Coach Alicia Fong

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Very interesting “FMS” article

I like to share the following article about FMS aka Functional Movement Screen.  It talks about the pros, cons and its studies. What are your thoughts?

Anyone who is interested in training, and browsing on the Internet now and then probably have hardly missed Functional Movement Screen, also commonly abbreviated as FMS, which currently is almost ridiculously hyped in the U.S.. Just as everything else from the U.S. so it’s about that you should pay the money to take a course and then get a license / a diploma that you then can show to their customers. What course would cost to go to Sweden I do not know, but education is in two days where you learn the tests and then a series of exercises that are designed to improve performance in the tests.

If you would like to be tested by someone who is licensed in the Functional Movement Screen and it will cost you around 600 SEK, ie the class with a PT-hours. The question then is whether it is worth the money? Is there any research showing that a training course in 2 days can make a random PT clever enough to determine whether it is the increased risk of injury?

I personally am not very fond of the Functional Movement Screen. I think it makes more sense than much else out there on the market but as usual when something strikes it big in the U.S., it’s an awful lot of talk and surprisingly little evidence behind. A very distinctive characters for almost all of those Americans who encountered a lot of searching on the web about exercise is that they all like to talk very much about studies and research, but almost never sees them actually refer to any studies or research.

Anyway. In this post I will look at the Functional Movement Screen and the research that does exist to try to determine whether the test adds nothing new and if it can help you as a coach or athlete to become better at what you do.

Brief Functional Movement Screen

Functional Movement Screen arrived in 1998 and is created by Gray Cook, Lee Burton and Kyle Kiesel. The first studies on the Functional Movement Screen is also performed by these gentlemen, if you will notice later, the results seem to differ a lot from when one of them is involved in the studies and when it is more independent people.

For those of you not familiar with the Functional Movement Screen and so does the seven different tests that can result in 0-3 points. 3 points are given if the movement is perfect. If the motion is carried out but with some form of compensation will be 2 points. If the test subject is unable to perform the test, he or she was 1 point and if the pain during movement, it will be 0 points. Maximum score for a test is thus 21 points and the minimum is 0 points, which occurs about every movement hurts.

One thing that is very good with the Functional Movement Screen purely scientific terms is that it is very standardized. In theory, this standardization mean that many people in different parts of the world can take the same tests and do basically the same assessment. So if you go to two different persons performing the various tests on you, you should get the same results in the two tests. If it really becomes so are studied in three different studies ( 1 , 2 , 3 ).

 

 

 

 

 

 

Functional Movement Screen is well standardized

In the first study, where Kyle Kiesel was co-author, saw a very good interrater reliability (IBR) ( 1 ). This long complicated words, how well the assessment is between two different people. Results from the study showed a rather good ability for different analysts to find the same results and the authors concluded that the Functional Movement Screen has high IBR and can be safely used by trained persons. Total overlapped approximately 70-92% of assessments for the various tests. In this study, also shared the team of an experienced team of two who both had at least 10 years of experience in Functional Movement Screen, a more inexperienced team with two newly trained assessors. Interestingly, more regular assessments of the newly trained assessors.

In the second study conducted on military performance was approximately the same result, the ( two ). This study also looked at how consistent assessment is from a single assessor. So if you have the same score by the same assessor if you do the test twice in succession. In this case the results were very good.

In the third study, the results were not as positive ( 3 ). The researchers in this study, the worse figures for IBR and they therefore recommend that the assessor should always perform the tests.

Despite the more adverse outcome in the third study is still a strength standardization of Functional Movement Screen. If we consider that it is still to some extent is a manual test that can be performed “on the ground” so the results are in good reliability. There is also a strength when you then must conduct studies on the test to see if it can predict future damage, reduce the number of injuries or even assessing how well a particular person will perform in a sport. For the fact that we know that different people consider pretty much the same means that studies can be performed in a standardized way of several different research groups.

The first studies

Knowing that a test is performed more or less the same way by different people is always interesting, but something that is far more interesting for an athlete is on the tests add nothing new. If they can contribute to either predict or damage by reducing the risk of injury. There are currently very few studies on the Functional Movement Screen, but mixed results and I will now briefly go through them all.

