Reliability, Validity, and Injury Predictive Value of the Functional Movement Screen: A Systematic Review and Meta-analysis

Little associations exist between the three commonly used functional screening tests in collegiate athletes

Although an abundant number of studies have investigated the predictability of the commonly used functional screening tests and despite their popularity and applicability, the relationships between these tests have rarely been studied and have not been well established. This study aimed to examine the potential association between the Functional Movement Screen (FMS), Y Balance Test (YBT), and Landing Error Scoring System (LESS). Six hundred twenty-seven Iranian collegiate athletes (347 males, age = 22.63 ± 4.07, weight = 75.98 ± 13.79, height = 181.99 ± 10.15, BMI = 22.84 ± 3.16; and 280 females, age = 22.22 ± 3.37, weight = 60.63 ± 9.58, height = 166.55 ± 6.49, BMI = 21.81 ± 2.84) participated in this study. Following a 5-min warm-up, each participant underwent a standardized screening battery including the FMS, YBT, and LESS, and the scores were recorded and live coded for the statistical analysis, except for the LESS. The LESS tests were video recorded and scored by one expert examiner using an open-source 2D video analysis software (Kinovea- version 0.9.5), afterwards. The Spearman correlation was utilized as a measure for the correlation, and the Mann‒Whitney U test with a significance level of 0.05 was used to check the differences between male and female athletes. The statistical analysis was performed with RStudio 2023.03.0 using R 4.3.1. A small correlation (0.364) was observed between the FMS composite score and the YBT in male athletes. All other pairwise correlations were negligible among male and female athletes, ranging from - 0.096 to 0.294. Reducing the FMS to the component scores targeting the lower extremities did not alter the correlation to the other screening scores. The median FMS composite score in female athletes was significantly higher than that in males (p < 0.001). Negligible correlations exist between the FMS, LESS, and YBT; they do not measure the same values and therefore are irreplaceable with one another. A combination of these tests as a standardized screening battery may potentially better identify injury-predisposed athletes than the application of each test as a stand-alone screening test. Females outperformed males in the FMS test significantly, so sex must be considered a key variable in the FMS studies. Males had slightly higher LESS scores (median difference = 0.5) than females, but this difference is not clinically meaningful. Future research should continue to explore the relationships between various functional screening tests and identify the most effective combinations for comprehensive assessment in different populations and sports disciplines.

Are physical fitness, a history of childbirth and injury history related to knee valgus in female Canadian Armed Forces members during a bodyweight overhead squat movement?

OBJECTIVES

A history of childbirth is associated with musculoskeletal injury (MSKi) in female members of the Canadian Armed Forces (CAF). While previous injury and pregnancy impact knee kinematics, it is unclear if a history of childbirth is associated with medial knee displacement (MKD) in an overhead squat movement screen. The aim of this study is to examine the relationship between MKD and (1) MSKi and (2) parity status in female CAF members.

METHODS

24 nulliparous and 21 parous female participants employed by the CAF completed a comprehensive physical fitness assessment of muscular flexibility, power, strength, endurance, aerobic capacity and a bodyweight overhead squat movement screen (recorded using two-dimensional video, and hip-knee-ankle angle measured using Kinovea software). Interactions between MKD, parity status and MSKi history were assessed by one-way analysis of variance and two-way analysis of covariance (ANCOVA) (adjusted for age).

RESULTS

An interaction between parity status and acute injury of the lower extremity was observed (F=4.379, p=0.043, η2 =0.099) in MKD of the right knee. The two-way ANCOVA examining acute injury of the lumbopelvic hip complex (lower back, pelvis, hip) yielded an interaction between acute injury to the lumbopelvic hip complex and parity status (F=4.601, p=0.038, η2=0.103) in MKD asymmetry.

DISCUSSION

Parous participants with acute injury to the lower extremity had larger MKD than parous without this injury type. Parous participants without acute injury to the lumbopelvic hip complex had greater MKD asymmetry than nulliparous without this injury type. Our findings suggest that researchers and clinicians should consider parity status in conjunction with MSKi history when assessing knee kinematics in female military members.

Predictive Validity of Multifactorial Injury Risk Models and Associated Clinical Measures in the U.S. Population

Background: Popular movement-based injury risk screens were shown to lack predictive precision, leading to interest in multifactorial models. Furthermore, there is a lack of research regarding injury risk assessment for those currently or planning to be recreationally active. This study aims to provide injury risk insights by analyzing multifactorial injury risk models and associated clinical measures in the U.S. population. Methods: Data related to injury, inflammatory markers, physical functioning, body composition, physical activity, and other variables from 21,033 respondents were extracted from NHANES. Odds ratios for self-reported injury were calculated for single predictors and risk models. Case-control and principal component analyses (PCA) were conducted to elucidate confounders and identify risk factor clusters, respectively. Receiver operating characteristic analysis was used to test the precision of a risk factor cluster to identify pain points and functional difficulties. Results: Sociodemographic, individual, and lifestyle factors were strongly associated with higher odds of injury. Increases in fibrinogen and C-reactive protein were significantly associated with all risk groups. Membership to the high-risk group (age over 40, obesity, no muscle-strengthening activities, sedentary lifestyle, and low back pain) predicted at least one functional difficulty with 67.4% sensitivity and 87.2% specificity. In the injury group, bone turnover markers were higher, yet confounded by age, and there was a significantly higher prevalence of self-reported osteoporosis compared to the control. In males, low testosterone was associated with injury, and high estradiol was associated with pain and functional difficulties. In females, high follicle-stimulating hormone was associated with functional difficulties. PCA revealed four high-risk profiles, with markers and activities showing distinct loadings. Conclusions: A comprehensive approach to injury risk assessment should consider the nexus of aging, lifestyle, and chronic disease to enhance tailored injury prevention strategies, fostering safe and effective physical activity participation and reducing the burden of musculoskeletal disorders.

The effect of auto-generated corrective exercise programming on movement literacy among firefighters: a pilot study

INTRODUCTION

Approximately 50% of firefighter injuries occur in the musculoskeletal system. Poor movement quality increases injury risk, while movement-based interventions may reduce injuries.

PURPOSE

Investigate the effectiveness of auto-generated exercise programming on movement literacy scores among firefighters with lower baseline Functional Movement System (FMS™) scores.

METHODS

Eleven male firefighters (mean age 44) with FMS™ scores less than 14/21 were included. Detailed explanations of the seven movement screens, five clearing procedures, and scoring were provided prior to baseline FMS™ assessments. Firefighters attempted each test up to three times, with highest scores retained. Scores ranged from 0 to 3 for each of the seven movement screens, with a maximum composite score of 21. Completed test scores were reviewed, and a report was provided to each firefighter through the FMS™PRO App. Additionally, auto-generated programs from the FMS™PRO App with exercise figures, descriptions, and videos to be performed prior to routine conditioning programs were provided. On average, participants were followed up after 262 days for a re-assessment.

RESULTS

Mean composite scores significantly improved (p = .003) from 11.2 to 15.6/21, with a large effect size (r = 0.9). Individual item scores significantly improved for the deep overhead squat, hurdle, shoulder mobility, and rotary stability (p ≤ .046), with effect sizes of r = 0.3-0.8. Significant changes were not present for the inline lunge, active straight leg raise, and trunk stability push-up (p ≥ .083).

CONCLUSION

An auto-generated corrective exercise program individualized to scores on the FMS™ was effective and exceeded error thresholds based on a minimal detectable change of 2.5/21.

Integrative function of proprioceptive system in the acute effects of whole body vibration on the movement performance in young adults

Background

The proprioceptive system coordinates locomotion, but its role in short-term integration and recovery of motor activity in imbalance of motor patterns and body remains debated. The aim of this study is investigating the functional role of proprioceptive system in motor patterns and body balance in healthy young adults.

Methods

70 participants (aged 20.1 ± 0.3) were divided into experimental groups EG1 (n = 30), EG2 (n = 30), control group (CG, n = 10). EG1 performed single WBV session on Power Plate (7 exercises adapted to Functional Movement Screen (FMS). EG2 performed single session of FMS Exercises (FMSE). CG didn't perform any physical activity. All participants performed pre- and post-session of FMS and stabilometric measurements.

