Efficacy of the functional movement screen: a review

Effects of functional training on tennis-specific physical fitness and functional movement screen in junior tennis players

OBJECTIVES

Functional training mimics the coordinated motions of multiple muscle groups and joints performed during exercise. The purpose of this study was to compare the effects of a 12-week functional training and traditional resistance training on the performance in junior tennis players.

METHODS

Trained tennis players (mean age: 16.6 years) were assigned to a traditional training group (n = 20) or functional training group (n = 20). The traditional training group received a resistance training program by their coach, while the functional training group was given Santana's Racket Sport Program. At baseline, after six weeks, and after 12 weeks (T12), the participants' tennis-specific physical fitness and functional movement screen (FMS) were evaluated.

RESULTS

At T12, both training improved the values for multistage fitness test, hexagon test, planned agility test, sit and reach, and 20 metre sprint (p < 0.05); except the flexibility, functional training provided no additional advantages. At T12, functional training enhanced (p < 0.01) all seven components of the FMS, and there is a 100% probability that the total score of the FMS would be enhanced. In contrast, for the traditional training group, shoulder mobility of the FMS decreased (p = 0.03), and there was no changes in other FMS components at T12.

CONCLUSIONS

Functional training is not only effective in improving tennis-specific physical fitness, but it also provides greater functional movement advantages for junior tennis players compared to traditional resistance training.

Platform Design for Optical Screening and Conditioning for Injury Resilience

INTRODUCTION

Musculoskeletal injuries (MSKIs) among active duty soldiers result in more than 10 million limited duty days each year and account for more than 70% of the medically nondeployable population. Overuse injuries in lower limbs from running, foot marching long distances with heavy loads, and lifting heavy objects are the most common types of injuries in the military. Physical training and rehabilitation exercises for greater resiliency through aerobic, muscle strength, endurance, and agility conditioning programs can prevent or reduce the effects of MSKIs if Soldiers adhere to proper biomechanics and training techniques. We are introducing a three-dimensional (3D) camera-based platform for Optical Screening and Conditioning for Injury Resilience (OSCIR) that is designed to identify and correct high-risk movement patterns based on quantifiable biomechanical measurements in clinical or field settings. Our goal is to improve resilience to MSKI by offering greater access to quality of movement skills in warfighters through an autonomous device that can be used in Sports Medicine and Reconditioning Team (SMART) clinics and High-Intensity Tactical Training (HITT) sites.

MATERIALS AND METHODS

OSCIR fuses four pairs of Kinect Azure cameras into a concise footprint to achieve suitable sampling rates and an unobstructed field of view for accurate dynamic movement tracking using a custom point cloud solution. We designed a unique multistage 3D joint tracking algorithm architecture to methodically isolate the human body point cloud from the background, identify individual limb segments, and perform iterative joint optimization at the global and local joint levels. We evaluated the feasibility of our prototype system among N = 12 control participants (6 M/6 F; 21-37 years) in compliance with the Western Institutional Review Board (Tracking #20225920, approved on November 4, 2022). Five task-specific MSKI outcome metrics identified by end-user physical therapists and athletic trainers as indicators for movement quality were assessed across 7 lower-extremity exercises derived from standardized MSK assessment/conditioning batteries used in the military. Data were recorded concurrently by OSCIR and a reference standard Vicon motion capture system for validating system accuracy.

RESULTS

Task-specific MSKI indicators for knee flexion and hip flexion range of motion achieved an average error of 4.05 ± 2.34°, while 3D position-based postural outcomes of left-right foot distance, left-right hand distance, and step length obtained mean absolute errors of 2.58 ± 2.30 cm. Results support the feasibility of our system in achieving outcomes that are comparable to currently accepted laboratory standards.

CONCLUSIONS

Our study describes the integration process for a 3D camera-based clinical system for MSKI conditioning and rehabilitation. The impact of our system will enable key stakeholders in the military to manage MSKIs in warfighters by automating key assessment and rehabilitation test batteries; making tests more readily accessible, and interpretations more accurate by providing objective biomechanical measures. OSCIR is undergoing turn-key design features to serve as a screening tool for warfighters to readily assess susceptibility to MSKI or as a training platform to help guide exercise techniques to achieve resiliency against future injuries.

Predicting functional movement capacity in adults: the effect of range of motion and isometric strength

The aim of the study was to determine the role of isometric strength and range of motion in predicting Functional Movement Screen (FMS) scores of adults. A total of 120 participants (age = 34.62 ± 11.82 years; height = 170.56 ± 9.63 cm; weight = 73.62 ± 15.39 kg) volunteered to participate in the study. Anthropometric measurements were performed, including height, body weight, muscle mass, and body fat. Following this, the ranges of motion of the shoulder, hip, knee, and ankle joints were measured sequentially. Isometric strength and FMS tests were then performed. Hip extension isometric strength explained 23% of the variation in FMStotal. The common effect of knee flexion, shoulder flexion, and dorsiflexion joint range of motion explained 34% of the change in FMStotal (F (3-116) = 20.375, p < 0.001). A significant relationship (R = 0.658, R2 = 0.413) was found between hip extension isometric strength, knee flexion, shoulder flexion, and dorsiflexion range of motion and FMStotal (F (4-115) = 21.952, p < 0.001). The common effect of all these variables explains 43% of the change in FMStotal. The results indicate that the FMS test scores, which are utilized to evaluate the risk of injury in sedentary adults, can be significantly predicted by the effect of hip extension isometric strength and parameters related to knee flexion, shoulder flexion, and dorsiflexion joint range of motion. At this time, it is advised that range of motion and isometric strength be taken into account when determining a person's functional movement capacity.

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.

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 Changing Landscape in Upper Limb Sports Rehabilitation and Injury Prevention

This editorial aims to feature authors who intend to submit their research to this Special Issue of Sports entitled "Clinical Advances in Upper Limb Sports Rehabilitation and Injury Prevention" in areas that need special consideration [...].

Functional Movement Patterns, Spinal Posture and Prevalence of Musculoskeletal Symptoms among Elite Ice Hockey Players: A Cross Sectional Study

The aim of this study was to evaluate functional movement patterns and spinal posture of elite ice hockey players and to examine the association between spinal posture, prevalence of musculoskeletal symptoms and Functional Movement Screen (FMSTM) scores. The study included 86 elite male ice hockey players aged 18 to 38 years. Sagittal spinal curvatures were measured with a Saunders digital inclinometer, and functional movement patterns were assessed by the FMSTM. Spinal posture of the studied ice hockey players was characterized by normal kyphosis (46%) or hyperkyphosis (41%) and decreased lumbar lordosis (54%). The mean total FMSTM score was 14.8. Most of the hockey players (57%) achieved a total FMSTM score in the range of 14-17 points, whereas 28% had a total FMSTM score of <14. Seventy-two percent of the studied athletes had at least one asymmetry. Significant differences between performing the movements on the right and the left sides of the body were observed in in-line lunges (p = 0.019) and shoulder mobility sub-tests (p < 0.001). The FMSTM sub-tests performed with the lowest success rates were rotatory stability and the hurdle step. A lower score in the rotatory stability test is related to shoulder pain. It is highly important to develop appropriate exercise programs to reduce or prevent muscle imbalances in ice hockey players.

