The field of sports has experienced tremendous growth and development. This has attracted sportsmen and women from different sports, including football, athletics, basketball, and rugby. With an aim to remain healthy, most people are also engaged in intensive physical exercises. One of the main challenges is being able to protect the body against injuries during and after physical exercises. The injuries can be costly, not only to the individuals but also to the teams they play for. Maintaining high levels of performance, strength, stability, and symmetry is vital. It ensures that one can endure intensive and strenuous physical exercises and remain fit even after participating in any particular sport.
One major challenge in achieving strength and stability in the physical exercises is the limited information about the proven and tested system that should precede the physical exercises, with a view to assessing and preventing injuries. One of such tools is the functional movement screen (FMS). It is one of the tools that will quickly assess the fundamental movements before one can begin engaging in strenuous physical exercises. The goal of FMS is to assess and predict any injuries. Those found to be at risk can take necessary corrective measures to improve their functional movements before they can begin exercises. As a result, individuals are able to protect themselves from injuries. The FMS™ consists of seven tests, each scored between zero and three points with three representing the best possible score. The composite score, or total screen score, ranges from 0 to 21 points. The seven tests include the deep squat, hurdle step, in-line lunge, shoulder mobility, active straight‐leg raise, trunk stability pushup, and rotary stability tests.
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While FMS is imperative in assessing injuries, its reliability has been put into question. To determine the validity and reliability of FMS as a tool for assessment and prediction of injuries, the study will focus on analysis the previous related studies. The findings will be vital in making informed decisions about future physical exercises. Additionally, the study will also establish the information gap in the previous studies, and propose what needs to be done in future studies.
Key Words: Functional Movement Screen (FMS), Interrater reliability, FMS intertester and intratester
Statement of the Problem
The reliability of functional movement screen as a tool for assessing and predicting injuries has continued to elicit mixed reactions from different experts. The study seeks to put the issue into perspective by focusing on previous studies. The main aim will be to determine whether FMS is a reliable tool in the assessment of injuries. The reliability of the tool will be judged by consisted results from related studies. Additionally, the study seeks to focus on the question of interrater reliability, which is also vital in determining if results from MFS score differ when tests are conducted by experienced and less-experienced (novice) raters.
Data Sources
The data sources were peer-reviewed articles obtained from the internet searches. The articles were obtained by the use of specific terminologies and phrases, such as Functional Movement Screen, interrater reliability, and the FMS as a predictor of injuries. While the search engine provided numerous articles, only the peer reviewed and relevant materials were picked. The articles were divided into those seeking to establish if FMS is a reliable tool for assessing injuries and evaluating the interrater reliability. Any materials that were not relevant for the study were ignored.
Annotated Bibliography
Bardenett, S., Micca, J., DeNoyelles, J., Miller, D., Jenk, D., & Gary, S. (2015). Functional Movement Screen Normative Values and Validity in High School Athletes: Can The Fms™ Be Used As A Predictor of Injury? International Journal of Sports and Physical Therapy 10(3); 2015 JunPMC4458917
Bardenett, Micca, DeNoyelles, Miller, Jenk, & Gary (2015) aimed at establishing the reliability of the FMS tool in predicting injuries among the high school athletes. The study involved a sample of 167 high school athletes, who were monitored using the FMS tool. The monitoring of the FMS score was imperative in determining which among the participants were at a higher risk of being injured after the test. The study indicated that while FMS is an important evaluation tool and predictor of future injuries, it is not effective in overall prediction. In other works, the FMS tool is only reliable in predicting injuries in some fundamental functional movements, but less in others. This study is more specific and seems to disagree with previous studies that provide a general conclusion about MFS. The conclusion was that future studies should concentrate on using a larger data in order to determine the effectiveness and reliability of the MFS in predicting injuries. Nevertheless, Bardenett et al. (2015) does not dispute the fact that the MFS scores can be used to predict the likelihood of an athlete getting injured. Therefore, the study will play a significant role in enhancing the success of the current study.
Chorba, R., Chorba, D., Bouillon, L., Overmyer, C., & Landis, J. (2010). Use of a functional movement screening tool to determine injury risk in female collegiate athletes. North American Journal of Sports Physical Therapy, 5: 47-54.
Chorba, Chorba, Bouillon, Overmyer & Landis (2010) conducted a study with an aim of establishing the reliability and the validity of the Functional Movement Screen (FMS) in predicting injuries. The study sample was a group of female collegiate athletes in the United States. A quantitative research design was used in the study. The researcher was concerned about the relationship between the composite FMS score and the possibility of getting an injury during the physical exercises. The study results indicated that athletes who had an FMS composite score of less than 14 had the highest likelihood of being injured. The results were similar to that of Kiesel, Pilsky, P., & Butler (2011) and Kiesel, Plisky, & Voight (2007), which also indicated that a low FMS Score predisposed athletes to injuries. The study indicated that 69% of females with scores of less than 14 had the risk of developing injuries. The conclusion was that FMS is a reliable and valid test for predicting injuries. The findings are relevant to the current study, which also seeks to find the reliability and validity of the FMS in predicting injuries in athletes.
