The Functional Movement Screen and Injury Risk: Association and Predictive Value in Active Men
Bushman TT, Grier TL, Canham-Chervak M, Anderson MK, North WJ, & Jones BH. Am J Sports Med. Published Online First: February 1, 2016; DOI: 10.1177/0363546515614815
Take Home Message: The Functional Movement Screen poorly predicts injury within 6 months after an assessment. A score less than 14 is a risk factor for injury, but more research is needed.
Injury screening helps to assess and identify injury risk in physically active people. There are many options for injury screening; however, the Functional Movement Screen (FMS) is becoming more widely used. Three prior studies have indicated that the FMS could identify individuals at risk for injury but other studies have questioned its validity. The authors of this study wanted to determine the association between FMS and injury risk, the effectiveness of the FMS for injury prediction, and an optimal cut point for FMS scores in young physically active male soldiers. A total of 2476 male soldiers (18 to 57 years of age) completed the FMS and injury incidence was collected over the following 6 months. The authors gathered injury data from the Defense Medical Surveillance System, including overuse injuries, traumatic injuries, or any diagnosed injury. Mean FMS scores for soldiers with overuse injuries (15), traumatic injuries (15.6), and any injuries (15.2) were lower than mean FMS scores in uninjured soldiers (16.3). Participants who had FMS scores < 14 were more likely to suffer an injury than those with scores between 19 to 21 as well as more likely than those who scored greater than 14. Utilizing an FMS score of 14, sensitivity ranged from 28-37%, specificity 77-82%, positive predictive value 19-52%, and negative predictive value of 68-85% for overuse, traumatic, or any injuries (link to definitions of these terms).
While a FMS score is related to future injuries it may not be a good clinical tool for identifying male soldiers at risk for an injury. The FMS had relatively low ability to correctly identify soldiers who become injured, which limits its clinical applicability. Additionally, it takes a moderate amount of time to learn how to administer/interpret as well as to actually conduct. Interestingly, scoring lower than 14 seems to be an injury risk factor. For example, a soldier with a lower score is approximately twice as likely to have an injury as a solider with a higher score. However, the authors found various cut points ranging from 14 for any injury to 16 for traumatic injuries. Lower FMS scores may be a little more accurate in predicting overuse injuries in comparison to traumatic injuries. It may be interesting to further classify injuries as contact or non-contact instead of traumatic, to determine FMS applicability within non-contact injuries. Ultimately, the FMS score may relate to future injuries but it does not seem to be great at predicting injury risk over the course of 6 months among male soldiers. The FMS consists of 7 tests, and it may be that a couple of the components of the test could be modified or focused on for certain pathologies. Further investigation may be needed to correctly identify at-risk individuals, determine a cut-point score, as well as target interventions for various reasons. In the meantime, clinicians should be cautious about relying on the FMS to identify male soldiers at risk for an injury.
Questions for Discussion: Are you currently using the FMS clinically? What types of interventions do you utilize after a poor FMS score? Do you have any experience with other injury screening tools?
Written by: Nicole Cattano
Reviewed by: Jeffrey Driban
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