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.

The effects of velocity-based versus percentage-based resistance training on athletic performances in sport-collegiate female basketball players

Introduction: The study compared the effects of 6-week (2 sessions/week) velocity-based resistance training (VBRT) and percentage-based resistance training (PBRT) on athletic performance in Sport-College female basketball players. Methods: Fifteen participants were assigned to the VBRT (n = 8) or PBRT (n = 7) groups. The load in VBRT group were determined through the sessional target velocity and velocity loss monitoring, whereas PBRT group used a fixed-load based on percentage of 1-repetition maximum (1RM). Both groups completed intervention that involved the free weight back squat and bench press using the same relative load (linear periodization from 65% to 95% 1RM). Training loads data was continuously recorded. Measurements at baseline (T0) and post-training (T2) included 1RM, countermovement-jump (CMJ), squat-jump (SJ), eccentric-utilization-ratio (EUR), drop-jump height and reactive-strength-index (DJ, DJ-RSI), plyometric-push-up (PPU), 505 change-of-direction (COD), 10-m、20-m sprint (T-10、T-20), 17 × 15 m drill-lines (17-drill), Hexagon agility, and functional movement screen (FMS). A mid-term (T1) assessment was included to investigate the short-term effects of both methods and the fluctuation of personalized 1RM. Results: No between-group differences were observed at T0 for descriptive variables (p > 0.05). Both groups showed significant improvement in strength gains for back squat and bench press, but VBRT showed likely to very likely favorable improvements in CMJ, SJ, EUR, DJ-RSI, Hexagon and COD among athletic performance. The VBRT showed likely to very likely improvements in 17-drill and DJ, while PBRT showed unclear effects. The lifted weights adjusted by VBRT method were higher than prescribed by PBRT (p < 0.05) for the same subjects. Conclusion: Compared with fixed-load PBRT, VBRT enhanced power and athletic performance despite similar strength gains. VBRT can be regarded as a more functional resistance-training method under linear periodization.

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.

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.

Acceptability and Practicality of a Quick Musculoskeletal Examination into Sports Medicine Pre-Participation Evaluation

BACKGROUND

Child musculoskeletal (MSK) diseases are common and, even if often benign, sometimes can lead to significant impairment in the future health of children. Italian pre-participation evaluation (PPE), performed by a sports medicine physician, allows for the screening of a wide range of children every year. Therefore, this study aims to evaluate the feasibility and the acceptability of pGALS (pediatric Gait, Arms, Legs and Spine) screening, a simple pediatric MSK screening examination, when performed as part of a routine PPE.

METHODS

Consecutive school-aged children attending a sports medicine screening program were assessed with the addition of pGALS to the routine clinical examination. Practicability (time taken) and patient acceptability (discomfort caused) were recorded.

RESULTS

654 children (326 male, mean age 8.9 years) were evaluated through pGALS. The average time taken was 4.26 min (range 1.9-7.3 min). Acceptability of pGALS was deemed high: time taken was "adequate" (97% of parents) and caused little or no discomfort (94% of children). Abnormal MSK findings were common.

CONCLUSIONS

pGALS is a practical and acceptable tool to perform in sports medicine PPE, even if performed by a non-expert in MSK medicine. Although common, abnormal MSK findings need to be interpreted in the global clinical context and assessment.

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.

Real-Life Social-Skills Training and Motor-Skills Training in Adults With Autism Spectrum Disorder: The Con-Tatto Project Walking Down the Francigena Route

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with an early onset and a genetic and epigenetic component. ASD is characterized by deficits in socio-emotional reciprocity, impaired verbal and non-verbal communication skills, and specific difficulties in developing and maintaining adequate social relationships with peers. Indeed, restricted, repetitive patterns of behavior, interests, or activities are required by DSM-5 diagnostic criteria. Autistic people usually need an unchanging environment (or in any case predictable and stable) and may have hypo- or hyper-sensitivity to sensory inputs. The onset of clinical symptoms occurs during the early years of life. Social skills competence is a significant therapeutic aim to be pursued when addressing ASD core symptoms. Several considerable motor difficulties (87%) in people with autism spectrum disorder in adulthood have been found. The Con-tatto project developed a project addressing social, physical, and mental health difficulties in real-life walking down the Francigena route for 9 days with 12 autistic people, by (1) Implementing daily sessions of social skills training program whose abilities were addressed to be immediately generalized and used throughout the day. (2) Educational movement and walking activity programs were led by a fitness coach. (3) The creation of walking peers' social community with a strong and relevant impact on adults with ASD social life respecting every person's individuality. (4) Provision of social reinforcers to reduce the stigma of people with autism and the experienced perception of low self-esteem, especially when they are bullied.

Assessment of Dysfunctional Movements and Asymmetries in Children and Adolescents Using the Functional Movement Screen-A Narrative Review

The Functional Movement Screen (FMS) is a screening tool that identifies dysfunctional movements in seven test items requiring an interplay of cognitive, perceptual, proprioceptive, and motor functions that involve muscular strength/endurance, flexibility, mobility, coordination, and balance. The results of the FMS include an overall composite score, scores on the individual test items, and identification of compensatory movement patterns and left-right asymmetries on 5 bilateral test items. Although there is a plethora of literature on the use of the FMS in adults, there is a growing body of evidence indicating its use in children. The available research in children involves school children and young athletes in at least 20 different sports in over 20 countries and comparisons between pre- and post-pubescent children, and normal weight, overweight, and obese children. Studies that include measures of adiposity and physical activity levels, or report prevalence of asymmetries and dysfunctional movement patterns are not well represented in the children’s literature. The purpose of this paper is to synthesize the currently available literature in children and suggest potential uses of the FMS by coaches, physical educators, and other health/fitness professionals, appropriate interpretation of results, and future research in children.

Effect of body composition on Functional Movement Screen scores in elite youth male soccer players

BACKGROUND

The Functional Movement Screen (FMS) is a clinical assessment tool used to determine musculoskeletal dysfunctions and asymmetries in athletes.

OBJECTIVE

The aim of this study was to investigate whether FMS scores differed between elite youth male soccer players with low body fat percentage and those with normal body fat percentage and between those with and without a history of soccer injury.

METHODS

Fifty-three elite youth male soccer players were included in the study. The participants' injury histories were recorded, followed by body composition assessment and FMS tests. The participants were grouped according to body fat percentage and injury history for data analysis.

