Gender may have an influence on the relationship between Functional Movement Screen scores and gait parameters in elite junior athletes - A pilot study

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.

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.

Association between pain and gait instability in patients with lumbar disc herniation

Objective

To determine whether pain is associated with gait instability in patients with lumbar disc herniation (LDH).

Methods

This retrospective cross-sectional study used data from electronic medical records. Among patients with lumbar back pain caused by LDH between January 2017 and July 2019, patients that underwent gait analysis were included. LDH was diagnosed using magnetic resonance imaging. An OptoGait photoelectric cell system was used for gait evaluation. Instability was measured using a gait symmetry index. Multivariate linear regression analysis was performed to determine the association between lumbar pain and gait instability.

Results

A total of 29 patients (12 females [41.4%] and 17 males [58.6%]; mean ± SD age, 40.6 ± 12.0 years) with LDH were enrolled in the study. With each 1-point increase in lumbar pain on the numeric rating scale, the symmetry index of the stance phase (0.33; 95% confidence interval [CI] 0.04, 0.62), swing phase (0.78; 95% CI 0.14, 1.43) and single support (0.79; 95% CI 0.15, 1.43) increased.

Conclusions

Gait instability in patients with LDH may occur due to an increase in pain.

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.

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.