Evaluation of the Functional Movement Screen as an Injury Prediction Tool Among Active Adult Populations: A Systematic Review and Meta-analysis
Dorrel BS, Long T, Shaffer S, Myer GD. Sport Health. Published Online First: September 27, 2015; DOI: 10.1177/1941738115607445
Take Home Message: Based on data from six studies, the Functional Movement Screen fails to predict who is at risk for injury. Unfortunately, the current research is low quality.
The Functional Movement Screen (FMS) is an assessment tool to analyze movement patterns to detect faulty performance patterns that may predispose a person to injury. However, the predictive ability of this tool to identify someone at risk for an injury has not been determined. Therefore, the authors of this systematic review critically analyzed 7 studies that examined predictive validity of FMS among active adults. The included articles consisted of 3 with a low risk of bias, 2 with a high risk of bias, and 2 with an unclear risk based on the QUADAS-2. The authors decided that the overall quality of the studies was low despite 6 of the studies being prospective in nature. The main limitation was a lack of blinding. Collectively, the authors conducted a meta-analysis with six studies. They found that the FMS had 85% specificity (ability of FMS to correctly identify adults without a future injury), 24% sensitivity (ability of FMS to correctly identify adults with a future injury), positive likelihood ratios of 1.65, and negative likelihood ratio of 0.87. The ability of FMS to accurately discriminate between those at risk and not at risk of injury was just above chance.
The authors of this study discovered that the FMS provided good specificity, relatively poor sensitivity, and poor diagnostic accuracy for injury prediction. The authors noted an inconsistency between studies in injury diagnosis/definition as well as statistical analyses. Injury definition ranged from any injury where an athlete had to seek medical attention to any injury where an athlete was removed from activity for 3 weeks or more. It is also unclear which cut point is appropriate with the FMS score because authors used various cut points. Obviously, there is a need for more research that uses standard definitions and cut points but you would hope that a screening tool would have a higher sensitivity when trying to identify individuals at risk for an injury. Clinically, it does not appear that the FMS has value as a predictive tool for injury. At least for now we should continue to focus on deploying injury prevention programs for all physically active individuals.
Questions for Discussion: Do you use any injury screening tools? What has your experience been with injury screening tools? Are there any other things you use to identify risk factors?
Written by: Nicole Cattano
Reviewed by: Jeffrey Driban