RESULTS

The mean age, weight and height of the participants were 17.11 ± 0.91 years, 68.78 ± 7.41 kg and 1.77 ± 0.57 meters, respectively. Comparisons of the groups according to body fat percentage and injury history revealed no differences in FMS scores (p> 0.05).

CONCLUSION

Lower body fat percentage did not confer an advantage or disadvantage to elite youth male soccer players in terms of FMS scores FMS scores provide limited information to predict injuries in elite youth male players.

Effects of functional correction training on injury risk of athletes: a systematic review and meta-analysis

Background

We explored functional correction training using the Functional Movement Screen (FMS™) tool. We also analyzed the effects of training on the injuries of athletes in a systematic review and meta-analysis of non-randomized clinical trials.

Methodology

We collected twenty-four articles from PubMed, CENTRAL, Scopus, ProQuest, Web of Science, EBSCOhost, SPORTDiscus, Embase, WanFang, and CNKI that were published between January 1997 to September 2020. Articles were selected based on the following inclusion criteria: randomized and non-randomized controlled trials, studies with functional correction training screened by FMS™ as the independent variable, and studies with injury risk to the athlete as the dependent variable. Data conditions included the sample size, mean, standard deviation, total FMS™ scores, number of injuries, and asymmetry movement patterns after interventions in the experimental and control groups. Exclusion criteria included: conference abstracts, cross-sectional studies, articles with retrospective study design.

Results

Twelve non-randomized trials were included in the meta-analysis. The injury risk ratio of athletes after functional correction training was 0.39 RR (95 CI [1.50–1.93]; Z = 15.53; P < 0.0001; I² = 2.6%), indicating an improvement of athletes functional patterns.

Conclusion

Grade B evidence indicates that functional correction training based on FMS™ may improve the functional patterns of athletes and Grade D evidence indicates that it may reduce the risk of sports injury. However, the true effect is likely to be different from the estimate of the effect. Therefore, further studies are needed to explore the influence of functional correction training on the injury risks of athletes. Protocol registration: CRD42019145287.

Functional Movement Screen Items Predict Dynamic Balance Under Military Torso Load

INTRODUCTION

Musculoskeletal injuries threaten military readiness and impose a significant financial burden. The functional movement screen (FMS), a 7-item, preparticipation screening tool, may aid in identifying compensatory movement patterns that can hinder physical performance and lead to injuries in active-duty military personnel. The primary aim of our study was to determine if items scores from the traditional FMS or a modified FMS (mFMS) obtained under loaded conditions can predict dynamic balance scores while wearing a military load.

MATERIALS AND METHODS

Thirty physically active adults (19 males and 11 females) who qualified for Army basic training completed unloaded and loaded FMS testing. Loaded balance was assessed using the Y balance test and the Biodex balance system. The mFMS and both loaded balance assessment protocols included a military load consisting of a standard issue rucksack (M.O.L.L.E.), kevlar helmet, and weighted vest (mass = 24.2 kg).

RESULTS

mFMS item scores were significantly lower than FMS scores for six of the seven movement items. Both FMS and mFMS composite scores were correlated with Y balance scores (FMS: r = 0.53, P = 0.003; mFMS: r = 0.37, P = 0.043). Participants with higher composite scores (≥15) outperformed those with lower composite scores (≤14) for the FMS (P =0.006, d = 1.16) and mFMS (P = 0.031, d = 0.75). Lasso penalized regression analyses revealed that (1) higher unloaded in-line lunge subscores predicted better Y balance scores, (2) loaded trunk stability push-up scores of three predicted worse balance on the Biodex, and (3) unloaded and loaded shoulder mobility scores of 3 predicted better performance on the Biodex balance system.

CONCLUSIONS

The in-line lunge subscore from the FMS was the strongest predictor of torso-loaded balance, and the FMS may be more appropriate than a torso-loaded FMS battery when predicting torso-loaded balance among adults with body composition and fitness profiles similar to those of entering military recruits. These findings provide evidence supporting the use of the conventional FMS to identify active-duty personnel who exhibit greater balance deficits and may develop related musculoskeletal injuries while performing operational tasks that require the transport of heavy loads over long distances.

Sex Differences in Dysfunctional Movements and Asymmetries in Young Normal Weight, Overweight, and Obese Children

This study evaluated overall performance on the functional movement screen (FMS), prevalence of asymmetries and dysfunctional movements, and the relationship between measures of adiposity and the FMS score. Methods: Ninety-four (53 boys; 41 girls) 10–12-year-old children in Hungary and Germany who were participating in daily physical education performed the FMS. The mean FMS score in girls (14.1) was significantly higher than in boys (12.9). Individual test item scores were similar, except girls scored higher on the straight-leg raise. Most children (55% of boys, 68% of girls) presented with at least one asymmetry and 72% of boys and 76% of girls had at least one dysfunctional score. Measures of adiposity were negatively correlated to performance on all test items. Underweight and normal weight children performed significantly better on the FMS than overweight and obese children. Sex differences and the high prevalence of asymmetries and dysfunctional scores should be interpreted with caution since they may be due to dynamic changes in strength, proprioception, balance, and motor control that occur as part of growth and involvement in activities. Nevertheless, the high prevalence of asymmetries and dysfunctional scores indicate that most children have movement limitations.

Can the Functional Movement Screen Method Identify Previously Injured Wushu Athletes?

The functional movement screen (FMS) is commonly used to evaluate sports injury risks, but no study has been reported for Wushu athletes. The aim of this study was to identify optimal FMS cut-off points for previously injured Wushu athletes and to examine the associations with other possible factors. In this study, a total of 84 Chinese Wushu athletes (15.1 ± 4.5 years old, 51% male) with a minimum of two years of professional training background in either Taiji, Changquan, or Nanquan were assessed by the FMS. Video recordings were used to confirm the scoring criteria, and previous injuries were assessed based on face-to-face interviews. An optimal cut-off of the FMS score was investigated by receiver operating characteristic curves with sensitivity and specificity. We found that FMS score of less than 16 (sensitivity = 80%, specificity = 56%) was related to an increased occurrence of injuries (odds ratio = 5.096, 95%CI: 1.679-15.465) for the current study sample. The training type and training levels were related with FMS scores. More than half of the athletes (58%) had FMS asymmetry and 21% of athletes reported pain while performing the FMS protocol. Future prospective studies are recommended to use FMS with cut-off of 16 points in Wushu athletes.

Do Normative Composite Scores on the Functional Movement Screen Differ Across High School, Collegiate, and Professional Athletes? A Critical Review

OBJECTIVE

The Functional Movement Screen (FMS) is a battery of 7 unloaded tests designed to rate human movement competency. Injury rates vary across the different level of a sport. The purpose of this critical review was to determine whether normative FMS composite scores differ across high school, collegiate, and professional athletic populations and to determine whether normative composite scores correlate with rates of severe injury across different collegiate sports.