Cook G, Burton L, Hoogenboom B. (2006). Pre-participation screening: the use of fundamental movements as an assessment of function - American Journal of Sports and Physical Therapy. 2006 Aug; 1(3):132-9
Cook, Burton & Hoogenboom (2006) were the main proponents of FMS as a reliable test for injuries. Cook et al. (2006) asserted that assessing the fundamental movements prior to the intensive physical exercises played an imperative role in minimizing future injuries. The goal of FMS was to evaluate the extent of the painful and dysfunctional movements with an aim of addressing the challenge prior to the actual physical exercises. The findings by Cook et al. (2006) indicated that FMS was a reliable measure of predicting and reducing injuries among the athletes. Different studies, such as Kiesel et al. (2007) and Chorba et al. (2010) also found results similar to that of Cook et al. (2006). Almost all the studies on the reliability of MFS give similar result. This indicates the reliability and validity of the MFS. The information provided by Cook et al. (2006) is relevant and useful in conducting the current study.
Kiesel, K., Plisky, J., & Voight, M. (2007). Can serious injury in professional football be predicted by a preseason functional movement screen? North American Journal of Sports Physical Therapy, 2: 147-158
Kiesel, Plisky, & Voight (2007) were some of the first researchers who sought to establish the lowest FMS composite score, below which the athletes will be predisposed to injuries. The populations of the study were football players from the United States. The researchers were also interested in determining the reliability of the FMS as a predictor of injuries. The study had football athletes with different scores, from about 10 to 20. The results was that the lower the score, the higher the risk of developing injuries during the physical exercises. In the study, the researcher found that any score below 14 put the football players in danger of developing injuries. The later studies by Kiesel, Pilsky, P., & Butler (2007) and Chorba, Chorba, Bouillon, Overmyer & Landis (2010) also yielded similar results. The consistency in the findings is a demonstration of the reliability and validity of the FMS as predictor of injuries in people involved in physical activities. The study also provides important information that is relevant to the current study.
Kiesel, K., Pilsky, P., & Butler, R. (2011). Functional movement test scores improve following a standardized off-season intervention program in professional football players. Scandinavian Journal of Science in Sports, 21: 287-292.
Kiesel, Pilsky, & Butler, R. (2011) conducted a study with a view to determine the correlation between the preseason intervention program and the post-FMS scores. The sample was made up of 62 football players. The preseason exercises consisted of the strength and conditioning program. This included stretching and individual corrective exercises. The program took seven weeks, and the participants practiced for four days in week. The post-test FMS score was obtained. The results indicated an increase in FMS score after the preseason training. This is an indication that less intensive exercises that increase the muscle strength can assist in reducing injuries during the intensive exercises. The results also show that the FMS scores can be used to predict injuries in athletes, making this study more reliable and relevant to the current research.
Minick, K., Kiesel, K., Burton, L., Taylor, A., Plisky, P., & Butler, R. (2010). Interrater reliability of the functional movement screen. Journal of Strength and Conditioning Research, 24 (2): 479-486.
Minick, Kiesel, Burton, Taylor, Plisky, & Butler (2010) conducted a study with a view to establish the interrater reliability of the FSM. The study consisted of two novices and two experts in the administration of FMS tests. Both the experts and novices used the standardized procedures as stipulated in the FMS tests. After the raters completed testing the fundamental movements, such as deep squat, pushups, and active straight leg raise, the results were compared. The study results indicated a very insignificant difference between the experts and the novice raters. The conclusion was that FMS tests were easier to administer, provided that one had FMS standardized introductory training course. The conclusion indicates that anyone can administer the FMS test provided he/she is trained. This result from the experts and the novice raters provides evidence that FMS is a reliable measure and predictor of injuries in athletes.
Onate, J., Dewey, T., Kollock, R., Thomas, K., Van Lunen, B., DeMaio, M., & Ringleb, S. (2012). Real-time intersession and interrater reliability of the functional movement screen. Journal of Strength and Conditioning Research, 26 (2): 408-415.
Onate, Dewey, Kollock, Thomas, Van Lunen, DeMaio, & Ringleb (2012) were interested on establishing the relevance of FMS certification in enhancing the interrater reliability. The study sought to examine some of the previous studies that had pointed out that the interrater reliability increases with the raters experience and FMS certification. In their study, Onate et al. (2012) found that the FMS certification did not have any significance influence on the interrater reliability scores. The results were similar to that of Minick et al. (2010) which had indicated that one needed some basic information on FMS standardized procedures. Onate et al. (2012) posited that even the less experienced raters would be able to yield reliable information. The results show a consistent in the findings, which proves that FMS is a reliable test for potential injuries in athletes. The findings will also help in providing useful information in the current study.
Schneiders, A., Davidsson, A., Horman, E., & Sullivan, J. (2011). Functional Movement Screen normative values in a young, active population. The international Journal of Sports Physical Therapy, 6 (2): 76-82.
