Predicting Musculoskeletal Injury in National Collegiate Athletic Association Division II Athletes From Asymmetries and Individual-Test Versus Composite Functional Movement Screen Scores

Abstract

Context: Functional Movement Screen (FMS) scores of ≤14 have been used to predict injury in athletic populations. Movement asymmetries and poor-quality movement patterns in other functional tests have been shown to predict musculoskeletal injury (MSI). Therefore, movement asymmetry or poor-quality movement patterns on the FMS may have more utility in predicting MSI than the composite score.

Objective: To determine if an asymmetry or score of 1 on an individual FMS test would predict MSI in collegiate athletes.

Design: Cohort study.

Setting: National Collegiate Athletic Association Division II university athletic program.

Patients or other participants: A total of 84 Division II rowers, volleyball players, and soccer players (men: n = 20, age = 20.4 ± 1.3 years, height = 1.77 ± 0.04 m, mass = 73.5 ± 4.8 kg; women: n = 64, age = 19.1 ± 1.2 years, height = 1.69 ± 0.09 m, mass = 64.8 ± 9.4 kg).

Main outcome measure(s): The FMS was administered during preseason preparticipation examinations. Injury-incidence data were tracked for an academic year by each team's certified athletic trainer via computer software. An MSI was defined as physical damage to the body secondary to athletic activity or an event for which the athlete sought medical care, and resulted in modified training or required protective splitting or taping. Composite FMS scores were categorized as low (≤14) or high (>14). Pearson χ(2) analyses were used to determine if MSI could be predicted by the composite FMS score or an asymmetry or score of 1 on an individual FMS test (P < .05).

Results: Athletes with FMS scores of ≤14 were not more likely to sustain an injury than those with higher scores (relative risk = 0.68, 95% confidence interval = 0.39, 1.19; P = .15). However, athletes with an asymmetry or individual score of 1 were 2.73 times more likely to sustain an injury than those without (relative risk = 2.73, 95% confidence interval = 1.36, 5.4; P = .001).

Conclusions: Asymmetry or a low FMS individual test score was a better predictor of MSI than the composite FMS score.

Keywords: movement patterns; risk factors; sport injury.

Figure.

Receiver operating characteristic curve for summed score and injuries. The straight line denotes the 50/50 reference line, which is approximated by the receiver operating characteristic curve plotted on sensitivity (true-positive rate) over 1 − specificity (false-positive rate) for each score total of the Functional Movement Screen (range, 0–21).