Results

FMS total score in EG1 increased by 2.0 ± 0.2 (p0 < 0.001), this was significantly differed (p0 < 0.001) from EG2 and CG. Acute effects of WBV and FMSE on rate of change and standard deviation (SD) of pressure center (COP) were shown in all groups during Static Test (p0 < 0.01). SD increased (p0 < 0.01) in Given Setting Test in EG1 and EG2, and in Romberg Test (p0 < 0.001) in EG1. Length, width and area (p0 < 0.01) of confidence ellipse, containing 95% of the statokinesiogram points, decreased in Static Test in EG1; width and area (p0 < 0.01) decreased in EG2 group. Significant (p0 < 0.01) decrease in Given Setting Test was in EG1, and significant (p0 < 0.01) increase was in Romberg Test (open eyes) in CG. Maximum amplitude of COP oscillations: significantly (p0 < 0.01) decreasing along X and Y axes in EG1 and EG2, and along Y axis in CG during Static Test; along Y axis (p0 < 0.01) in all groups during Given Setting Test. Significant differences were identified (p0 < 0.01) in calculated energy consumption for COP moving during all stabilometric tests. However, inter-group differences in COP after acute WBV and FMSE sessions have not been identified.

Conclusions

Acute WBV session eliminates the deficits in motor patterns which is not the case after acute FMSE session, which, according to our integrative movement tuning hypothesis, is due to high activation of integrative function of proprioceptive system. Efficacy of WBV and FMSE on COP performance indicates a high sensitivity of postural control to different levels of proprioceptive system activity.

Deep squat test - Functional movement Screen: Convergent validity and ability to discriminate subjects with different levels of joint mobility

BACKGROUND

Functional Movement Screen (FMS) is an important tool in the assessment of exercise practice. Assuming FMS lacks precise validity for assessing postural deficits, further research is needed to assess whether it is a sufficiently precise tool for analysing joint mobility. Research aims were to evaluate: convergent validity of Deep Squat (DS) - one of FMS tests - regarding joint mobility, using data from a three-dimensional motion analysis as a comparable method; DS's ability to discriminate between subjects with different joint mobility levels.

METHODS

Sixty subjects were selected (23.6 ± 3.8 years). DS was performed according to FMS guidelines. Subjects' performance in frontal and sagittal planes was recorded by two video cameras and subsequently scored by two FMS-certified evaluators. Three-dimensional motion analyses of DS were acquired by a Vicon Motion Capture System (200 Hz). Ten trials were acquired for each subject. Ankle, knee, hip, and shoulder angular positions in sagittal plane were determined from the FullBody PlugInGait model. Spearman's coefficient examined the correlation between angular positions and DS score. Kruskal-Wallis test was used to assess the DS ability to discriminate between subjects with different joint mobility levels by comparing different scores.

RESULTS

Negligible to moderate correlations were found between DS score and angular positions (-0.5 < r < 0.5). Only shoulder angular positions showed differences between score "1" and "2" (p < 0.05). Shoulder and hip angular positions showed no differences between score "2" and "3" (p < 0.05).

CONCLUSIONS

DS yielded low convergent validity regarding joint mobility and did not show the ability to discriminate between subjects with different joint mobility levels.

Development and feasibility of a function-based preventive intervention for lifestyle-related disorders

BACKGROUND

The enormous effect of lifestyle-related disorders on health of the global population warrants the development of preventive interventions. Focusing on musculoskeletal health and physical activity may be a way to encourage necessary lifestyle changes by making them more concrete and understandable. The aims of the current study were to develop a function-based preventive intervention aimed at lifestyle-related disorders in physically inactive 40-year-old people and to investigate the feasibility of the intervention. The feasibility study aimed to solve practical and logistical challenges and to develop the intervention based on the experiences of participants and involved clinical personnel according to defined criteria.

METHODS

Development of the standardised functional examination was based on literature-validated tests and clinical reasoning. Development of a risk profile was based on the functional examination and similar profiles which have already proved feasible. The feasibility of the functional examination and risk profile, together with function-based lifestyle counselling was tested on 27 participants in a pilot study with two physiotherapist examinations over a four-month period. Practical results and feedback from participants and collaborating personnel were examined.

RESULTS

The functional examination consists of 20 established tests not requiring specialised equipment or training which were deemed relevant for a middle-aged population and a sub-maximal ergometer test. The risk profile consists of seven functional dimensions: cardiovascular fitness, strength in upper extremity, lower extremity and trunk, mobility, balance and posture, and three non-functional dimensions: weight, self-assessed physical activity and pain. Each dimension contains at least two measures. The participants appreciated the intervention and found it motivating for making lifestyle changes. They found the tests and risk profile understandable and could see them as tools to help achieve concrete goals. The examination required 60-75 min for one physiotherapist. The recruitment rate was low and recruited participants were highly motivated to making lifestyle changes.

CONCLUSION

This project developed a functional test battery and risk profile aimed at inactive 40-year-olds which fulfilled our feasibility criteria. Functional screening and lifestyle counselling were found to be of value to a sub-group of inactive 40-year-olds who were already motivated to improve their health situations.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT05535296 first posted on 10/09/2022.

The Impact of Interaction between Body Posture and Movement Pattern Quality on Injuries in Amateur Athletes

Background: this study aimed to examine the impact of interaction between body posture and the quality of movement patterns on injury frequencies in amateur athletes. Methods: The study sample consisted of 89 young amateur athletes. Movement pattern quality was assessed by the Functional Movement Screen (FMS), test and body posture in the frontal plane was assessed by the moire method for the parameters Shoulder Slope Angle, Lower Scapula Protrusion Difference, and Pelvic Tilt Angle. Injury data were collected through completion of the Injury History Questionnaire for the past 12 months. Results: Using cluster analysis, participants were allocated into a either category with good (BPg) body posture or poor (BPp), and using FMS cutoff points (14), either a category of good movement pattern quality (MPg) or poor (MPp). Two-way ANOVA was performed, and the Bonferroni post-hoc test revealed a reduction in injuries among participants from the MPg-BPg group compared to the other three groups (p < 0.05). However, no interaction between factors was revealed. No statistically significant differences were observed among the remaining three groups in the case of injury prevalence (p > 0.05). Conclusions: A combination of proper body posture and high-quality movement patterns is associated with a lower frequency of injuries, without direct interaction between chosen factors, which suggests that they impact injury risk independently. Practicing suitable BP and ensuring high-quality MPs should be regarded as a strategy in injury prevention.

Effects of functional correction training on movement patterns and physical fitness in male college students

The objective of this study is to investigate the effects of functional corrective training and static stretching on the quality of movement patterns and physical fitness in college students. The study was conducted with 30 male college students from a university in Guangzhou, China. The participants were randomly assigned to either the functional corrective training group (FCT, n = 15, age = 20.93 ± 0.85, BMI = 22.07 ± 2.33) or the static stretching group (SS, n = 13, age = 20.85 ± 0.86, BMI = 21.98 ± 1.80). Two participants from the SS group dropped out due to personal reasons, leaving 13 subjects in that group. Both groups underwent a 6-week training intervention, with sessions held twice a week. The FCT group participated in flexibility training, and/or static motor control training, and/or dynamic motor control training for 10-15 min. The SS group performed static stretching exercises targeting five specific muscles, with 30 s per side and two sets. The Functional Movement Screen (FMS), body composition, sit-and-reach, standing long jump, and pull-ups were assessed before and after the intervention. Differences in FMS outcomes were analyzed using two samples of the Mann-Whitney U test. Physical fitness outcomes were analyzed using a repeated measures analysis of variance (ANOVA) with a 2 (group) × 2 (time) design. After 6 weeks of intervention, the FCT group showed statistically significant improvements in the hurdle step (Z = -2.449, p = 0.014), inline lunge (Z = -2.000, p = 0.046), rotary stability (Z = -2.309, p = 0.021), and composite scores (Z = -3.316, p = 0.001). Comparisons between groups indicated that BMI (FCT, ES = 0.04; SS, ES = -0.11), 30-m sprint (FCT, ES = 0.12; SS, ES = 0.28), body fat percentage (BF%) (FCT, ES = -0.25; SS, ES = -0.07), and sit-and-reach (FCT, ES = 0.17; SS, ES = 0.06) were not statistically significant in both the pre- and post-tests. The effect sizes of all physical fitness indicators were greater in the FCT group than in the SS group. The FCT, consisting of two sessions per week for 6 weeks, has been proven to be effective in improving the quality of movement patterns by improved stability and advanced movements. However, the improvements in physical fitness did not reach statistical significance. FMS and FCT are generally affordable and accessible for college students. College students have the opportunity to employ the FMS tool to assess potential injury risks and address them, thereby reducing the risk of injuries.

Effects of functional training on muscle strength, jumping, and functional movement screen in wushu athletes: A systematic review

This study aims to analyse the effects of functional training on muscle strength, jumping, and functional movement screen in wushu athletes.

