Functional Movement Screen yielded low predictive values for physically active male soldiers

The Functional Movement Screen is not recommended to screen for injury risk among physically active male soldiers as it had low predictive values and misclassification of injury risk, according to study results.

“Although low functional movement scores have been associated with higher risk of injuries among both athletes and military personnel, it is not a particularly good screening tool,” Bruce H. Jones, MD, of the Injury Prevention Program at the Army Institute of Public Health, told Orthopedics Today.

Functional Movement Screen

Jones and his colleagues had 2,476 physically active male soldiers aged 18 to 57 years complete the Functional Movement Screen and collected demographic and fitness data by survey. Medical record data for overuse injuries, traumatic injuries and any injury were collected 6 months following the assessment.

Results showed a greater risk for injuries in soldiers who scored 14 or lower using the composite score for overuse injuries, traumatic injuries and any injury compared with soldiers who scored higher than 14. According to multivariate logistic regression analysis, poor Functional Movement Screen performance was an independent risk factor for injuries when controlling for other known injury risk factors. Researchers noted low measures of predictive values for overuse injuries, traumatic injuries and any injury with a cut point of 14 or lower, and sensitivity or positive predictive values did not improve when shifting the injury risk cut point to the optimal cut points indicated by the receiver operating characteristic.

“Only 33% of those who eventually got injured were detected by the [Functional Movement Screen] FMS. So, 67% of individuals who did become injured were undetected,” Jones said. “Another important factor that has clinical implications is among those who were identified with a positive test, only 52% of them actually got injured, which meant 48% of those who were identified as positive by the test did not get injured at all, but may have had to go through remedial therapy or training if there was a follow-up.”

Importance of accuracy

Jones noted as a screening tool, the Functional Movement Screen should be able to pick up a higher percentage of patients at risk for injury so an athlete’s or soldier’s time, as well as that of an athletic trainer, physical therapist or physician, is not wasted with possible unnecessary rehabilitation.

“The other important thing with FMS and other such screening tools is if you are going to screen someone and identify them, you want to know that the remedial treatment or therapies are going to work,” he said. “As far as we know, there is not a lot of evidence the remedial training actually reduces risk of injury. It may show improvement in scores, but in terms of the association with injury, the proof is just not there.”

Jones added, “You have to recognize just having a strong positive association with risk of injury does not necessarily mean the tool has the characteristics that you would want from a screening tool. … I think early on, people were misled by the positive and significant association association with risk of injury, which is not synonymous with necessarily being a good screening tool.” – by Casey Tingle

Reference:

Bushman TT, et al. Am J Sports Med. 2016;doi:10.1177/0363546515614815.

For more information:

Bruce H. Jones, MD, can be reached at the Army Institute of Public Health, 5158 Blackhawk Rd., Aberdeen Proving Ground, MD 21010; email: chanel.s.weaver.civ@mail.mil.

Disclosure: Jones reports no relevant financial disclosures.