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

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Dorrel, B., Long, T., Shaffer, S., & Myer, G. (2015). Evaluation of the Functional Movement Screen as an Injury Prediction Tool Among Active Adult Populations: A Systematic Review and Meta-analysis Sports Health: A Multidisciplinary Approach, 7 (6), 532-537 DOI: 10.1177/1941738115607445