METHODS

This study followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic search of electronic databases was also conducted, including EBSCOhost, Scopus, PubMed, Web of Science, CNKI, Google Scholar, and Wanfang. The Physiotherapy Evidence Database (PEDro) scale was an effective indicator to evaluate the quality of studies included in the systematic review.

RESULTS

This systematic review included 474 participants aged 8-24 years old. The intervention period for most studies was 12 weeks. Among the included studies, 6 focused on muscle strength, 4 on jumping performance, and 11 on functional movement screen.

CONCLUSION

These articles have been analysed, and the positive impact of functional training interventions on muscle strength, jumping, and functional movement screen of wushu athletes has been verified.

Markerless vision-based functional movement screening movements evaluation with deep neural networks

The functional movement screen (FMS) test is a seven-test battery used to assess fundamental movement abilities of individuals. It is commonly used to predict sports injuries but relies on clinical expertise and is not suitable for self-examination. This study presents an automatic FMS movement assessment framework using a multi-view deep neural network called MVDNN. The framework combines automatic skeleton extraction with manual feature selection to extract 3D trajectory features of human skeleton joints from two different directions. Three mainstream methods of time-series modeling are then used to learn high-level feature representation from skeleton sequences, and motion features from two views are fused to provide complementary information. Results of public FMS movements dataset demonstrate that our MVDNN outperforms current state-of-the-art methods with an average miF1 score of 0.857, maF1 score of 0.768, and Kappa score of 0.640 over ten runs.

Comparison of Intervention Programs to Improve Trunk Stability for Active Females

Background

Current literature illustrates a disparity in trunk stability push up performance (TSPU), as measured by the Functional Movement Screen (FMSTM), in females throughout the lifespan when compared to their male counterparts.

Hypothesis/Purpose

The purpose of this study was to evaluate the effectiveness of a novel exercise approach to a trunk stability (NEATS) program compared to a standard Pilates program on TSPU performance in active females aged 18-45 years. It was hypothesized that subjects in the NEATS program would have greater improvements on outcomes related to trunk stability than subjects in the Pilates program.

Study Design

Randomized controlled trial.

Methods

All subjects were tested at baseline on Beighton criteria, the FMSTM, Y-Balance Test Upper Quarter and Lower Quarter, and grip strength by an evaluator blinded to group allocation. Subjects were randomized into the NEATS (n=17) or the Pilates group (n=19). The intervention period lasted eight weeks, with exercise progression at weeks two, four, and six.

Results

The main outcome was between-group pass rates on the TSPU. At posttest, 41% (n=7) of the NEATS group and 42% (n=8) of the Pilates group passed the TSPU, though there was no difference between groups (p=0.97). Significant differences were noted on the TSPU (Pilates, NEATS p=0.01) and composite scores (Pilates p=0.01; NEATS p=0.03). No within-group improvements were noted on the individual scores of the FMSTM (p=0.05-0.66). Within-group differences were noted on the posterolateral reach on the Y-Balance Test Lower Quarter (p=0.03) in the Pilates group. Between-group posttest continuous measures were not significantly different (p=0.17-0.96).

Conclusion

Improvements in trunk stability were comparable between the multi-planar NEATS program and a standard Pilates program suggesting that both can be used to improve trunk stability performance in active females.

Level of Evidence

2.

Characterization of movement patterns using unsupervised learning neural networks: Exploring a novel approach for monitoring athletes during sidestepping

The monitoring of athletes is crucial to preventing injuries, identifying fatigue or supporting return-to-play decisions. The purpose of this study was to explore the ability of Kohonen neural network self-organizing maps (SOM) to objectively characterize movement patterns during sidestepping and their association with injury risk. Further, the network's sensitivity to detect limb dominance was assessed. The data of 67 athletes with a total of 613 trials were included in this study. The 3D trajectories of 28 lower-body passive markers collected during sidestepping were used to train a SOM. The network consisted of 1247 neurons distributed over a 43 × 29 rectangular map with a hexagonal neighbourhood topology. Out of 61,913 input vectors, the SOM identified 1247 unique body postures. Visualizing the movement trajectories and adding several hidden variables allows for the investigation of different movement patterns and their association with joint loading. The used approach identified athletes that show significantly different movement strategies when sidestepping with their dominant or non-dominant leg, where one strategy was clearly associated with ACL-injury-relevant risk factors. The results highlight the ability of unsupervised machine learning to monitor an individual athlete's status without the necessity to reduce the complexity of the data describing the movement.

Distribution and Prevalence of Elbow Pain (EP) in Elite Swimmers in Tianjin, China-A Regional Epidemiological Study

Elbow pain (EP) in overhead sports is a common phenomenon. Swimming is classified as an overhead sport, but a lack of attention regarding EP in swimming has created a gap in the knowledge around elite freestyle swimming in Tianjin, China. The purpose of this study was to identify the distribution and prevalence of EP among elite freestyle swimmers in Tianjin, China. The methodology involved a total of 311 qualified participants who volunteered to undertake all measurements. The main findings showed that 183 of the elite freestyle swimmers in this study had EP (accounting for 58.84% of the total 311 participants), with 147 in slight pain and 36 in critical pain. The characteristics of a heavier body weight, taller height, longer left/right forearm length, and longer weekly average training hours serve as contributing factors to the occurrence of EP issues. Gender, age, weekly average training hours, and left/right forearm length are the primary factors correlating with and influencing the assessment scores. In conclusion, swimmers with longer weekly training hours, older ages, heavier bodyweight, and longer forearm lengths should receive greater attention in relation to EP. Regular assessments at a high frequency serve as a means to identify the risk of EP.

Well-being as a performance pillar: a holistic approach for monitoring tennis players

This perspective article aims to discuss the usefulness of tools that can assist tennis professionals effectively manage the well-being of their players. This includes identifying and monitoring meaningful metrics (i.e., training load, training intensity, heart rate variability), as well as careful planning of training and competition schedules with appropriate recovery periods. The use of innovative training methods (i.e., repeated-sprint training in hypoxia and heat training), and proper dietary practices, along with biometric assessment for young players, represents should be considered. Adopting a holistic approach to decision-making about training and competition, balancing both health and performance considerations, is crucial for tennis players and their support teams. More research is needed to refine best practices for enhancing tennis performance while prioritizing the well-being of players.

Altered sagittal plane mechanics is associated with Functional Movement Screen deep squat score

Background

The Functional Movement Screen (FMS) assesses the quality of movements, including the deep squat (DS), which is used in sports settings. The validity of the individual item scores has yet to be established.

Objectives

To investigate the validity of the FMS DS by comparing the sagittal plane kinematics of participants who achieve different observer scores.

Method

Seventeen injury-free, adolescent male cricket bowlers were assessed. The movement was captured using the Optitrack® motion capture system. Simultaneously, observers scored participants' execution of the DS according to the standard FMS scoring criteria. Participants were grouped into Group 1 (lowest score), Group 2 (altered movement mechanics) or Group 3 (perfect score) according to observer scores. Specific joint angles of each group were compared using the Kruskal-Wallis and Mann-Whitney U tests.

Results

There were significant differences in the degree to which the femur passed the horizontal between Group 3 and Group 1 (p = 0.04, r = 0.61) and Group 2 and Group 1 (p = 0.03, r = 0.66) and the difference in the degree to which the torso was kept vertical between Group 3 and Group 1 (p = 0.02, r = 0.66) and Group 2 and Group 1 (p = 0.02; r = 0.72).

Conclusion

Kinematic differences exist between participants who achieve different observer scores for the FMS DS.

Clinical implications

While differences in sagittal plane kinematics have been observed in participants scoring high on the FMS DS and participants scoring low, further investigation into the validity of the frontal plane kinematics is warranted, as well as the concurrent validity of the individual scoring criteria.

Pilot Study: The Relationship between Foot Posture and Movement Quality in Non-Professional Male Football Players

(1) Background: This study focusses on establishing the relationship between quality of movement (based on the functional movement screen, or FMS) and foot posture (based on the foot posture index, or FPI-6). We hypothesised that a poor FMS test score may be derived from the foot position in the space measured by FPI-6. (2) Methods: a quasi-experimental and cross-sectional study was designed to analyse foot posture in 30 healthy football players, using the foot posture index and the functional movement screen. (3) Results: No significant relationships were found between movement quality and foot posture. Poor movement quality is present in more than half of all foot positions, supination, pronation, and neutral. Good quality seems to be more associated with a neutral foot position (23.3%) and supinated (16.6%) than a pronated foot position (6.6%). (4) Conclusions: this study found no relationship between the two tests; therefore, we cannot demonstrate that foot posture is relevant in the quality of the movement of the football players studied.