DATA SOURCES

PubMed, Web of Science, and EBSCO databases from inception to September 2017 with the following syntax: "functional movement screen*" OR "movement screen*". Additional records were identified by citation tracking and hand search of articles.

STUDY SELECTION

A total of 708 records identified, of which 36 were included. Studies were included if they reported a FMS composite score for one of the groups.

DATA EXTRACTION

Two reviewers (T.R.P. and F.K.) screened records for the author and year; sample size; study design; sport(s); number, age, and sex of participants; testing conditions; methodological quality; and mean or median composite score(s).

DATA SYNTHESIS

Normative FMS composite scores were invariant to level of play, with 61% of reported scores falling between 14 and 16, despite injury rates increasing by level of play. Scores for high school, college, and professional athletes were 14.1, 14.8, and 15.7, respectively. There was a significant positive relationship between composite scores and rate of severe injury in college sports (r(11) = 0.66, P = 0.014).

CONCLUSIONS

Our findings potentially undermine the FMS's predictive validity. Although the FMS may have other applications, this critical review provides further evidence against the composite score for injury prediction in competitive athletes.

FUNCTIONAL MOVEMENT SCREEN™ (FMS™) SCORES DO NOT PREDICT OVERALL OR LOWER EXTREMITY INJURY RISK IN COLLEGIATE DANCERS

Purpose

Dance is a physically demanding activity, with 50-85% of dancers suffering injury during a single performance season. The majority of dancers' injuries are in the lower extremity (LE) and chronic in nature. These injuries often arise when causal factors are not identified early and addressed before they ultimately result in an injury. Practitioners often use movement screens such as the Functional Movement Screen™ (FMS™) to detect and quantify kinetic chain dysfunction. Prior researchers have suggested that these screens can stratify at-risk individuals and allow practitioners to devise targeted interventions to reduce their injury risk. However, whether the FMS™ can identify at-risk dancers remains unclear. Thus, the purpose of this study was to examine whether FMS™ scores predicted injury risk in collegiate dancers.

Methods

In this prospective study, 43 collegiate dance majors (34 female, 9 male; 18.3 ± 0.7yrs; 163.9 ± 7.3cm; 60.8 ± 8.1kg) in a program which emphasizes modern dance were scored on the seven FMS™ movements (scale 0-3, total maximum score=21) where 3=movement completed without compensation, 2=movement completed, but with compensation(s), 1=unable to complete movement, 0=pain during movement or during clearing tests as described in prior literature at the start of the academic year. An in-house certified athletic trainer documented dancer's overall and LE injuries over an academic year (40 weeks). Separate Receiver Operator Characteristic (ROC) curve analyses examined whether composite FMS™ score predicted (1) Overall or (2) LE injury status.

Results

The subjects FMS™ scores were 16.2 + 1.7 (range=11-19). Twenty dancers were injured, whereas 23 remained injury-free. Injured dancers had 55 overall (1.28 injuries/dancer) and 44 LE injuries (1.02 LE injuries/dancer). FMS™ score did not predict overall (AUC=.28, SE=.08, p=.02, 95%CI=.13-.43) or LE injury risk (AUC=.38, SE=.1, p=.21, 95% CI=.21-.56).

Discussion

While nearly half of the dancers in this group suffered from injury over the year, composite FMS™ scores did not predict overall or LE injury risk in collegiate dancers. Dancers face unique and challenging physical demands that distinguish them from traditional sport-athletes including greater ranges of movement during performance. Thus, the FMS™ may not be sensitive enough to distinguish 'appropriate' from 'excessive' mobility and adequately identify injury risk in dancers. Overall, it is suggested that practitioners should use caution before using the FMS™ as a primary screening mechanism to identify collegiate dancers at overall or LE injury risk.

Level of Evidence

2.

Is Adiposity Associated with the Quality of Movement Patterns in the Mid-Adolescent Period?

This study examined the association between functional movement (FM) and adiposity in adolescent population (16–17 years). This study was conducted in a representative sample of urban adolescents as the part of the CRO-PALS longitudinal study (n = 652). Body mass index (BMI), a sum of four skinfolds (S4S), waist and hip circumference were measured, and FM was assessed via Functional Movement Screen^TM (FMS^TM). Furthermore, total FMS^TM screen was indicator of FM with the composite score ranged from 7 to 21, with higher score indicating better FM. Multilevel analysis was employed to determine the relationship between different predictors and total FMS score. In boys, after controlling for age, moderate-to-vigorous physical activity, and socioeconomic status, total FMS score was inversely associated only with BMI (β = −0.18, p < 0.0001), S4S (β = −0.04, p < 0.0001), waist circumference (β = −0.08, p < 0.0001), and hip circumference (β = −0.09, p < 0.0001). However, among girls, in adjusted models, total FMS score was inversely associated with S4S (β = −0.03, p < 0.0001), while BMI (β = −0.05, p = 0.23), waist circumference (β = −0.04, p = 0.06), and hip circumference: (β = −0.01, p = 0.70) failed to reach statistical significance. Results showed that the association between adiposity and FM in adolescence is sex-specific, suggesting that boys with overweight and obesity could be more prone to develop dysfunctional movement patterns. Therefore, exercise interventions directed toward correcting dysfunctional movement patterns should be sex-specific, targeting more boys with overweight and obesity rather than adolescent girls with excess weight.

Using Machines or Free Weights for Resistance Training in Novice Males? A Randomized Parallel Trial

This study compared the effect of a resistance training (RT) program with machines, free weights, or a combination of both on changes in anthropometrics, strength, and functional ability in novice adult males. Thirty-six male novices in RT (18–45 years) followed a 10-week RT program. Participants were randomly assigned to one of three groups (N = 12 each): machines only; free weights only; or switching from machines to free weights (after 5 weeks). Muscle size (circumferences of upper arm, thigh and chest), strength (1 Repetition Maximum) on both machines and free weights, and functional ability (Functional Movement Screen^TM (Functional Movement Systems Inc., Chatham, VA, USA)) were assessed prior to the RT program, halfway at 5 weeks, and within one week after the final training bout. Repeated measures MANOVAs showed no significant time by RT group interactions for the different outcome measures. Regardless of RT group, significant improvements over time were observed for anthropometrics (F = 9.144, p < 0.001), strength (F = 6.918, p < 0.001), and functional ability (F = 25.578, p < 0.001). To conclude, similar gains in muscularity, strength, and functional ability can be expected for male novices in RT regardless of the equipment being used and without a fallback when changing from machines to free weights. Accordingly, any choice of RT equipment can be made, considering individual preferences.

Preseason Screen Cannot Predict Injury over Three Years of College Football

PURPOSE

This study aimed to investigate if the Functional Movement Screen (FMS) total score, individual component test scores, or number of asymmetries can predict noncontact injury risk over three consecutive seasons of National Collegiate Athletic Association Division I football.

