8. Comprehensive functional testing shall be carried out to assess the functional state of an athlete during special training camps of national teams of the Republic of Kazakhstan in various sports.

Comprehensive functional testing shall include the following examinations:

1) examination by a sports medicine physician (examination by specialized specialists as prescribed by a sports medicine physician);

2) laboratory studies of biological material;

3) functional diagnostic and anthropometric studies:

anthropometry, body composition analysis;

plantoscopy;

spirography;

multidimensional spine analysis;

ECG;

echocardiography;

stress cardiac testing;

magnetic resonance imaging of joints;

assessment of special endurance with gas analysis and lactate determination;

assessment of speed-strength indicators.

Examinations for comprehensive functional testing of an athlete are prescribed by a sports medicine physician in agreement with the head coach of the national team of the Republic of Kazakhstan for the sport, in accordance with the sport, the cycle of training camps and competitions, and also taking into account the individual characteristics of each athlete.

Footnote. Paragraph 8 – as amended by Order № 127 of the Minister of Tourism and Sports of the Republic of Kazakhstan dated July 8, 2025 (shall come into effect upon expiration ten calendar days after its first official publication).

9. A pre-competition examination of sportsmen shall be carried out by a sports medicine doctor in order to determine the true changes in the health and functional fitness of sportsmen in the process of extreme activity, the possibility of admission to participation in competitions, prescription of a system of means for recovery and increase in efficiency.

Chapter 3. The procedure for conducting medical examination of sportsmen

10. An in-depth medical examination of sportsmen shall be carried out twice a year at the beginning of preparatory period and before sports competitions.

11. A staged medical examination of sportsmen shall be carried out depending on the number of stages of preparation during the annual cycle.

12. A current medical examination of sportsmen and medical-pedagogical supervision shall be carried out throughout the entire calendar year.

13. Comprehensive functional testing of athletes shall be conducted at least twice a year during special training camps of national teams of the Republic of Kazakhstan in sports in preparation for international and national sports competitions.

Footnote. Paragraph 13 – as amended by Order № 127 of the Minister of Tourism and Sports of the Republic of Kazakhstan dated July 8, 2025 (shall enter into force ten calendar days after its first official publication).

14. A pre-competition examination of sportsmen shall be carried out before each sports competition.

15. Based on the results of an in-depth medical examination of athletes to obtain admission to the educational and training process and participation in sports competitions, a sports medicine physician prepares a conclusion (in any form), which shall include:

1) assessment of health status and determination of membership in a functional group:

healthy, sports activities are possible without restrictions;

practically healthy with a diagnosis that does not limit physical activity during sports activities;

indication of the diagnosis requiring treatment, suspension from sports during the rehabilitation and recovery of athletes;

indication of a diagnosis that limits physical activity during sports activities and requires permanent suspension from sports;

2) assessment of physical development (based on anthropometric data and the index method);

3) assessment of adaptive capabilities and functional state (physical performance, functional reserve of the heart, type of autonomic support, orthostatic stability, speed of sensorimotor reaction).

Footnote. Paragraph 15 – as amended by Order № 127 of the Minister of Tourism and Sports of the Republic of Kazakhstan dated July 8, 2025 (shall enter into force ten calendar days after the date of its first official publication).

16. Based on the results of in-depth, stage-by-stage, current, comprehensive-functional testing and pre-competition medical examinations of athletes, form № 052/y “Outpatient Medical Record” shall be filled out, approved by the order of the Acting Minister of Healthcare of the Republic of Kazakhstan dated October 30, 2020, № ҚР ДСМ-175/2020 “On approval of forms of accounting documentation in the field of healthcare, as well as instructions for filling them out” (hereinafter referred to as Order № ҚР ДСМ-175/2020) (registered in the State Register of Normative Legal Acts under № 34558).

Footnote. Paragraph 16 – as amended by Order № 127 of the Minister of Tourism and Sports of the Republic of Kazakhstan dated July 8, 2025 (shall enter into force ten calendar days after its first official publication).