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 functional movement screen predicts sports injuries in Chinese college students at different levels of physical activity and sports performance

Background

Functional Movement Screen (FMS) is used to evaluate the movement quality of an individual. However, the FMS composite score used to predict sports injuries is currently ambiguous. Further refinement of the FMS scoring method may be required to more accurately predict sports injuries.

Objectives

To investigate whether FMS scores could accurately predict sports injuries in college students with different levels of physical activity (PA) and sports performance (SP).

Methods

One hundred eighty-seven college students aged 18 to 22 were prospectively screened by the FMS test and grouped by the levels of PA and SP. Sports injury occurrences were monitored and collected 12 months later. Spearman's rank coefficients and binary logistic regression were used to identify the risk factors for sports injuries. The receiver operating characteristic (ROC) curve and the total area under the curve (AUC) value were used to determine the optimal FMS cut-off point for sports injuries.

Results

The FMS composite score (sum of the seven FMS tests) exhibited a fair association with sports injuries (r = -0.434, P < 0.001). Those with an FMS cut-off point of 17.5 were more likely to acquire sports injuries. The AUC value of the ROC curves was 0.764 (95% CI: 0.618-0.909) in the low PA students, 0.781 (95% CI: 0.729-0.936) in the moderate PA students, and 0.721 (95% CI: 0.613-0.879) in the high PA students. Furthermore, students stratified by SP level showed an AUC value of 0.730 (95% CI 0.607-0.853) in the low SP group and 0.778 (95% CI 0.662-0.894) in the moderate SP group, while it declined to 0.705 (95% CI 0.511-0.800) in the high SP group. The FMS cut-off score successfully identified individuals who reported sports injuries at a higher rate in the low (PA, 84.62%; SP, 90.48%) and moderate (PA, 93.75%; SP, 77.78%) groups than in the high groups (PA, 65.52%; SP, 57.89%).

Conclusions

The FMS composite score could be used to predict sports injuries in college students with an FMS cut-off value of 17.5. Population stratification by the levels of PA and SP seems to influence the predictive accuracy of the FMS.

Self-Movement Screening using the Symmio Application is Reliable and Valid for Identifying Musculoskeletal Risk Factors

Background

Musculoskeletal health problems are one of the greatest healthcare expenses in the United States but patient-driven screening procedures to detect risk factors do not exist.

Hypothesis/Purpose

The purpose was to establish the inter-rater reliability of the Symmio Self-Screen application in untrained individuals and to investigate its accuracy to detect MSK risk factors such as pain with movement, movement dysfunction, and decreased dynamic balance.

Study Design

Cross-Sectional.

Methods

Eighty (42 male, 38 female) healthy individuals mean age 26.5 ± 9.4 participated in the study. The inter-rater reliability of Symmio application was established by comparing self-screen scores from untrained subjects with the results simultaneously determined by a trained healthcare provider. Each subject was evaluated for pain with movement, movement dysfunction, and deficits in dynamic balance by two trained evaluators who were blinded to the Symmio results. The validity of Symmio was determined by comparing self-screen performance dichotomized as pass or fail with the reference standard of pain with movement, failure on the Functional Movement Screen™, and asymmetry on the Y Balance Test-Lower Quarter™ using three separate 2x2 contingency tables.

Results

The mean Cohen's kappa coefficient was 0.68 (95% CI, 0.47-0.87) and the absolute agreement was 89% between self-assessment of subjects and the observation of a trained healthcare provider. There were significant associations for the presence of pain with movement (p=0.003), movement dysfunction (p=0.001), and dynamic balance deficits (p=0.003) relative to poor Symmio performance. The accuracy of Symmio to identify pain with movement, movement dysfunction, and dynamic balance deficits were 0.74 (95% CI, 0.63-0.83), 0.73 (95% CI, 0.62-0.82), and 0.69 (95% CI, 0.57-0.79), respectively.

Conclusions

The Symmio Self-Screen application is a reliable and feasible screening tool that can be used to identify MSK risk factors.

Level of Evidence

Level 2.

Dynamic valgus knee revealed with single leg jump tests in soccer players

BACKGROUND

Dynamic valgus knee occurs in sports that involve jumps and landing such as soccer and pose an increased risk for anterior cruciate ligament injury. Visual estimation is biased by the athlete's body type, the experience of the evaluator and the movement phase at which the valgus is assessed - thus the result is highly variable. The aim of our study was to accurately assess dynamic knee positions during single and double leg tests through a video-based movement analysis system.

METHODS

Young soccer players (U15, N.=22) performed single leg squat, single leg jump, and double leg jump tests while the knee medio-lateral movement was monitored with a Kinect Azure camera. Jumping and landing phases of the movement were determined within the continuous recording of the knee medio-lateral position over the ankle and the hip vertical position. Kinect measurements were validated by Optojump (Microgate, Bolzano, Italy).

RESULTS

Soccer players retained their predominantly varus knee positions in all phases of double-leg jumps, which was far less prominent in single leg tests. Interestingly, a marked dynamic valgus was observed in athletes who participated in traditional strengthening exercises, while this valgus shift was mostly prevented in those who participated in antivalgus training regimes. All these differences were only revealed during single leg tests, while the double leg jump tests masked all valgus tendencies.

CONCLUSIONS

We propose to use single-leg tests and movement analysis systems for evaluating dynamic valgus knee in athletes. These methods can reveal valgus tendencies even in soccer players who have a characteristic varus knee while standing.

The Influence of Age and Dynamic Balance on Functional Movement Among Active-Duty Police Officers

CONTEXT

Although occupational injuries for police officers cannot be prevented, factors that contribute to musculoskeletal injury risk could be better identified to inform preventative interventions. Previous research has supported screening tools such as the functional movement screen (FMS) and Y-Balance Test (YBT) as possible indicators of musculoskeletal injury risk. The purposes of this study are to (1) examine the relationships between age, dynamic balance, and functional movement in police officers and (2) determine how much variance in functional movement is predicted by age and dynamic balance.

METHODS

This study was conducted in a university research laboratory as part of an ongoing collaboration with a local police department. All data for the current study were collected across 2 separate laboratory visits within a 14-day period.

PARTICIPANTS

Thirty-five active-duty police officers (31 men and 4 women; mean [SD], age 33.4 [9.4] y, height 177.4 [8.0] cm, body mass 88.4 [15.3] kg) volunteered to participate in this study.

MAIN OUTCOME MEASURES

Functional movement was assessed using the FMS, and FMS overall scores were calculated. Dynamic balance was assessed via the YBT, and lower quarter Y-Balance Test scores (LQYBT%) were calculated.

RESULTS

There was a significant negative correlation between FMS overall score and age (r = -.641, P < .001). Correlations between FMS overall score and LQYBT% and between LQYBT% and age were not statistically significant. Age and LQYBT% scores significantly predicted FMS overall scores (F2,32 = 11.162, P < .001), accounting for 41.1% of the variance in FMS overall scores (R2 = .411) with age being the only significant predictor.

CONCLUSIONS

This study confirms that age and FMS overall score have a strong, negative relationship, suggesting that age may be a contributing factor to movement quality and may lead to an increased risk of musculoskeletal injury within this unique population.

Functional Exercise Versus Specific Pelvic Floor Exercise: Observational Pilot Study in Female University Students

OBJECTIVES

To evaluate the electromyographic (EMG) activity of the pelvic floor musculature (PFM) that takes place when performing the functional movement screen (FMS) exercise, comparing it with the activation in the maximum voluntary contraction of PFM in the supine position (MVC-SP) and standing (MVC-ST).

MATERIAL AND METHODS

A descriptive, observational study conducted in two phases. In the first study phase, the baseline EMG activity of PFM was measured in the supine position and standing during MVC-SP and MVC-ST and during the execution of the seven exercises that make up the FMS. In the second phase of the study, the baseline EMG activity of PFM was measured in the supine position and standing during MVC-SP and MVC-ST and during the FMS exercise that produced the most EMG in the pilot phase: trunk stability push-up (PU). ANOVA, Friedman's and Pearson's tests were used.

RESULTS

All FMS exercises performed in the pilot phase showed a value below 100% maximum voluntary contraction (MVC) except PU, which presented an average value of 101.3 μv (SD = 54.5): 112% MVC (SD = 37.6). In the second phase of the study, it was observed that there were no significant differences (p = 0.087) between the three exercises performed: MVC-SP, MVC-ST and PU (39.2 μv (SD = 10.4), 37.5 μv (SD = 10.4) and 40.7 μv (SD = 10.2), respectively).