METHODS

Because football teams comprise individuals with vastly different physical characteristics and playing responsibilities, we divided the subjects into three homogeneous groups based on position (big, combo, and skill). Each FMS score was assessed with regard to the total team score and by individual position groups. For our injury analysis, we also controlled for exposure. Two hundred and eight National Collegiate Athletic Association Division I athletes participated over three consecutive seasons, yielding a total of 343 observations.

RESULTS

There was no significant relationship between total FMS score and likelihood of injury when analyzed by the total team or by position group. These findings were the same for all groups, for both the total number of injuries and injuries weighted by injury exposure. The only significant findings occurred when we considered individual test item scores to injury by position group. We only found a significant relationship in the expected direction with push-up stability in the combo group.

CONCLUSIONS

FMS was not a good predictor of noncontact injury.

Hybrid neuromuscular training promotes musculoskeletal adaptations in inactive overweight and obese women: A training-detraining randomized controlled trial

This study investigated the effects of a 10-month high-intensity interval-type neuromuscular training programme on musculoskeletal fitness in overweight and obese women. Forty-nine inactive females (36.4 ± 4.4 yrs) were randomly assigned to either a control (N = 21), a training (N = 14, 10 months) or a training-detraining group (N = 14, 5 months training followed by 5 months detraining). Training used progressive loaded fundamental movement patterns with prescribed work-to-rest intervals (1:2, 1:1, 2:1) in a circuit fashion (2-3 rounds). Muscular strength and endurance, flexibility, passive range of motion (PRoM), static balance, functional movement screen (FMS) and bone mass density (BMD) and content (BMC) were measured at pre-, mid-, and post-intervention. Ten months of training induced greater changes than the controls in (i) BMD (+1.9%, p < 0.001) and BMC (+1.5%, p = 0.023) ii) muscular strength (25%-53%, p = 0.001-0.005); iii) muscular endurance (103%-195%, p < 0.001); and iv) mobility (flexibility: 40%, p < 0.001; PRoM [24%-53%, p = 0.001-0.05;]; balance: 175%, p = 0.058; FMS: +58%, p < 0.001). The response rate to training was exceptionally high (86-100%). Five months of detraining reduced but not abolished training-induced adaptations. These results suggest that a hybrid-type exercise approach integrating endurance-based bodyweight drills with resistance-based alternative modes into a real-world gym setting may promote musculoskeletal fitness in overweight and obese women.

Movement quality in adolescence depends on the level and type of physical activity

OBJECTIVES

This study examined the relationship between functional movement and physical activity (PA) levels in adolescents.

DESIGN

Cross-sectional study.

SETTING

This research is a part of the CRO-PALS longitudinal study conducted in a random sample of adolescents in Zagreb at the Faculty of Kinesiology, University of Zagreb, Croatia.

PARTICIPANTS

Seven hundred and twenty-five adolescents aged between 16 and 17 years were included.

MAIN OUTCOME MEASURE

Total Functional Movement Screen score (total FMS score).

RESULTS

After adjusting for age, body fat and SES, both VPA and MVPA showed minor but significant effects on total FMS score among girls (β = 0.011, p = 0.001, β = 0.005, p = 0.006, respectively), but not in boys (β = 0.004, p = 0.158; β = 0.000, p = 0.780). Regarding PA type, volleyball and dance improved total FMS score (β = 1.003, p = 0.071; β = 0.972, p = 0.043, respectively), while football was associated with lower FMS score (β = -0.569, p = 0.118).

CONCLUSION

Results suggest that the PA level is positively associated with the functional movement in adolescent girls, but not in boys, where the type of PA moderates these associations. Therefore, functional movement patterns incorporated into physical education curriculum could be beneficial to the musculoskeletal health of the children.

Investigating the Age-Related Association between Perceived Motor Competence and Actual Motor Competence in Adolescence

Irish adolescents have been found to possess high perceptions of motor competence. However, there is an evidential value to investigating the strength of the relationship between adolescent perceptions of motor competence and their low levels of actual motor competence. The purpose of this research was to gather data on the fundamental, functional, and perceived motor competence in adolescents, differentiated by year group, to discern if participants could assess their perceptions of ability. Data were collected on adolescents (N = 373; mean age: 14.38 ± 0.87 years; 47.7% female) across six second-level schools in Ireland, including measurements of fundamental movement skills, functional movement, and perceived motor competence. Poor levels of fundamental and functional movement were observed, with significant differences between year groups detected. Participants in 1st year scored the highest in overall fundamental movement skills; however, for overall functional movement, 3rd-year participants scored highest. High levels of perceived motor competence were reported across the entire sample. These scores did not align with actual motor competence, nor did any alignment between these measurements improve with aging, countering theorized age-related associations. Future research should target low levels of actual motor competence while emphasizing the cognitive aspects of movement to ensure greater accuracy between actual and perceived motor competence.

Twelve-week sensorimotor training as a factor influencing movement patterns of canoe slalom athletes, assessed by the Functional Movement Screen

Introduction: The aim of the study was to evaluate whether our own twelve-week Sensorimotor Exercise Programme (SEP) affected FMS results in canoe slalom athletes. The Functional Movement Screen (FMS) is a tool for detecting asymmetries and movement range limitations in order to prevent sport injuries. The screen evaluates mobility and stability in seven fundamental movement patterns.

Material and methods: The study population consisted of 16 athletes from the Canoe Slalom National Team of Poland who competed in three sports categories: kayak single, canoe single, canoe double. The athletes, 13 men and 3 women, undertook the FMS screen twice before the starting season. Between the first and the second screen the athletes undertook a twelve-week long sensorimotor training programme.

Results: The result analysis showed a statistically significant difference in FMS results. The mean FMS screen result after twelve weeks of training increased from 16.6 points to 19.6 points.

Conclusions: An adequately designed SEP can lead to an improvement in athlete movement patterns. The FMS screen allows for assessment of changes in athlete movement patterns after twelve weeks of SEP training.

Effects of dynamic neuromuscular stabilization (DNS) training on functional movements

Functional movements (FMs) dysfunction is a potential risk factor of injuries. A variety of training strategies is proposed to improve the performance of FMs. We investigated if a system of fundamental movement exercises called Dynamic Neuromuscular Stabilization (DNS) could improve FMs. Thirty-four female students were randomly assigned into two matched groups to receive DNS (the study protocol) versus physical fitness (PF) training. The groups practiced for six-weeks (three sessions of 50 min weekly). We used five FMs tests as pre and post measures of exercise effectiveness. Repeated Measures ANOVA showed a significant interaction in all five FMs tests in favour of DNS group (F_(1,32) ≥ 4.13, P ≤ .001 and ƞ² ≥ 0.29), meaning that DNS group had a higher progress rate compared to that of PF group. Based on Eta-square coefficients, the highest and lowest differences in the progression rate were observed in Y-Balance and Functional Movement Screening Tests, respectively. Our findings supported the hypothesis that fundamental movements of DNS could be used to improve FMs. However, the progression coefficient declined as FMs became more specific. Lower progression of "specific FMs" suggests that it might prove more effective to add "specific training" to "fundamental training" for them.

