Are we really "screening" movement? The role of assessing movement quality in exercise settings

Factors associated with patient-reported mouth opening activity limitations in individuals with persistent intra-articular temporomandibular disorders: A cross-sectional study exploring physical and self-reported outcomes

BACKGROUND

Individuals living with intra-articular temporomandibular disorders (IA-TMDs) often report limitations with mouth opening activities. While clinical measures such as active range of motion (AROM) and movement quality are often used to assess mouth opening function, it is unclear if and how these relate to patient-reported limitations and whether other factors such as kinesiophobia influence mouth opening activities in those with IA-TMDs.

OBJECTIVES

Compare clinical measures of mouth opening function in those with IA-TMDs to asymptomatic controls. In those with an IA/TMD, explore relationships between patient-reported mouth opening limitations, and mouth opening function and kinesiophobia.

DESIGN

Cross-sectional study.

METHOD

Clinical mouth opening function (AROM, movement quality, pain on movement/10, stiffness on movement/10) was compared between groups (n = 30 IA-TMD, n = 30 controls). Within the IA-TMD group, correlations between patient-reported mouth opening limitations (Patient specific functional scale), kinesiophobia (Tampa Scale for Kinesiophobia for Temporomandibular Disorders) and clinical measures of mouth opening function were explored.

RESULTS

Impairments in AROM (-4 mm, p = 0.04, d = 0.5), movement quality (p < 0.01, φ = 0.6), pain on movement (p < 0.01, d = 0.8) and stiffness on movement (p < 0.01, d = 1.6) were observed in the IA-TMD group compared to controls. Patient-reported mouth opening limitations and kinesiophobia were significantly correlated (r = -0.48, p < 0.01); no correlation was found between patient-reported limitations and clinical mouth opening measures (r < 0.3, p > 0.05).

CONCLUSIONS

Mouth opening function is impaired in IA-TMD. However, kinesiophobia appears more related to patient-reported mouth opening limitations than clinical impairments. Consideration of clinical, kinesiophobia and patient-reported limitation measures are necessary to direct management of IA-TMD in those presenting for care.

Sacroiliac Joint Dysfunction in Endurance Runners Using Wearable Technology as a Clinical Monitoring Tool: Systematic Review

BACKGROUND

In recent years, researchers have delved into the relationship between the anatomy and biomechanics of sacroiliac joint (SIJ) pain and dysfunction in endurance runners to elucidate the connection between lower back pain and the SIJ. However, the majority of SIJ pain and dysfunction cases are diagnosed and managed through a traditional athlete-clinician arrangement, where the athlete must attend regular in-person clinical appointments with various allied health professionals. Wearable sensors (wearables) are increasingly serving as a clinical diagnostic tool to monitor an athlete's day-to-day activities remotely, thus eliminating the necessity for in-person appointments. Nevertheless, the extent to which wearables are used in a remote setting to manage SIJ dysfunction in endurance runners remains uncertain.

OBJECTIVE

This study aims to conduct a systematic review of the literature to enhance our understanding regarding the use of wearables in both in-person and remote settings for biomechanical-based rehabilitation in SIJ dysfunction among endurance runners. In addressing this issue, the overarching goal was to explore how wearables can contribute to the clinical diagnosis (before, during, and after) of SIJ dysfunction.

METHODS

Three online databases, including PubMed, Scopus, and Google Scholar, were searched using various combinations of keywords. Initially, a total of 4097 articles were identified. After removing duplicates and screening articles based on inclusion and exclusion criteria, 45 articles were analyzed. Subsequently, 21 articles were included in this study. The quality of the investigation was assessed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) evidence-based minimum set of items for reporting in systematic reviews.

RESULTS

Among the 21 studies included in this review, more than half of the investigations were literature reviews focusing on wearable sensors in the diagnosis and treatment of SIJ pain, wearable movement sensors for rehabilitation, or a combination of both for SIJ gait analysis in an intelligent health care setting. As many as 4 (19%) studies were case reports, and only 1 study could be classified as fully experimental. One paper was classified as being at the "pre" stage of SIJ dysfunction, while 6 (29%) were identified as being at the "at" stage of classification. Significantly fewer studies attempted to capture or classify actual SIJ injuries, and no study directly addressed the injury recovery stage.