CONCLUSIONS

There is no evidence of the existence of significant differences in EMG activation in PFM among the three exercises analysed: MVC-SP, MVC-ST and PU. The results show better EMG values in the functional exercise of PU.

Motor Competence Among Irish Adolescents: An Investigation of Sex Differences and Relatedness Between Fundamental Movement Skills and Functional Movement

In prior research, Irish youth displayed poor motor competence across fundamental movement skills (FMS) and functional movements (FM). Our purpose in this study was to compare FMS and FM across male and female Irish adolescents and to determine whether there are associations between these movement domains. We collected data on 373 adolescents (178 females; M age = 14.38, SD = 0.87 years) from six Irish secondary schools, including motor competence testing of 10 FMS, and 7 FM. Overall levels of motor competence of both FMS and FM were low, and certain levels of dysfunctional movement were high. We observed significant sex-based differences in both FMS and FM, and there was a moderate association between FMS and FM that warrants further investigation. There is a need for societal intervention and policy changes to address low levels of motor competence among adolescent youth.

The Association Between Functional Movement Screen Scores and Knee Valgus Moments During Unplanned Sidestep Cutting in Netball

Background

Regular employment of three-dimensional (3D) motion analyses to assess and monitor knee valgus moments; a contributor to non-contact anterior cruciate ligament (ACL) injury; during unplanned sidestep cutting (USC) is costly and time-consuming. An alternative quick-to-administer assessment tool to infer an athlete's risk for this injury could allow prompt and targeted interventions to mitigate this risk.

Purpose

This study investigated whether peak knee valgus moments (KVM) during weight-acceptance phase of an unplanned sidestep cut were correlated with composite and component scores of the Functional Movement Screen (FMS™).

Study Design

Cross-sectional, Correlation.

Methods

Thirteen female national-level netballers performed six movements of the FMS™ protocol and three trials of USC. A 3D motion analysis system captured lower limb kinetics and kinematics of each participant's non-dominant leg during USC. Averages of peak KVM across USC trials were calculated and examined for correlations with composite and component scores of the FMS™.

Results

No correlations were found between FMS™ composite or any of its component scores with peak KVM during USC.

Conclusions

The current FMS™ did not show any correlations with peak KVM during USC on the non-dominant leg. This suggests that the FMS™ has limited utility in screening for non-contact ACL injury risks during USC.

Level of Evidence

3.

"A breath of fresh air": mindfulness training for early-career mental health social workers in Israel during COVID-19

The present study examined the effectiveness of participation in a mindfulness group for Israeli early career social workers during the COVID-19 period. Eleven participants conducting fieldwork in a mental health rehabilitation center were interviewed. The participants described a variety of benefits from their mindfulness training, in three main areas: (1) Personal: applying mindfulness in their daily life; (2) Family: improved work-life balance and family relationships; and (3) Professional: applying mindfulness in their work with mental health clients. Mental support and self-care tools provided to early-career social workers were perceived by the participants as helping them overcome uncertainty, fatigue, and overwork.

Resistance Training for Patients with Cancer: A Conceptual Framework for Maximizing Strength, Power, Functional Mobility, and Body Composition to Optimize Health and Outcomes

There are many benefits to the addition of exercise to cancer treatment and survivorship, particularly with resistance training regimens that target hypertrophy, bone mineral density, strength, functional mobility, and body composition. These goals are best achieved through a series of individualized high-intensity compound movements that mirror functional mobility patterns and sufficiently stress the musculoskeletal system. As a result of adequate stress, the body will engage compensatory cellular mechanisms that improve the structural integrity of bones and muscles, stimulate metabolism and the immune system, optimize functional performance, and minimize mechanical injury risk. The current evidence suggests that application of the above exercise principles, practiced in a safe environment under expert observation, may offer patients with cancer an effective means of improving overall health and cancer-specific outcomes. The following article poses several important questions certified exercise specialists and physicians should consider when prescribing resistance exercise for patients with cancer.

Long-term effects of deep-learning digital therapeutics on pain, movement control, and preliminary cost-effectiveness in low back pain: A randomized controlled trial

Objective

The present study aimed to compare the effects of a deep learning-based digital application with digital application physical therapy (DPT) and those of conventional physical therapy (CPT) on back pain intensity, limited functional ability, lower extremity weakness, radicular symptoms, limited range of motion (ROM), functional movement, quality of life, cost-effectiveness, and postintervention questionnaires for perceived transmission risk of COVID-19 and satisfaction results in 100 participants with low back pain (LBP).

Methods

One hundred participants with LBP were randomized into either DPT or CPT groups, three times per week over four weeks. Outcome measures included the (1) Oswestry Disability Index, (2) Quebec Back Pain Disability Scale, (3) Roland-Morris Disability Questionnaire (RMDQ), (4) Numeric Pain Rating Scale, (5) functional movement screen (FMS), (6) short form-12, (7) lower extremity strength, (8) ROM of trunk flexion, extension, and bilateral side bending, (9) questionnaires for perceived transmission risk of COVID-19, (10) preliminary cost-effectiveness, and (11) postintervention satisfaction questionnaire results. The analysis of variance was conducted at p < 0.05.

Results

Analysis of variance showed that DPT showed superior effects, compared to CPT on RMDQ, hip extensor strength, transmission risk of COVID-19, as well as satisfaction. Both groups showed significant improvement pre- and postintervention, suggesting that DPT is as effective as CPT, and was superior in preliminary cost-effectiveness and transmission risk of COVID-19.

Conclusions

Our results provide novel, promising clinical evidence that DPT was as effective as CPT in improving structural and functional impairment, activity limitation, and participation restriction. Our results highlight the successful incorporation of DPT intervention for clinical outcome measures, lower extremity strength, trunk mobility, ADL improvement, QOL improvement, and FMS in LBP.

Validity of the KOJI AWARENESS self-screening test for body movement and comparison with functional movement screening

OBJECTIVE

This study aimed to validate the KOJI AWARENESS™, a self-screening movement test, and compare it with the Functional Movement Screen (FMS).

METHODS

Fifty-seven healthy participants completed the KOJI AWARENESS™ and functional movement screening. Pearson's correlation coefficients were used to assess the validity of the test. Subsequently, partial correlation analysis was used to determine the associations between age, sex, body mass index, and sports level as control variables and motor function.

RESULTS

Correlation and partial correlation analyses showed a strong positive correlation between the functional movement screening and the KOJI AWARENESS™ scores.

CONCLUSION

This study found that the KOJI AWARENESS™ test is valid and comparable to functional movement screening. It can be used for self-screening of movement.

Automatic Assessment of Functional Movement Screening Exercises with Deep Learning Architectures

(1) Background: The success of physiotherapy depends on the regular and correct unsupervised performance of movement exercises. A system that automatically evaluates these exercises could increase effectiveness and reduce risk of injury in home based therapy. Previous approaches in this area rarely rely on deep learning methods and do not yet fully use their potential. (2) Methods: Using a measurement system consisting of 17 inertial measurement units, a dataset of four Functional Movement Screening exercises is recorded. Exercise execution is evaluated by physiotherapists using the Functional Movement Screening criteria. This dataset is used to train a neural network that assigns the correct Functional Movement Screening score to an exercise repetition. We use an architecture consisting of convolutional, long-short-term memory and dense layers. Based on this framework, we apply various methods to optimize the performance of the network. For the optimization, we perform an extensive hyperparameter optimization. In addition, we are comparing different convolutional neural network structures that have been specifically adapted for use with inertial measurement data. To test the developed approach, it is trained on the data from different Functional Movement Screening exercises and the performance is compared on unknown data from known and unknown subjects. (3) Results: The evaluation shows that the presented approach is able to classify unknown repetitions correctly. However, the trained network is yet unable to achieve consistent performance on the data of previously unknown subjects. Additionally, it can be seen that the performance of the network differs depending on the exercise it is trained for. (4) Conclusions: The present work shows that the presented deep learning approach is capable of performing complex motion analytic tasks based on inertial measurement unit data. The observed performance degradation on the data of unknown subjects is comparable to publications of other research groups that relied on classical machine learning methods. However, the presented approach can rely on transfer learning methods, which allow to retrain the classifier by means of a few repetitions of an unknown subject. Transfer learning methods could also be used to compensate for performance differences between exercises.