The Thoracic Spine in the Overhead Athlete

Overhead athletes are susceptible to many injuries, particularly in the shoulder and lumbar spine. Due to the heterogeneity of these two regional injuries, it is difficult to pinpoint the exact origin. A potential contributing factor that should be thoroughly evaluated is the thoracic spine. It can be challenging to quantify exactly how much thoracic spine mobility or lack thereof plays a role toward injury. Despite this, when examining mechanics of an overhead athlete, if neuromuscular control of the thorax is impaired, adjacent motion segments often take the brunt of the required movements. This article addresses the need to incorporate the thoracic spine when analyzing the entire kinetic chain. Clinical pearls regarding thoracic neuromuscular control and rehabilitation were explored, as well as a review of recent literature. Further investigation of thoracic spine therapeutic interventions should be considered when treating overhead athletes.

A comparison of the Functional Movement ScreenTM and the Landing Error Scoring System: A cohort study

The Functional Movement Screen (FMSTM) is a nonspecific movement pattern assessment while the Landing Error Scoring System (LESS) is a screen for movement patterns associated with lower extremity injury. The purpose of this study was to determine if the LESS and FMSTM are correlated or if they can be used as complementary assessments of preseason injury risk for anterior cruciate ligament injury.

METHODS

FMSTM and LESS were used to conduct a cohort study of 126 male National Collegiate Athletic Association Division IA football players. One hundred and eleven players met the criteria for inclusion during data review. At risk and not at risk LESS scores of players and FMSTM exercise score status were compared using Welch's t-test. Associations between FMSTM composites and LESS scores were evaluated using linear regression.

RESULTS

The average LESS score was 5.51±1.34, and the average composite FMSTM score was 11.77±2.13 (max=15). A poor FMSTM squat score (≤1 or asymmetry present) was associated with a higher LESS score (P<0.001). No other FMSTM individual exercise score was associated with an at-risk LESS score (P>0.05). Composite FMSTM score was loosely associated with the LESS score (R-squared=0.0677, P=0.006). Prior history of an ACL injury and player position were not associated with LESS score on multivariate regression (P>0.05).

CONCLUSIONS

The LESS and FMSTM are not well correlated and may serve as complementary assessments for preseason injury risk.

LEVEL OF EVIDENCE

Level III.

The Relationship Between a Jump-Landing Task and Functional Movement Screen Items : A Validation Study

Kraus, K, Schütz, E, and Doyscher, R. The relationship between a jump-landing task and functional movement screen items : a validation study. J Strength Cond Res 33(7): 1855-1863, 2019-Sports injuries and athletic performance are complex areas, which are characterized by manifold interdependencies. The landing error scoring system (LESS) is a valid screening tool to examine bilateral jump-landing mechanics, whereas the Functional Movement Screen (FMS) items are thought to operationalize flexibility and motor behavior during low-intense bodyweight patterns. The aim of the study was to explore possible interdependency of the diagnostic information of these screening tools. Fifty-three athletes (age 23.3 ± 2.1 years) were tested in a sport scientific laboratory. In detail, 31 professional soccer players (third division) and 22 collegiate athletes were studied. Linear, partial correlational, and cluster analysis were performed to examine possible trends. Generally, the sportsmen achieved a LESS score of 6.6 ± 2 and a jumping height of 37 ± 7.8 cm. Partial correlational analysis indicates that trunk control (r = 0.4; p < 0.01) is moderately related to landing mechanics, which in turn was negatively related on LESS height (r = -0.67, p < 0.01). In addition, clustering showed by trend that a higher active straight leg raise (ASLR) score is related to better landing mechanics (ASLR score 1: LESS 6.9 ± 1.8; n = 15 vs. ASLR score 3: LESS 5.6 ± 2.1; n = 10). On the task-specific level, jump-landing mechanics were directly related to jumping performance in this cohort with poor mechanics. On unspecific analysis level, kinetic chain length (ASLR) and trunk control have been identified as potential moderator variables for landing mechanics, indicating that these parameters can limit landing mechanics and ought to be optimized within the individual's context. A potential cognitive strategy shift from internal (FMS) to external focus (LESS) and different muscle recruitment patterns are potential explanations for the nonsignificant linear relationship between the FMS and LESS data.

Examining the Reliability of the Landing Error Scoring System With Raters Using the Standardized Instructions and Scoring Sheet

CONTEXT

Dynamic movement-based screens, such as the Landing Error Scoring System (LESS), are becoming more widely used in research and practical settings. Currently, 3 studies have examined the reliability of the LESS. These studies have reported good interrater and intrarater reliability. However, all 3 studies involved raters, who were founders of the LESS. Therefore, it is unclear whether the reliability reported reflects that which would be observed with practitioners without such specialized and intimate knowledge of the screen and only using the standardized set of instructions.

OBJECTIVE

To investigate the interrater and intrarater reliability of the final score and the individual scoring criteria of the LESS.

DESIGN

Reliability protocol.

SETTING

Controlled laboratory.

PARTICIPANTS

Two raters scored 30 male participants (age = 21.8 [3.9] y; height = 1.75 [0.46] m; mass = 75.5 [6.6] kg) involved in a variety of college sports.

MAIN OUTCOME MEASURE

Two raters using only the standardized scoring sheet assessed the interrater reliability of the total score and individual scoring criteria independently of each other. The principal author scored the videos again 6 weeks later for the intrarater reliability component of the study.

INTERVENTION

Participants performed a drop box landing from a 30-cm box was recorded with a video camera from the front and side views.

RESULTS

The intraclass coefficients interrater and intrarater reliability for the total scores were excellent (intraclass coefficients range = .95 and .96; SEM = 1.01 and 1.02). The individual scoring criteria of the LESS had between moderate and perfect agreement using kappa statistics (κ = .41-1.0).

CONCLUSION

The final score and individual scoring criteria of the LESS have acceptable reliability with raters using the standardized scoring sheet. Practitioners using only the standardized scoring sheet should feel confident that the LESS is a reliable tool.

Is a low Functional Movement Screen score (≤14/21) associated with injuries in sport? A systematic review and meta-analysis

Objective

To assess whether Functional Movement Screen (FMS) score is associated with subsequent injuries in healthy sportspeople.

Design

Systematic review and meta-analysis.

Data sources

The following electronic databases were searched to December 2017: Medline, PubMed, PsycINFO, SPORTDiscus, Cumulative Index of Nursing and Allied Health Literature, Scopus, Embase, and Physiotherapy Evidence Database.