17. Based on the results of an in-depth medical examination for participation in sports events, a certificate shall be issued in the form № 027/y, approved by the order № KR HM-175/2020.

Appendix to the Rules for medical examination of athletes for participation in sports competitions

In-depth medical examination program

Footnote. Appendix – as amended by Order № 127 of the Minister of Tourism and Sports of the Republic of Kazakhstan dated July 8, 2025 (shall come into effect ten calendar days after its first official publication).

№		Athlete category	Frequency of implementation	Medical specialists	Clinical, laboratory and functional diagnostic examination methods
1.		Athletes involved in the stage of sports and health training	once a year	Pediatrician or therapist (depending on age), GP, traumatologist-orthopedist, surgeon, otorhinolaryngologist, dentist, ophthalmologist, neurologist, cardiologist, physical therapy physician, sports medicine physician	Clinical blood test (hereinafter referred to as CBT), clinical urine test (hereinafter referred to as CUT), anthropometry electrocardiography (hereinafter referred to as ECG), echocardiographic examination (hereinafter referred to as ECHOCG)
2.		Athletes at the initial training stage	once every six months	Pediatrician or therapist (depending on age), GP, traumatologist-orthopedist, surgeon, otorhinolaryngologist, dentist, ophthalmologist, neurologist, cardiologist, physical therapy physician, sports medicine physician	CBT, CUT, anthropometry, ECG, echocardiography, hand dynamometry, deadlift (hereinafter referred to as Dynamometry), ultrasound examination of the abdominal organs and kidneys (hereinafter referred to as Ultrasound of the abdominal cavity and kidneys), fluorography or chest x-ray (from age 15, no more than once a year) Functional tests to determine general physical performance: PWC-170 by L.V. Karpman, Martinet, Letunova sample, Harvard Step Test, 3-minute jog in place with high hip raises, 3-minute shadow boxing
3.		Athletes involved in the training phase	once every six months	Traumatologist-orthopedist, surgeon, otorhinolaryngologist, ophthalmologist, dentist, gynecologist, urologist, neurologist, cardiologist, sports medicine physician	CBT, biochemical blood test (total protein, creatinine, uric acid, glucose, total cholesterol, total bilirubin, bilirubin direct alanine aminotransferase (hereinafter referred to as ALT), aspartate aminotransferase (hereinafter referred to as AST), creatine phosphokinase (hereinafter referred to as CPK), alkaline phosphatase, phosphorus, sodium, calcium, potassium, magnesium, iron, cortisol, testosterone, thyroid-stimulating hormone (TSH), free T4 (FT4), CUT, anthropometry, ECG, ECG with exercise stress, echocardiography, dynamometry, Ultrasound of the abdominal cavity and kidneys, spirography fluorography or chest x-ray (from age 15, no more than once a year) Functional tests to determine general physical performance: PWC-170 by L.V. Karpman, Martinet, Letunova sample, Harvard Step Test, 3-minute jog in place with high hip raises, 3-minute shadow boxing
	4.	Athletes at the stage of sports improvement	once every six months	Traumatologist-orthopedist, surgeon, otorhinolaryngologist, ophthalmologist, dentist, gynecologist, urologist, neurologist, cardiologist, psychologist, sports medicine physician	CBT, Blood biochemistry (total protein, creatinine, uric acid, glucose, total cholesterol, high-density lipoprotein cholesterol (hereinafter referred to as HDL), low-density lipoprotein cholesterol (hereinafter referred to as LDL), total bilirubin, direct bilirubin, ALT, ACT, CPK, creatine phosphokinase- MB (hereinafter referred to as CPK-MB), alkaline phosphatase, lactate dehydrogenase (hereinafter referred to as LDH), the 1st isoenzyme of LDH; phosphorus, sodium, calcium, potassium, magnesium, iron, high-sensitivity C-reactive protein (CRP), ferritin; cortisol, testosterone, TSH, FT4). Blood test for viral hepatitis, syphilis, CUT, anthropometry and body composition analysis, ECG, ECG with exercise