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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Bushman, T., Grier, T., Canham-Chervak, M., Anderson, M., North, W., & Jones, B. (2015). The Functional Movement Screen and Injury Risk: Association and Predictive Value in Active Men The American Journal of Sports Medicine, 44 (2), 297-304 DOI: 10.1177/0363546515614815