Eligibility criteria for selecting studies

Eligibility criteria included (1) prospective cohort studies that examined the association between FMS score (≤14/21) and subsequent injuries, (2) a sample of healthy and active participants without restrictions in gender or age, and (3) the OR was the effect size and the main outcome.

Results

Thirteen studies met the criteria for the systematic review and 12 were included in the meta-analysis. In 5 of the 12 studies, and among female athletes in 1 study, FMS score ≤14 out of 21 points was associated with subsequent injuries. The overall OR of the selected studies in the meta-analysis was 1.86 (95% CI 1.32 to 2.61) and showed substantial heterogeneity (I²=70%).

Summary/Conclusion

Whether or not a low FMS score ≤14 out of 21 points is associated with increased risk of injury is unclear. The heterogeneity of the study populations (type of athletes, age and sport exposure) and the definition of injury used in the studies make it difficult to synthesise the evidence and draw definitive conclusions.

Trial registration number

CRD42015015579.

An Examination of the Relationship Between the Functional Movement Screen, Landing Error Scoring System, and 3D Kinematic Data During a Drop Jump Task

Everard, E, Lyons, M, and Harrison, AJ. An examination of the relationship between the functional movement screen, landing error scoring system and 3D kinematic data during a drop jump task. J Strength Cond Res XX(X): 000-000, 2019-Tests such as the Functional Movement Screen (FMS) and Landing Error Scoring System (LESS) have become an established component of preparticipation screening. Despite their practical use, there is a lack of empirical evidence examining their relationship to established assessments of movement, such as 3D kinematics of a drop jump. Fifty-two male collegiate athletes undertook the LESS, FMS, and a drop jump where 3D lower-limb kinematic variables were assessed. Spearman correlations were conducted to examine the relationship between LESS, FMS, and drop-jump 3D kinematic variables. A series of independent t-tests examined differences in hip and knee kinematic variables in acceptable and poor FMS and LESS groups as determined by established cut-off scores. Landing Error Scoring System scores had significant moderate correlations with most kinematic variables (r = 0.35-0.64; p < 0.01). Subjects with poor LESS scores displayed significantly worse lower-limb kinematics compared with their high-scoring counterparts (effect size = 1.99-2.76, large effect). There were significant moderate correlations with maximal hip and knee flexion (r = 0.46 and 0.39 respectively; p < 0.01) and small or nonsignificant correlations between all other kinematic variables and FMS scores. Hip flexion and knee valgus at maximal displacement were the only kinematic variables significantly different between FMS groups (ES = 0.70-0.72, small-to-moderate effect). The results confirm limitations in the ability of the FMS to distinguish between groups for landing biomechanics.

Association between motor competence and Functional Movement Screen scores

Background

Motor competence (MC) is generally used to describe a person’s proficiency in a variety of motor skills and is the basis for one’s performance in sports and recreational activities. Functional Movement Screen (FMS^TM) is one of the most used screening systems to provide interpretable measure of movement quality. Both FMS^TM and MC constructs share three components: locomotor, manipulative and stabilizing movements. In the present study, it was hypothesized that MC scores can explain FMS^TM variables. It was also predicted that better MC leads to better functional movement patterns in young adults.

Methods

A sample of 92 young adults (73.9% men) with a mean age of 21.2 years participated in this study. All participants were evaluated on anthropometric measurements, dual x-ray absorptiometry; FMS^TM and MC.

Results

Men showed better MC scores and fat mass composition than women. Regarding specific tests, women scored higher in the FMS^TMactive straight leg raise test, whereas men performed better in the FMS^TM trunk stability push-up (TSP) test. Manipulative tasks and construct presents’ significant and positive associations with FMS^TM composite score (r ≥ 0.303). The significant negative correlation were more related to FMS^TM TSP and MC shuttle run and FMS^TM in-line lunge and MC manipulative. The FMS^TM TSP presents significant associations with all MC constructs and tasks. Meanwhile, the FMS^TM composite score is associated with all components of MC Stability (p < 0.05). In young adults, and independent of gender, the FMS^TMexplains fundamental movements based on motor control according to the stability construct. Moreover, the FMS^TM TSP is associated with better performance in the all MC constructs and MC tasks. The FMS^TM, on its own, is linked to objective MC stability measures.

Dose-response effects of high-intensity interval neuromuscular exercise training on weight loss, performance, health and quality of life in inactive obese adults: Study rationale, design and methods of the DoIT trial

Obesity is associated with high mortality and morbidity rates and low levels of quality of life among adults globally. It is critical to examine evidence-based practices for developing lifestyle behavioral changes such as physical movement and structured exercise training. The DoIT protocol, a high-intensity interval exercise training (HIIT) program, effectively reduces body mass, alters energy balance, and improves performance of obese adults with a high adherence rate. This study aims to determine the dose-response effects of the DoIT protocol on body composition, health, performance and quality of life in sedentary obese adults. This study will recruit 88 sedentary, obese males and females (BMI 25.0–34.9; 30–50 years) who will be randomly assigned to one of four groups: (i) control (n = 22), (ii) one session/week (n = 22), (iii) two sessions/week (n = 22) or (iv) three sessions/week (n = 22). DoIT will use a supervised, circuit-type (1–3 rounds), functional/neuromotor and progressive exercise program for 12 months. DoIT incorporates 8–12 multi-planar, fundamental and complex, whole body movements and uses bodyweight and alternative exercise modes as a resistance. DoIT utilizes prescribed work-to-rest ratios which will be varied every four weeks. Each session will last less than 30 min. DoIT will be implemented for a year and its effects on body mass and body composition, physical fitness, functional capacity, bone health, leptin, adiponectin, blood lipids, glycemic control, inflammation, oxidative stress and quality of life will be assessed. The outcomes of the proposed study will provide insight on optimal exercise prescription guidelines for such HIIT-type exercise protocols for overweight or obese individuals.

A Substruction Approach to Assessing the Theoretical Validity of Measures

BACKGROUND

Validity is about the logic, meaningfulness, and evidence used to defend inferences made when interpreting results. Substruction is a heuristic or process that visually represent the hierarchical structure between theory and measures.

PURPOSE

To describe substruction as a method for assessing the toretical validity of research measures.

METHODS

Using Fawcett's Conceptual-Theoretical-Empirical Structure. an exemplar is presented of substruction from the Individual and Family Self-Management Theory to the Striving to be strong study concepts and empirical measures.

RESULTS

Substruction tables display evidence supporting theoretical validity of the instruments used in the study.

CONCLUSION

A high degree of congruence between theory and measure is critical to support the validity of the theory and to support attributions made about moderating, mediating, causal relationships, and intervention effects.

Characteristics of functional movement screening testing in elite handball players: Indicative data from the 9

OBJECTIVES

To test 9 + screening batterie's intra-rater reliability, to provide indicative data of elite handball players, and to analyze difference between age, playing positions and level of play.