American footballer

The first of these studies appeared in 2007 and in that looked at American football player ( 4 ). This study was conducted by Kyle Kiesel, founder of the Functional Movement Screen, and is retrospective. With retrospective meant looking at the outcome afterwards to try to find connections. This is a form of study design that gives uncertain results should always be interpreted with caution. Study participants were 46 players in a professional club in the United States. Physical coach of this team had under study a total of 11 years of experience in Functional Movement Screen and the upcoming season, he had performed these tests on the players on the team. Using these results and injury statistics for the past season, the scientists then look at whether they could see no statistical correlation between test results and injury risk.

The mean football players of the test were found to be 16.9 points. For those who spent an injury, the mean 14.3 and for those who received no injury, the mean rather than 17.4. This difference in mean was significant. Apart from this simple comparison was made also a calculation to try to come up with a test value in the best possible way could make out the people who were in greater risk of injury while not unnecessarily included many who were not at increased risk of injury. If one were to set the threshold at 20 points so it would be guaranteed to get with virtually all of which harm themselves, but offers almost all of which do not harm themselves. The boundary is thus totally useless.

The value that was reached after the calculations was 14 points. Of those who scored below 14 points in the study were over 90% damage. Of those who had come to around 50% damage. This represents a specificity of 0.9 and a sensitivity of 0.5. They gave then some other ways of looking at this value which indicates an odds ratio of 11.7 which means that people under 14 points has an 11-fold higher risk of injury to a person with more than 14 points.

Can Functional Movement Screen predict damage in play in the NFL?

There are some very big questions of this study. In addition to being retrospective as I have said, I wonder immediately why you only included one season in the study? If the physical coach has worked with the Functional Movement Screen for 11 years should he is reasonably have data for several seasons. Perhaps it is the physical coach just got the job, we do not know. To me this feels like a big warning flag, especially when one of the authors of the study self-developed tests and has sold them commercially for almost 10 years before the study. Other problems are that you get to know very little about the individual values ​​of the test persons. The reason for this separation is to protect the players’ identity. Nor shall we know the name of the club we’ve tested. Or to put it another way, there is no way to verify this information.

In all cases, this study underpinning the value of 14 which now is established in the performing Functional Movement Screens.

For athletes before a marathon

This study is unfortunately only published as an abstract ( 5 ). In this study, we performed tests of the 60 runners who signed up for a marathon. After this, the participants each week before the race to fill out a form online where they could indicate whether they had any damage. The results of this study is far from impressive. A total of 12 pieces that had an injury of which only one participant had an overall score in 14th

After this daunting performance as tested is moving at the limit of 14 points to see if any other border could work better. The best value that was reached was then 17, which gave a specificity of 42% and a sensitivity of 57%. Still very bad and it can in principle be likened to a coin flip.

In women’s sports

Another study looked at 38 women’s sports that are either trained soccer, volleyball or basketball ( 7 ). In this study it was found that participants with a score over 14 points had 3.85 times as likely to go on an injury compared to those with 15 points and more. The sensitivity of this study was 0.58 which means that the test could find 58% of those who spent an injury. The specificity was 0.74, which means that 26% who did not went on a damage still had a profit during the 14th

All injuries except one in this study was the lower extremity and when we excluded the debt test in the Functional Movement Screen was the correlation between test results and injury risk clearly evident.

With firefighters in a year

This study involved 433 firefighters who face a new year underwent a Functional Movement Screen and then after a major intervention where the goal was to increase both bålstyrka and flexibility ( 6 ). There was no control group, but instead looked at injury statistics from the year before the intervention.

Nor in this study saw no connection between scores in tests and risk of injury. There was a small correlation between test results and previous injury in which those who were hurt had a slightly lower score. The real difference in score was only 0.24 points between previously injured and ‘never’ wounded so the practical usefulness here is basically none.

Youth Basketball player in a season

This study included 112 youth basketball players in which roughly half were girls and half boys aged 14-18 years ( 8 ). The results of this study was that 24% of those receiving the 14 points went to an injury, but 22% of those under 14 points was an injury. In other words, there was no difference in injury risk depending on the results that the girls and boys received the Functional Movement Screen test. The use of any value other than 14 as a border nor did it any significant results.