stress, echocardiography, dynamometry, Ultrasound of the abdominal cavity and kidneys, spirography, Chest fluorography or X-ray (from age 15, no more than once a year). Physical performance and exercise tolerance testing: step-by-step bicycle ergometry with gas analysis for sports where the muscles that dominate when pedaling a bicycle ergometer may be limiting; step-by-step manual bicycle ergometry with gas analysis for sports where the muscles of the trunk and arms may be limiting, step-by-step testing on a treadmill with gas analysis for sports where running is involved; testing the maximum alactic power (MAP) of the muscles dominant during pedaling on a bicycle ergometer. Study of psycho-emotional status
	5.	Athletes engaged in the highest level of sports mastery	once every six months	Traumatologist-orthopedist, surgeon, otorhinolaryngologist, ophthalmologist, dentist, gynecologist, urologist, neurologist, cardiologist, psychologist, sports medicine physician	CBT, Blood biochemistry (total protein, creatinine, uric acid, glucose, total cholesterol, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), total bilirubin, direct bilirubin, ALT, ACT, CPK, creatine phosphokinase -MB (CPK-MB), alkaline phosphatase, lactate dehydrogenase (LDH), 1st isoenzyme of LDH; phosphorus, sodium, calcium, potassium, magnesium, iron, high-sensitivity C-reactive protein (CRP), ferritin, cortisol, testosterone, TSH, FT4). Blood test for viral hepatitis, syphilis, CUT, anthropometry and body composition analysis, ECG, ECG with exercise stress, echocardiography, dynamometry, Ultrasound of the abdominal cavity and kidneys, spirography, Chest fluorography or X-ray (from age 15, no more than once a year). Physical performance and exercise tolerance testing: step-by-step bicycle ergometry with gas analysis for sports where the muscles that dominate when pedaling a bicycle ergometer may be limiting; step-by-step manual bicycle ergometry with gas analysis for sports where the muscles of the trunk and arms may be limiting, step-by-step testing on a treadmill with gas analysis for sports where running is involved; testing the maximum alactic power (MAP) of the muscles dominant during pedaling on a bicycle ergometer. Study of psycho-emotional status
	6.	Athletes of the national teams of the Republic of Kazakhstan in sports	once every six months	Traumatologist-orthopedist, surgeon, otorhinolaryngologist, ophthalmologist, dentist, gynecologist, urologist, neurologist, cardiologist, psychologist, sports medicine physician	CBT, Blood biochemistry (total protein, creatinine, uric acid, glucose, total cholesterol, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), total bilirubin, direct bilirubin, ALT, ACT, CPK, creatine phosphokinase -MB (CPK-MB), alkaline phosphatase, lactate dehydrogenase (LDH), 1st isoenzyme of LDH; phosphorus, sodium, calcium, potassium, magnesium, iron, high-sensitivity C-reactive protein (CRP), ferritin, cortisol, testosterone, TSH, FT4). Blood test for viral hepatitis, syphilis, CUT, anthropometry and body composition analysis, ECG, ECG with exercise stress, echocardiography, dynamometry, Ultrasound of the abdominal cavity and kidneys, spirography, Chest fluorography or X-ray (from age 15, no more than once a year). Physical performance and exercise tolerance testing: step-by-step bicycle ergometry with gas analysis for sports where the muscles that dominate when pedaling a bicycle ergometer may be limiting; step-by-step manual bicycle ergometry with gas analysis for sports where the muscles of the trunk and arms may be limiting, step-by-step testing on a treadmill with gas analysis for sports where running is involved; testing the maximum alactic power (MAP) of the muscles dominant during pedaling on a bicycle ergometer. Study of psycho-emotional status

Note: The in-depth medical examination program for athletes with disabilities shall vary depending on the type of health disorder in terms of functional diagnostics, stress tests, and the specifics of examinations by specialized specialists.