DESIGN

Descriptive study.

SETTING

Icelandic elite male handball players.

PARTICIPANTS

182 elite male handball players.

MAIN OUTCOME MEASURES

Nine + screening battery.

RESULTS

Reliability test: Intra-class correlation for the total score was 0.95. The correlation of each of the test factors varied from 0.63 to 0.91. The mean total score was 22.3 ± 2.9 (95%CI 16.7-28.1), with no difference in total score comparing players age or level of play. Goalkeepers displayed a higher total score than other players (F_3,151 = 5.75, p = 0.001). Junior players had a lower score than senior players in tests measuring abdominal strength and core stability; Test 5; │²(3, 182) = 41.5, p < 0.0001, Test 6; │²(3, 182) = 55.7, p < 0.0001, Test 7; │²(3, 182) = 11.8, p < 0.005, but higher scores in tests measuring trunk and shoulder mobility Test 8; │²(3, 182) = 18.2, p < 0.0001, Test 9; │²(3, 182) = 22.2, p = 0.006.

CONCLUSIONS

The 9+ intra-rater reliability was acceptable for the total score and individual tests. Age-related differences were provided in many individual tests.

The Effect of Functional Movement Training After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

Objectives: To evaluate the effect of functional movement screen (FMS)-based functional exercise in patients after anterior cruciate ligament reconstruction (ACLR). Design: Randomized, controlled, single-blind trial. Setting: Institutional, single center. Patients: A total of 38 patients who underwent ACLR were recruited and randomly assigned to group 1 (n = 19) or group 2 (n = 19). Interventions: Both groups received 6-month routine rehabilitation immediately after surgery. From the postoperative fourth to sixth month, group 1 received FMS-based functional exercise plus routine rehabilitation and group 2 received routine rehabilitation only. The FMS-based functional exercise was individualized and customized functional corrective exercise, which was designed based on the 3-month postoperative FMS results. The frequency of rehabilitation was 1 hour per session, twice a week, for a total duration of 6 months. Main Outcome Measures: At 3 and 6 months postoperatively, patients were evaluated by FMS scoring, Lysholm Knee Score, and International Knee Documentation Committee 2000 Score. Results: After the intervention, both groups had significantly increased FMS, Lysholm Knee Score, and International Knee Documentation Committee 2000 score. Group 1 had significantly greater changes in FMS (median: 4 vs 3, P < .001), Lysholm Knee Score (median: 24 vs 16, P = .001), and International Knee Documentation Committee 2000 Score (median: 22 vs 8, P < .001) than group 2. Conclusion: The application of FMS-based functional exercise to patients after ACLR resulted in significant improvement in knee function and movements. The authors suggested integrating FMS evaluation and FMS-based training into routine post-ACLR rehabilitation programs.

Do Irish Adolescents Have Adequate Functional Movement Skill and Confidence?

Recent research has shown that post-primary Irish youth are insufficiently active and fail to reach a level of proficiency across basic fundamental movement skills. The purpose of the current research was to gather cross-sectional data on adolescent youth, differentiated by gender, specifically to inform the development of a targeted movement-oriented intervention. Data were collected on adolescents (N = 219; mean age : 14.45 ± 0.96 years), within two, mixed-gender schools. Data collection included actual and perceived movement measurements comprised of fundamental movement skills, the functional movement screen, perceived movement confidence, and perceived functional confidence. Overall, levels of actual mastery within fundamental and functional movement were low, with significant gender differences observed. Adolescent males scored higher in the overall fundamental movement skill domain (male mean score = 70.87 ± 7.05; female mean score = 65.53 ± 7.13), yet lower within the functional movement screen (male mean score = 13.58 ± 2.59), in comparison to their female counterparts (female mean score = 14.70 ± 2.16). There were high levels of perceived confidence reported within fundamental and functional movement scales. Future intervention strategies should combat the low levels of actual movement skill proficiency, while identifying the reasons for higher perceived movement confidence within adolescents.

Utility of FMS to understand injury incidence in sports: current perspectives

The Functional Movement Screen (FMS) is a popular movement screen used by rehabilitation, as well as strength and conditioning, professionals. The FMS, like other movement screens, identifies movement dysfunction in those at risk of, but not currently experiencing, signs or symptoms of a musculoskeletal injury. Seven movement patterns comprise the FMS, which was designed to screen fundamental movement requiring a balance between stability and mobility. The 7 movement patterns are summed to a composite FMS score. For an instrument to have wide applicability and acceptability, there must be high levels of reliability, validity, and accuracy. The FMS is certainly a reliable tool, and can be consistently scored within and between raters. Although the FMS has high face and content validity, the criterion validity (discriminant and convergent) is low. Additionally, the FMS does not appear to be studying a single construct, challenging the use of the summed composite FMS score. The accuracy of the FMS in screening for injury is also suspect, with low sensitivity in almost all studies, although specificity is higher. Finally, within the FMS literature, the concepts of prediction and association are conflated, combined with flawed cohort studies, leading to questions about the efficacy of the FMS to screen for injury. Future research on the use of the FMS, either the composite score or the individual movement patterns, to screen for injury or injury risk in adequately powered, well-designed studies are required to determine if the FMS is appropriate for use as a movement screen.

Dynamic Movement Assessment and Functional Movement Screening for injury prediction: a systematic review

ABSTRACT Dynamic Movement AssessmentTM (DMATM) and Functional Movement ScreeningTM (FMSTM) are tools to predict the risk of musculoskeletal injuries in individuals who practice physical activities. This systematic review aimed to evaluate the association of DMATM and FMSTM with the risk of musculoskeletal injuries, in different physical activities, categorizing by analysis. A research without language or time filters was carried out in November 2016 in MEDLINE, Google Scholar, SciELO, SCOPUS, SPORTDiscus, CINAHL and BVS databases using the keywords: “injury prediction”, “injury risk”, “sensitivity”, “specificity”, “functional movement screening”, and “dynamic movement assessment”. Prospective studies that analyzed the association between DMATM and FMSTM with the risk of musculoskeletal injuries in physical activities were included. The data extracted from the studies were: participant’s profile, sample size, injury’s classification criteria, follow-up time, and the results presented, subdivided by the type of statistical analysis. The risk of bias was performed with Newcastle-Ottawa Scale for cohort studies. No study with DMATM was found. A total of 20 FMSTM studies analyzing one or more of the following indicators were included: diagnostic accuracy (PPV, NPV and AUC), odds ratios (OR) or relative risk (RR). FMSTM showed a sensitivity=12 to 99%; specificity=38 to 97%; PPV=25 to 91%; NPV=28 to 85%; AUC=0.42 to 0.68; OR=0.53 to 54.5; and RR=0.16-5.44. The FMSTM has proven to be a predictor of musculoskeletal injuries. However, due to methodological limitations, its indiscriminate usage should be avoided.