Effects of functional training on sprinting, jumping, and functional movement in athletes: A systematic review

This systematic review aims to illuminate the effects of functional training on sprinting, jumping, and functional movements in athletes. A systematic search of electronic databases—that include PubMed, EBSCOhost (Sport Discus), SCOPUS, ProQuest, Google Scholar, and additional references—was carried out using keywords associated with functional training, jumping, sprinting, functional movement skills, and athletes, in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement criteria. The Physiotherapy Evidence Database (PEDro) scale was used to measure the methodological quality of the studies included in the systematic review. Results: From a total of 220 studies, 15 included ones met all eligibility criteria and were scored between 4-5 points—considered as“ moderate quality”—by the PEDro scale. Most studies recorded positive effects of functional training on athletes’ sprinting, jumping, and functional movement. In contrast, a small number of studies did not find any positive effects of functional training on sprinting, squat jump, vertical jump, and countermovement jump due to the short duration and frequency of the training, as well as the lack of additional exercises that come with the interventions. Furthermore, the reviewed studies reveal that there is limited research within the literature on 5, 15, 25, and 50 m sprinting, squat jump, quadrant jump, and functional movement in athletes. Conclusion: Although the length of training interventions varied across studies in this systematic review, functional training interventions were found to help improve athletes’ performance. The review reveals that training duration, intensity, and frequency are some critical variables that need to be taken into account when developing a successful functional training intervention for athletes. More studies are required to evaluate the influence of different accessible functional training durations on athletes’ sprinting, jumping performance, and functional movement. Finally, further research needs to be done to investigate the impacts of functional training on performance and movement skills of male and female athletes at all levels in other sports.

Systematic Review Registration: https://inplasy.com/inplasy-2022-5-0130/, identifier INPLASY202250130

Effects of Core Stability Training on Functional Movement Patterns in Tennis Players

The aim of this study was to assess the effects of a six-week core stability training program on the fundamental movement pattern assessed using the Functional Movement Screen Test in tennis players. The study group consisted of 160 subjects (74 women, 86 men) with a mean age of 20.26 ± 1.55. The Functional Movement Screen Test (FMS™), as well as the core stability tests including the lateral trunk muscles endurance test (the side bridge test), the abdominal muscles endurance test and the trunk extensors muscle endurance test—were used to evaluate the effects of core stability training. Statistical analysis revealed significant differences in the FMS test scores before and after introducing a core stability exercise program. Initially, the average total score of the FMS test in female tennis players was 14.58 ± 2.91, and after core stability training it was 17.20 ± 1.68 (p < 0.001). In the male group, the total FMS test score was 14.44 ± 2.76 before and 16.91 ± 1.36 after (p < 0.001) in the final assessment. Additionally, statistically significant differences were observed in the core stability test scores before and after introducing a stabilisation training program. The results of the study showed that specific core strengthening exercises could improve the FMS test scores in adult tennis players. This may also have an influence on reducing injury risk in this group, although further studies would be required to test this.

Efficacy of Injury Prevention Using Functional Movement Screen Training in High-School Baseball Players: Secondary Outcomes of a Randomized Controlled Trial

This study of a randomized controlled trial aimed to clarify the effect of functional movement screen (FMS) training on the FMS score and the number of injuries in high-school baseball players. Accordingly, 71 high-school baseball players (age: 15-17 years) were randomized into an intervention group (n = 37; FMS training 4 times per week for 12 weeks on the ground of each team) or a control group (n = 34; team practice without limits). No significant differences were observed in terms of the participant characteristics of the two groups. The FMS score of the intervention group significantly increased after 12 weeks of training compared with the control group. However, there was no difference between the groups in terms of the FMS score after 24 weeks. Injuries in the intervention group were significantly reduced after 24 weeks. The time lost due to noncontact injuries (12 weeks/follow-up) was 56.5 h/113 h in the intervention group and 33 h/325.5 h in the control group. Injuries were found all over the body. Based on these results, FMS training was proven to reduce injury in high-school baseball players. Although continued training is required to improve FMS scores, the number of injuries decreased after training.

Effects of Yoga Intervention on Functional Movement Patterns and Mindfulness in Collegiate Athletes: A Quasi-Experimental Study

High-quality movement patterns and high levels of mindfulness are thought to be beneficial in preventing sports injuries. Yoga is recommended in the field of athlete rehabilitation. This study investigated the effects of yoga intervention on functional movement patterns and mindfulness in collegiate athletes. It is a quasi-experimental study with a pre/post-test control design. The participants were divided into a yoga group and a control group. A Functional Movement Screen and the Mindful Attention Awareness Scale were used to assess participants' basic movement patterns and mindfulness before and after 12 weeks of yoga intervention (two classes per week, 90 min per class). The results show that the yoga group's FMS scores improved more compared to the control group [F(1,78) = 29.08, p < 0.001, ŋp² = 0.27], and that the scores for the deep squat (ŋp² = 0.4), shoulder mobility (ŋp² = 0.17), and trunk stability pushup (ŋp² = 0.36) improved substantially. The dysfunctional score ratio for deep squats (χ² = 18.57, p < 0.001), shoulder mobility (χ² = 26.90, p < 0.001), trunk stability pushup (χ² = 17.07, p < 0.001), and rotatory stability (χ²= 38.29, p <0.001) decreased significantly compared with the control group, but there was no significant improvement in asymmetric movement patterns (χ² = 0.75, p = 0.39). The mindfulness scores in the yoga group significantly exceeded those of the control group [F(1,78) = 13.56, p < 0.001, ŋp² = 0.15]. These results suggest that yoga intervention can improve functional movement patterns and mindfulness levels, but further evidence is needed to determine whether yoga could positively influence sports injuries.

Relationship between a Maximum Plank Assessment and Fitness, Health Behaviors, and Moods in Tactical Athletes: An Exploratory Study

A maximum plank hold (PH) has been implemented in the Army Combat Fitness Test (ACFT) with the Holistic Health and Fitness (H2F) program. The H2F program introduces a shift in wellbeing from a fitness centered approach to framework also comprising nutrition, sleep, mental, and spiritual components. The purpose was to analyze how a maximum PH correlated with fitness, lifestyle behaviors, and mood states in tactical athletes (TA) and assess differences between those who pass and fail. Forty-nine TA completed fitness testing, lifestyle behavior, and mood state surveys. Bivariate correlations were used to examine relationships with PH performance. PH time was significantly correlated with total body mass, fat mass, BMI, push-ups, and state physical energy (SPE). VO_2max was significantly different between the groups who passed and failed the PH. PH was not associated with lifestyle behaviors or trait mood states. PH performance could vary day-to-day as it was correlated with SPE. Individuals with poorer aerobic fitness and body composition may be at risk for failing the PH.

Does Cycling Training Reduce Quality of Functional Movement Motor Patterns and Dynamic Postural Control in Adolescent Cyclists? A Pilot Study

The aim of this study was to assess whether cycling training may influence quality of functional movement patterns and dynamic postural control. We also sought to determine if the Functional Movement Screen and Lower Quarter Y-balance tests could be predictive of injury risk among adolescent road cyclists. Twenty-three male road cyclists, aged 15-18 years, were involved in the study. Quality of functional movement patterns was assessed using the Functional Movement Screen test (FMS). Dynamic postural control was evaluated using the Lower Quarter Y-balance test (YBT-LQ). Information on injury occurrence was collected through a retrospective survey. The results showed the highest percentage of scores equalling 0 and 1 (>30% in total) in two FMS component tests: the hurdle step and trunk stability push-up. The results also demonstrated a low injury predictive value of the Functional Movement Screen (cut-off <14/21 composite score) and the Lower Quarter Y-balance test (cut-off <94% composite score and >4 cm reach distance asymmetry) in adolescent road cyclists. The most important information obtained from this study is that youth road cyclists may have functional deficits within the lumbo-pelvic-hip complex and the trunk, while neither the FMS nor the YBT-LQ test are not recommended for injury risk screening in cyclists.