CONCLUSIONS

SIJ dysfunction remains underdiagnosed and undertreated in endurance runners. Moreover, there is a lack of clear diagnostic or treatment pathways using wearables remotely, despite the availability of validated technology. Further research of higher quality is recommended to investigate SIJ dysfunction in endurance runners and explore the use of wearables for rehabilitation in remote settings.

Effect of Aging on Movement Quality in Australian Urban Firefighters

ABSTRACT

Redshaw, AS, Carrick-Ranson, G, Bennett, H, Norton, KI, and Walker, A. Effect of aging on movement quality in Australian urban firefighters. J Strength Cond Res 37(11): e601-e608, 2023-Adequate levels of movement quality (MQ) are required to safely perform occupational tasks in physically demanding and hazardous professions such as firefighting. Although it is well established that MQ deteriorates with age in population studies, there is conflicting evidence in older tactical populations. This study sought to examine the relationship between age and MQ in Australian urban firefighters. The impact of physical activity, injury history, and body mass index on MQ were also explored. The MQ of 324 professional Australian urban firefighters was assessed using MovementSCREEN MQ assessment tool. Scores of whole-body MQ ranged from 35.3 to 82.6 (0-100 scale), with a mean score of 59.2 ± 10.0. There was a moderate, negative association between MQ and age (r = -0.500; p ≤ 0.001), with those older than 50 years of age having significantly lower scores of MQ than their younger counterparts (p ≤ 0.001). Secondary analysis found that higher body mass index (r = -0.285; p ≤ 0.001), lower habitual physical activity levels (r = 0.165; p ≤ 0.003), and the presence of any musculoskeletal injury in the previous 12 months (p = 0.016) had significant negative effects on composite MQ. Firefighters older than 50, obese, and engaging in low levels of physical activity should be considered a high priority for functional strength training interventions to maintain adequate MQ throughout their careers.

The Functional Movement Screen: Exploring Interrater Reliability between Raters in the Updated Version

Background

The Functional Movement Screen™ (FMS™) was updated by adding the ankle clearing test and modifying the rotary stability movement pattern and scoring criteria. This updated FMS™ may be used to support clinical decisions for the well-being of athletes and active adults.

Purpose

The purpose of this study was to determine if the updated FMS™ has acceptable interrater reliability, so that various practitioners can utilize it with their patients.

Study Design

Observational Laboratory Study.

Methods

Two licensed Physical Therapists (PTs) conducted the testing for the study. No warmup was allowed for the participants. Each participant underwent one FMS™ session while being recorded on video lasting approximately 15 minutes. Participants were allowed three attempts to complete each movement pattern with the best score recorded. The participants, 45 healthy active PT students, were taken through the FMS™ by a licensed PT and videotaped. The raters were four second-year PT students that observed and scored the FMS independently after videotaping was completed. SPSS was used for the interrater reliability analysis. ICC was calculated using a 2-way mixed model looking for absolute agreement.

Results

The interrater reliability was highest for the rotary stability test (ICC 0.96) while the deep squat was the least reliable (ICC 0.78). The total scores showed excellent reliability among the four student raters with an ICC of 0.95. The updated FMS™ produced good to excellent interrater reliability.

Conclusion

The updated FMS™ has acceptable interrater reliability between minimally, but adequately trained individuals. The updated FMS™ may be reliably used to assess risk for future injury.

Level of Evidence

3.

The Use of Wearable Sensors for Preventing, Assessing, and Informing Recovery from Sport-Related Musculoskeletal Injuries: A Systematic Scoping Review

Wearable technologies are often indicated as tools that can enable the in-field collection of quantitative biomechanical data, unobtrusively, for extended periods of time, and with few spatial limitations. Despite many claims about their potential for impact in the area of injury prevention and management, there seems to be little attention to grounding this potential in biomechanical research linking quantities from wearables to musculoskeletal injuries, and to assessing the readiness of these biomechanical approaches for being implemented in real practice. We performed a systematic scoping review to characterise and critically analyse the state of the art of research using wearable technologies to study musculoskeletal injuries in sport from a biomechanical perspective. A total of 4952 articles were retrieved from the Web of Science, Scopus, and PubMed databases; 165 were included. Multiple study features-such as research design, scope, experimental settings, and applied context-were summarised and assessed. We also proposed an injury-research readiness classification tool to gauge the maturity of biomechanical approaches using wearables. Five main conclusions emerged from this review, which we used as a springboard to propose guidelines and good practices for future research and dissemination in the field.