Performance
Medicine

Background

Performance Medicine describes the integration of health optimisation and performance enhancement across high-demand human systems. Although related models are used in elite sport, military, and other high-performance environments, the field lacks an agreed definition, conceptual structure, and governing framework.

Objectives

To map the literature relating to integrated health and performance systems, examine how such systems are described across domains, and determine whether a coherent conceptualisation of Performance Medicine currently exists.

Design

PRISMA-ScR scoping review with descriptive and thematic synthesis.

Setting

Peer-reviewed and grey literature identified through database searching, targeted web searching, and citation screening.

Sources

Empirical studies, reviews, models, frameworks, and organisational descriptions relating to integrated health and performance systems in high-performance populations.

Outcomes

Conceptual definitions, system characteristics, multidisciplinary structures, recurring domains, and evidence relevant to the existence of coherent Performance Medicine models.

Results

The literature demonstrated widespread practical implementation of integrated and multidisciplinary performance systems, particularly within elite sport and increasingly in corporate and technical settings. However, directly relevant evidence was limited, heterogeneous, and distributed across multiple disciplines and applied settings. Terminology was inconsistent, and no unified framework, taxonomy, or governance structure was identified. Existing publications described important components, including performance health, interdisciplinary teams, system coordination, and domain-specific support functions, but these were fragmented and rarely assembled into a single conceptual model. Much of the literature was descriptive or practice-led rather than theory-building, which limited comparability and reduced the strength of generalisable conclusions across contexts. Overall, the evidence suggested an active field of practice without a clearly articulated conceptual architecture.

Conclusions

Performance Medicine appears to be widely practised but insufficiently defined. The absence of a coherent conceptual architecture limits standardisation, evaluation, communication, and development of best practice. These findings support further multidisciplinary synthesis to define the field more clearly and to develop an integrated framework and practical tools for system design, delivery, and governance.

Background

Following identification of conceptual and structural gaps in Performance Medicine, there is a need to synthesise existing multidisciplinary knowledge into a coherent framework that can support practice, governance, service design, and future research.

Objectives

To develop a Performance Medicine framework and associated operational tools through structured multidisciplinary synthesis of scientific and applied literature.

Design

Structured narrative synthesis with thematic analysis and iterative framework development.

Setting

Peer-reviewed literature, consensus statements, organisational models, and key texts drawn from sport, medicine, psychology, and related high-performance domains.

Sources

Sources describing relevant concepts, systems, domains, professional roles, and organisational approaches to integrated health and performance support.

Outcomes

A conceptual architecture for Performance Medicine, together with applied tools to define system purpose, structure, roles, functions, and evaluation criteria.

Results

The synthesis produced a Performance Medicine Framework describing integrated domains of human performance and health, linked through system-level components including governance, team structure, decision-making, and data integration. Two applied outputs were also developed. The Performance Medicine Operational Specification defines domain-level purpose, responsibilities, and core functions across the system. The Performance Medicine Assessment Tool provides a structured method for reviewing current provision, identifying gaps, and supporting service development. Together, these outputs offer a coherent model linking conceptual structure to operational application and providing a practical basis for implementation across high-performance settings. However, the framework remains under development and its transferability, reliability, and utility across different environments will require further testing.

Conclusions

This work addresses an important gap by presenting a unified conceptual architecture and practical tools for Performance Medicine. Together, the Performance Medicine Architecture, Operational Specification, and Assessment Tool provide an initial framework for system design, evaluation, and governance across high-performance settings, while establishing a basis for subsequent refinement, validation, and applied testing.