Effects of a dynamic stretching warm-up on functional movement patterns in female hip-hop dancers

Background: A large percentage of dancers suffer an injury to their musculoskeletal system at least once in their careers, as well as from pain caused by overloading or overtraining this system. A high frequency of injuries has been observed in hip-hop dancers. Before each workout, there should be a solid warm-up and stretching period. The lack of these two important elements increases the risk of injury. Aim of the study: This study aimed to examine the effects of dynamic stretching warm-ups on fundamental movement patterns in female hip-hop dancers. Material and methods: This study included 14 hip-hop female dancers, aged 15–17. Dancers participated in 6 weeks of dynamic stretching warm-ups. Anthropometric and demographic variables were measured. The effectiveness of dynamic stretching warm-ups in improving fundamental movement patterns was assessed using the Functional Movement Screen (FMS) test including qualitative assessments using Deep Squat (DS) Hurdle Step (HS), In-Line Lunge (ILL), Shoulder Mobility (SM), Active Straight-Leg Raise (ASLR), Trunk Stability Push-Ups (TSPU) and Rotational Stability (RS). Results: Before the intervention, the mean composite FMS™ score was 15.00 ± 1.84 points and after the intervention was 16.64 ± 1.39 (p < 0.05). There were also statistically significant differences before and after the intervention in the DS (1.86 ± 0.53 vs. 2.36 ± 0.49, p < 0.05) and ASLR (2.21 ± 0.69 vs. 2.57 ± 0.65, p < 0.05). The number of dancers who scored 14 points or less on the FMS test before and after dynamic stretching warm-ups decreased from 50% to 0%. HS (r = 0.63, p = 0.01) and TPSU (r = 0.79, p = 0.01) were positively correlated with composite FMS scores before the intervention. After the intervention, positive correlations were observed between ASLR and composite FMS scores (r = 0.68; p = 0.01). Conclusions: Dynamic stretching warm-ups significantly improve functional movement patterns, including DS, ASLR, and composite FMS scores. It is important to use movement competency screenings in injury prevention programs.

The relationship between the Functional Movement Screen and the Y Balance Test in youth footballers

Background

The Functional Movement Screen (FMS) and the Y Balance Test (Y-BT) are screening tools to detect movement deficits and to identify footballers at high risk of injury. If these tools are able to identify athletes with high risk of injury, they should measure the same construct and also be highly correlated.

Objectives

The aim of the study was to determine the relationship between the FMS and Y-BT in youth footballers. The present study also aimed to assess the degree of association between the FMS and Y-BT considering high-injury-risk (FMS <= 14 points and Y-BT <= 89.6%) and low-injury-risk groups (FMS > 14 points and Y-BT > 89.6%).

Method

A sample of 226 healthy athletes (mean age: 14.0 ± 2.3 years) was selected from a football club. The FMS and Y-BT data were collected from all participants. The Y-BT raw data were normalised to the relative length of the lower limbs. Spearman's correlation was used in the analysis.

Results

For the whole group, there was a moderate correlation (R = 0.41; p < 0.001) between the composite FMS score and composite Y-BT score. The strength of relationships varied from weak to moderate between the FMS subtests and most Y-BT results for each direction. In the high-injury-risk group, there was no correlation (R = 0.11; p = 0.61) between the composite FMS score and composite Y-BT score. For the low-injury-risk group, there was a weak significant correlation (R = 0.27; p < 0.007) between the composite FMS score and composite Y-BT score. Additionally, 56 and 53 athletes were classified to the high-injury-risk group based on the FMS and Y-BT, respectively. Only 23 athletes were classified to the high-risk group by both tests.

Conclusions

Youth footballers showed only weak to moderate correlations between the FMS and the Y-BT. Footballers classified in the high-injury-risk group based on the FMS and Y-BT presented a different relationship between the FMS and Y-BT tasks compared to the low-injury-risk group. The results confirmed that the FMS and Y-BT should not be used interchangeably as they assess different movement deficits in the group of youth football players. The study results may partially suggest that using one of these screening tools cannot successfully predict injury risk in adolescent football players. This justifies the need to use these tests simultaneously to identify possible neuromuscular control deficits in youth footballers.

Relationships between Functional Movement Quality and Sprint and Jump Performance in Female Youth Soccer Athletes of Team China

This study aimed to determine the optimal functional movement screen (FMS) cut score for assessing the risk of sport injury, and to investigate the correlations between functional movement quality and sprint and jump performance. Twenty-four (N = 24) athletes performed all tests in one day at 10−30 min intervals, and the FMS test was performed first, without a warm-up session. After a standard warm-up, athletes then completed the Y-balance Test (YBT), sprint, counter-movement jump (CMJ), and standing long jump (SLJ), in turn. For each test, the best of three attempts was recorded for further analysis. A receiver operating characteristic (ROC) curve and area-under-the-curve (AUC) were used to determine the optimal FMS cut score for assessing the risk of sport injuries, and Spearman’s rank correlation analysis was used to quantify associations between functional movement scores and athletic performance. The average FMS score was 16.2 and the optimal FMS cut score for assessing the risk of sport injuries was 14.5. There were moderate relationships between total FMS score and 10−20 m sprint time (r = −0.46, p < 0.05), between In-line Lunge and 0−20 m sprint time (r = −0.47, p < 0.05), between Shoulder Mobility and 0−10 m sprint time (r = −0.48, p < 0.05), and between Trunk-stability Push-up and 10−20 m sprint time (r = −0.47, p < 0.05). Moreover, Hurdle Step score was largely correlated with 0−10 m time (r = −0.51, p < 0.05). For Y-balance, moderate correlations were observed between CMJ height and anterior asymmetry score (r = −0.47, p < 0.05) and posteromedial asymmetry score (r = −0.44, p < 0.05). However, there were no significant associations between YBT performance (asymmetric in three directions and composite score) and sprint performance (p > 0.05). Taken together, the results indicate that a FMS score of 14 is not a gold standard for assessing the risk of injury in all populations; we recommend that the FMS cut score of 14.5 should be the optimal score for assessing risk of injury in young female elite soccer players. Moreover, the FMS and YBT were introduced to assess the quality of functional movements, and they cannot be used to assess sprint and jump performance. Practitioners can use components of the FMS that have similar characteristics to specific sports to assess athletic performance.

Effects of Exercise-Based Interventions on Functional Movement Capability in Untrained Populations: A Systematic Review and Meta-Analysis

The purpose of this meta-analysis was to determine the effects of exercise-based interventions on functional movement capability in untrained populations and provide a reference for future intervention studies in this field. PubMed, Embase, Scopus, Web of Science, EBSCOhost, Cochrane Library, WanFang, and CNKI databases were systematically searched from inception until February 2022, for randomized or non-randomized controlled trials, addressing the effect of physical activity on functional movement capability in untrained populations. Two researchers independently conducted study selection, data extraction, and quality evaluation. Meta-analysis was performed using RveMan 5.3 and Stata 16.0 software. Twenty studies with 1596 participants were included in the meta-analysis. The results of meta-analysis demonstrated that exercise-based interventions were associated with improved asymmetry functional patterns (RR = 0.40; 95% CI [0.31, 0.50]; p < 0.00001), FMS composite score (MD = 3.01; 95% CI [2.44, 3.58]; p < 0.00001), deep squat (MD = 0.57; 95% CI [0.37, 0.77]; p < 0.00001), hurdle step (MD = 0.56; 95% CI [0.38, 0.75]; p < 0.00001), in-line lunge (MD = 0.54; 95% CI [0.43, 0.66]; p < 0.00001), shoulder mobility (MD = 0.37; 95% CI [0.15, 0.60]; p = 0.001), active straight leg raise (MD = 0.42; 95% CI [0.24, 0.60]; p < 0.00001), trunk stability push up (MD = 0.40; 95% CI [0.16, 0.63]; p = 0.001), and rotary stability (MD = 0.45; 95% CI [0.24, 0.67]; p < 0.0001). Exercise-based interventions were effective in improving functional movement capability in untrained populations. However, there is a need for high-quality, sufficiently powered RCTs to provide a more definitive conclusion.

Criterion Validity of Functional Movement Screen as a Predictor of Sports Injury Risk in Chinese Police Staff

The occurrence of sports injury has been proven to be highly associated with injury history. (1) Background: This study aimed to validate the feasibility and effectiveness of the Functional Movement Screen (FMS) as a predictor of sports injury risk for Chinese police staff by exploring the optimal cut-off value of the FMS total score for the identification of previous injury. (2) Methods: More than 160 Chinese police staff were recruited and completed the FMS and interviews. The recorders of 148 (79 females and 69 males) participants met the data analysis requirements. For the goal of evaluating the total score of the FMS as a predictor of sports injury risk, all data underwent statistical analysis, calculation of ROC and AUC, evaluation of threshold validity, and so on. (3) Results: The total score frequency distribution of participants’ FMS presented the shape of a normal distribution. The statistical results of the study showed that the FMS composite scores (10.6 ± 2.28) of the police staff with a sports injury history were indeed less than those without an injury history (12.4 ± 2.26). The threshold of a total score of the FMS test that warned of a sports injury risk in Chinese police staff on the basis of a previous injury history was 13.5, with an acceptable AUC value (0.701). In accord with the real social environment and the rule of natural human physiological change, the FMS results of this study showed a distinct deterioration trend with increasing age. (4) Conclusions: The FMS deserves consideration by trainers and clinicians as a pre-exercise physical examination for Chinese police staff to avoid sports injury.