In the military

By far the best study published just one week ago and was performed on an aspiring military officers ( 9 ). The total includes 874 pieces of people which may be seen as a very impressive figure in terms of training studies. About half of them went through a workout that lasted 68 days and the other half an exercise period of 38 days. Before the training period all participants underwent a Functional Movement Screen, and a standard physical tests, which consisted of chins, sit-ups and well as a fitness test at 3 miles, that is almost 5 km.

The results showed that with a test result in 14 points had an injury that was 1.5 times greater than that which had more than 14 points. Overall, 45% of those who had a test result in 14 points of damage compared with 30% of those who had more points. The sensitivity of the test was 0.45 and specificity was 78%. This is not really impressive results, but we look only at these numbers, however, seems pretty Functional Movement Screen and still be able to fulfill a purpose in these contexts. However, there are two more things to do that in any case I am in really look into its benefits.

The first thing that is most telling is that when the researchers plotted the test results from damage to a graph that saw them to the risk of injury seemed to increase again among the participants who received more than 17 points on the test. The “plot up” means to put out items for each participant in a graph and then try to calculate any correlation. You’ve probably seen a graph at some point with a slanted line through the whole lot and points here and there. It is called a scatter plot.

The results of the study of military officers. Persons who scored below 14 points was the increased risk of injury but also those who received 18 points and more were in increased risk of injury.

This is quite surprising results. The person who was best on the tests proved to be more injury risk than their counterparts who were only decent on tests.

The other thing that speaks against Functional Movement Screen has something good for at least the military is that the physical tests they did at the beginning predicted which individuals were in the risk of injury as good as the Functional Movement Screen. Not only fystestet ability to predict who was at risk of injury was the same, its sensitivity was higher than for Functional Movement Screen. To put it in a very simple and obvious way. Less fit individuals are at increased risk for going on an injury when they begin to train more intensively.

Functional Movement Screen and performance

The relationship between test results of the Functional Movement Screen and performance is still not clear. There is a degree at Master’s level where the author looked at whether there was any link between performance on the test and the results of the various fitness tests like the vertical jump, sprint, throw the medicine ball and a “witty incitement” test ( 10 ). This study showed a very weak link between performance and test results. Another study conducted as part of a PhD. also showed that the disappointing results and in this also looked at differences between right and left sides to see if the Functional Movement Screen would predict that ( 11 ). Another study conducted by a graduate student in search of her PhD looked at the relationship between test results at a Functional Movement Screen and performance in 23 brandmänsanspiranter and found no significant relationship ( 12 ). The same study also did not do any correlation between test results and injury risk.

The study of military officers that I have mentioned here above was seen even where a relationship between performance on fystestet and results in the Functional Movement Screen, but even that was somewhat weak. The correlation was weak this explains why we saw a more straightforward relationship between injury risk and performance at fystestet compared with injury and scored in the Functional Movement Screen, which has said both the under 15 points and over 17 points had increased risk of injury.

Another study also conducted as part of a doctoral dissertation looked at whether you could see some form of systematic error in the Functional Movement Screen ( 13 ). Unfortunately I have not managed to get hold of this study in full text, but the abstract can be read out to more people seem to be more difficult to perform tests than shorter people. This suggests anyway that taller people are likely to be “designated” to be at risk of injury more often than shorter people, despite the risk of injury does not really differ slightly.

Summary

This post is hardly a celebration of the Functional Movement Screen. When it comes to predict the risk of injury or performance, it appears to be an awful lot to be desired. As I see it is really not worth the money to go to a place like this test unless you’re the type who likes to make movements that it is not possible, then it is probably Functional Movement Screen, a funny thing. It should be mentioned that there are good things to Functional Movement Screen. What I like most is the exercises you learn to increase his mobility again.

If you are however looking to reduce the risk of injury, I think it is far better to just look at what you need to take on and then try to increase their strength, balance and mobility so you can handle the movement. There is also in a lot of knee injuries that studies that have demonstrated several testable factors, if they are not working properly, leading to an increased risk of ACL injuries ( 11 ). If you want to reduce the risk of athletes do you probably will want to first of all abide by these factors.

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July 21, 2011 Posted by | Uncategorized | , , , , , , , , , , , , | Leave a comment