Schneiders, Davidsson, Horman, & Sullivan (2011) carried out a study with a view to establish the interrater reliability and validity. While this study was similar to that by Minick et al. (2011), there was a difference in the procedure used to obtain the results. Instead of using the experts and novice raters, Schneiders et al. (2011) used filmed subjects from whom they had previously obtained results. The results indicated that the composite score for both evaluators was 0.971. This according to the study indicated a high interrater reliability. The study shows that the FMS test is more reliable and valid, therefore can be used to accurately predict injuries in people performing physical exercises. The study results are similar to that of Minick et al. (2011), which further demonstrates the consistency in the findings. This study is more useful in the current study which also seeks to establish the interrater reliability and validity.
Teyhen, D. Shaffer, W., Lorenson, D., Halfpap, J., Donofry, F., Walker, J. (2012). The Functional Movement Screen: A Reliability Study journal of orthopaedic & sports physical therapy 2012, volume 42, number 6
The aim of the study was to establish the interrater reliability involving the experienced and less experienced raters. Like in the previous studies, such as Schneiders (2011) and Minick et al. (2011), the interrater reliability was high regardless of whether the MSF evaluation was done by a novice or an experienced individual. The study concluded that the MFS is a reliable measure and predictor for future injuries among the athletes.
Clinical Implication
In summary, the MFS is an important tool that can be used to make assess and predict injuries among the athletes or anyone engaged in physical exercises. The information from the literature review can play an imperative role in the clinical setting. The results assist in decision-making process, especially concerning the best approach to physical exercises. The medical practitioners and experts giving advice on the best way of doing physical exercises will benefit most from the study. One of the main implications may be a change of physical exercises policy from the traditional to a more scientific approach.
Another implication of the study is the application of the MFS tool for assessing athletes and other individual prior to participating in any physical exercises. The literature review concluded that FMS is reliable in both assessment and prediction of the future injuries. This means that the medical practitioners can become more effective in advising their clients, as well as writing accurate reports. It is expected that the medical experts and other experts in the sports field will be able to minimize the injuries.
Conclusion
The FMS is an important tool in assessing and predicting injuries among people engaging in physical exercises. Various studies conducted by different researchers have found MSF to be a reliable tool in predicting injuries. The high interrater reliability increases the effectiveness of MSF in accurately assessing injuries. The tool can be used in the sporting field and clinical setting to minimize injuries. However, there is a need for more studies in order to address some fundamental issues, including the injuries that can be accurately be assessed and predicted.
Future Research
The findings provide important information that act as a basis for future studies. The implication is that the reinvention of the wheel is avoided. The future researchers will rely on the current findings, where they will only seek to replicate such studies. Future studies should seek to address weaknesses associated with the current studies. One of the researchers in the literature review had indicated that FMS cannot give an overall assessment of all the potential injuries. This statement seems to disagree with what most of the studies had found. Therefore, it will be imperative that the future studies address such information gaps. Additionally, there is a need to use larger samples from different cultures and conduct longitudinal studies. These efforts will assist in increasing the validity and reliability of the studies on the effectiveness of FMS in assessing and predicting injuries.
References
Bardenett, S., Micca, J., DeNoyelles, J., Miller, D., Jenk, D., & Gary, S. (2015). Functional Movement Screen Normative Values and Validity in High School Athletes: Can The Fms™ Be Used As A Predictor of Injury? International Journal of Sports and Physical Therapy 10(3); 2015 JunPMC4458917
Chorba, R., Chorba, D., Bouillon, L., Overmyer, C., & Landis, J. (2010). Use of a functional movement screening tool to determine injury risk in female collegiate athletes. North American Journal of Sports Physical Therapy, 5: 47-54.
Cook G, Burton L, Hoogenboom B. Pre-participation screening: the use of fundamental movements as an assessment of function - American Journey of Sports and Physical Therapy. 2006 Aug; 1(3):132-9
Kiesel, K., Pilsky, P., & Butler, R. (2011). Functional movement test scores improve following a standardized off-season intervention program in professional football players. Scandinavian Journal of Science in Sports, 21: 287-292.
Kiesel, K., Plisky, J., & Voight, M. (2007). Can serious injury in professional football be predicted by a preseason functional movement screen ? North American Journal of Sports Physical Therapy, 2: 147-158
Minick, K., Kiesel, K., Burton, L., Taylor, A., Plisky, P., & Butler, R. (2010). Interrater reliability of the functional movement screen. Journal of Strength and Conditioning Research, 24 (2): 479-486.
Onate, J., Dewey, T., Kollock, R., Thomas, K., Van Lunen, B., DeMaio, M., & Ringleb, S. (2012). Real-time intersession and interrater reliability of the functional movement screen. Journal of Strength and Conditioning Research, 26 (2): 408-415.
Schneiders, A., Davidsson, A., Horman, E., & Sullivan, J. (2011). Functional Movement Screen normative values in a young, active population. The international Journal of Sports Physical Therapy, 6 (2): 76-82.
Teyhen, D. et al. (The Functional Movement Screen: A Reliability Study. Journal of orthopaedic & sports physical therapy 2012, volume 42, number 6