Feasibility and reliability of the Functional Movement Screen battery in adults with intellectual disability

BACKGROUND

The feasibility and reliability of the Functional Movement Screen (FMS) battery for predicting injury risk have been widely studied in athletic, military, public service and healthy populations. However, scant research has been carried out in people with disabilities. This study aimed at identifying the feasibility and reliability of the FMS battery when administered to adults with intellectual disability (ID).

METHODS

Adults from a residential and day care centre over 18 years of age, diagnosed with ID and able to follow simple instructions, were included in the study. All participants with behavioural or health problems that prevented the completion of the FMS battery were excluded. All exercises were video recorded to assure proper scoring. Three assessors (one trained and two novices) scored each of the FMS subtests performed separately from the videos. Feasibility was based on completion rates. Reliability of the composite test scores was analysed using intraclass correlation coefficients (ICCs).

RESULTS

A total of 30 people with ID (mean age: 35.5 ± 7.12 years; 33.3% women) completed all assessments. The battery showed to be feasible, although difficulties when performing two of the subtests were observed among those with moderate and severe ID. Mean total scores from the three assessors ranged from 7.83 to 8.90. An inverse trend was observed indicating that the higher the ID level, the lower the total FMS score. Test-retest reliability was good for the trained assessor (ICC = 0.89) and mostly moderate for both novice assessors (ICC range: 0.60 to 0.76). Moderate to good inter-rater reliability was observed (ICC range: 0.65 to 0.80).

CONCLUSION

The FMS battery is a reliable tool that can be performed by people with ID, albeit with certain difficulties, especially in those with moderate to severe impairment. The battery does not seem to be useful for identifying people with ID at risk of suffering a sport injury. Adequately powered, well-designed studies are required to determine if the FMS battery is appropriate for identifying changes in functional performance in this population.

Association Between the Functional Movement Screen and Landing Kinematics in Individuals With and Without Anterior Cruciate Ligament Reconstruction

OBJECTIVES

The purpose of this study was to compare functional movement screen (FMS) scores and drop vertical jump (DVJ) kinematics between those with and without anterior cruciate ligament reconstruction (ACLR), and to evaluate the association between FMS composite score and DVJ kinematics.

DESIGN

Cross-sectional.

PARTICIPANTS

Sixty individuals with and without a history of ACLR.

MAIN OUTCOME MEASURES

Composite FMS score and the dorsiflexion, knee-flexion, hip-flexion, knee abduction, hip adduction, and trunk-flexion angles during a DVJ.

RESULTS

The FMS scores did not differ between groups (P > .05). There were smaller peak and initial contact hip-flexion angles in the ACLR and contralateral limbs compared with controls, and smaller peak dorsiflexion angles in the ACLR compared with contralateral limbs (P < .05). Lower FMS score was associated with a smaller peak dorsiflexion angle, smaller peak knee-flexion angle, and larger peak knee abduction angle in the ACLR limb (ΔR2 = .14-.23); a smaller peak dorsiflexion angle and smaller peak knee-flexion angle in the contralateral limb (ΔR2 = .17-.19); and a smaller peak dorsiflexion angle, smaller peak knee-flexion angle, and larger peak knee abduction angle in the control limb (ΔR2 = .16-.22).

CONCLUSION

The FMS scores did not differ between groups, but were associated with DVJ kinematics and should be a complementary rather than substitute assessment.

Biomechanical and Psychological Predictors of Failure in the Air Force Physical Fitness Test

Physical fitness is a pillar of U.S. Air Force (USAF) readiness and ensures that Airmen can fulfill their assigned mission and be fit to deploy in any environment. The USAF assesses the fitness of service members on a periodic basis, and discharge can result from failed assessments. In this study, a 21-feature dataset was analyzed related to 223 active-duty Airmen who participated in a comprehensive mental and social health survey, body composition assessment, and physical performance battery. Graphical analysis revealed pass/fail trends related to body composition and obesity. Logistic regression and limited-capacity neural network algorithms were then applied to predict fitness test performance using these biomechanical and psychological variables. The logistic regression model achieved a high level of significance (p < 0.01) with an accuracy of 0.84 and AUC of 0.89 on the holdout dataset. This model yielded important inferences that Airmen with poor sleep quality, recent history of an injury, higher BMI, and low fitness satisfaction tend to be at greater risk for fitness test failure. The neural network model demonstrated the best performance with 0.93 accuracy and 0.97 AUC on the holdout dataset. This study is the first application of psychological features and neural networks to predict fitness test performance and obtained higher predictive accuracy than prior work. Accurate prediction of Airmen at risk of failing the USAF fitness test can enable early intervention and prevent workplace injury, absenteeism, inability to deploy, and attrition.

Emotion mapping: Exploring creative methods to understand the psychology of long-term injury

This methodological study details the effectiveness of emotion mapping as a method to explore the lived experiences of professional male athletes ( n = 9) with a long-term injury. This represents the first use of emotion mapping to garner phenomenal knowledge on long-term injury within a sport psychology context, and as such is a departure from traditional approaches in this field. Following an orientation meeting, each participant was asked to produce an emotion map in the privacy of their home of two critical spaces occupied during their rehabilitation. Using video conferencing software, they were then asked to narrate their map, to facilitate understanding of their lived experiences of injury. Overall, the method was found to be efficacious in supporting existing literature on injury and revealing previously unknown aspects of long-term injury. In particular, the study provided phenomenal knowledge that was previously absent. As such, recommendations are made for the use of emotion mapping both as an effective research technique, and as a therapeutic tool.

Association between Functional Movement Screen Scores and Athletic Performance in Adolescents: A Systematic Review

This study systematically reviews the literature examining the relationship between Fundamental Movement Screen (FMS©) scores and athletic performance in youth. We searched English-language papers on PubMed/MEDLINE, SportsDiscus, CINAHL, and EBSCO for the following inclusion criteria: Participants aged between 11 and 17 years, studies had to include the Functional Movement Screen© (FMS©) and at least one of the following performance outcomes, highlighted by athletic development models (i.e., long-term athletic development (LTAD), youth physical development (YPD)): agility, speed, power, strength, endurance, and balance (YPD), fitness (LTAD), or sport-specific skill (LTAD and YPD). A total of 3146 titles were identified, with 13 relevant studies satisfying the inclusion criteria after full-text screening. The results of this systematic review suggest that children and youth who score highly on the FMS© also tend to have better scores for agility, running speed, strength, and cardiovascular endurance. The strength of associations was weak to moderate in nature. Only one study was considered or controlled for biological maturation in their analysis. These results provide evidence that, while there is a relationship between FMS© scores and tests of athletic performance in youth, they are not the same thing and should be considered conceptually different constructs.

Bibliometric Analysis of Top 100 Systematic Reviews and Meta-analyses in Orthopaedic Literature

Aim

We performed a bibliometric analysis of top 100 systematic reviews (SR) and meta-analyses (MA) in orthopaedic literature and also evaluated articles with maximum average citation per year, which were unable to make up in the present top 100 cited list, but may have a promising future in the world of citations.

Methods

This bibliometric study was performed by searching Web of Science database according to a specific search strategy by two independent authors according to eligibility criteria of the studies. Articles with more than 100 citations were eligible for analysis and were evaluated for following parameters: number of citations, journal name, publication date and year, first author, the total number of authors, average citations per year, methodological design of the study, geographic origin and institute associated. Inter-rater reliability was evaluated using Kappa coefficient.

Results

The number of citations ranged from 1073 to 198 with a total citation count of 30,589. Inter-rater reliability came to out in the good agreement (Kappa value-0.8). There was visible up-gradation of the research from the 2000 year till today. Spine journal had the maximum articles (26) followed by Journal of Bone and Joint Surgery-America (12 articles). The topics "Spine" and "Sports Medicine" were the most frequently cited topics with 41 and 20 articles, respectively. USA has the maximum articles in the top 100 cited SR and MA. Based on the maximum average citations per year, 34 old articles were replaced in the list with the latest articles that have a bright future ahead and can be predicted to be in the top 100 cited SR and MA of Orthopaedics soon.

Conclusion

This study recognizes those articles that have contributed significantly to the growth of knowledge and influenced clinical practices in orthopaedics. We believe that this will facilitate and encourage researchers and clinicians in their future research.

Supplementary Information

The online version contains supplementary material available at 10.1007/s43465-022-00604-9.