Does changing the Functional Movement Screen composite score threshold influence injury risk estimation in junior Australian football players?

This study aimed to identify whether a revised lower Functional Movement Screen (FMS) composite score threshold would be associated with a greater injury risk for junior athletes than the common threshold of≤14. This prospective cohort study included tracking of 809 elite junior male Australian football players for injuries that resulted in a missed game. All athletes completed pre-season FMS testing and a 12-month self-reported retrospective injury questionnaire. Analyses examined the relationship between composite score thresholds of≤14, ≤13, and≤12 and the risk of injury. The relationship between prospective injury and the common composite threshold score of ≤ 14 was dependent on the presence of a recent injury history (relative risk [RR] = 1.45, p = 0.004) in comparison to no recent injury history (RR = 0.98, p = 0.887). Scoring≤12 in the presence of a recent injury history had the greatest diagnostic accuracy but only a trivial increase in injury risk (RR = 1.59, p = 0.001, sensitivity = 0.35, specificity = 0.80, negative and positive likelihood ratios = 0.81 and 1.75). Whilst some small statistical relationships existed between prospective injury and the FMS composite score thresholds, all three thresholds were not associated with a clinically meaningful relationship with prospective injury and were no more effective than retrospective injury for determining athletes at risk of injury.

Functional Movement Screen Pain Location and Impact on Scoring Have Limited Value for Injury Risk Estimation in Junior Australian Football Players.

OBJECTIVE: To describe the location and severity of pain during Functional Movement Screen (FMS) testing in junior Australian football players and to investigate its effect on FMS composite score and injury risk. DESIGN: Prospective cohort study. METHODS: Junior male Australian football players (n = 439) completed preseason FMS testing. Pain location and severity (on a 0-to-10 numeric pain-rating scale [NPRS]) were assessed for painful subtests. The FMS composite score was calculated using 3 scoring approaches: "traditional," a score of zero on painful subtests; "moderate," a score of zero on painful subtests if an NPRS pain severity was greater than 4; and "raw," did not adjust painful FMS subtest scores. Players were monitored throughout the competitive season and considered injured when 1 or more matches were missed due to injury. RESULTS: One hundred seventy players reported pain during FMS testing. The pain-scoring approach affected mean composite score values (raw, 14.9; moderate, 14.5; traditional, 13.6; P<.001). Sixty-eight percent of pain was mildly severe (NPRS of 4 or less). Back pain (50%) was more common than upper-limb (24%) or lower-limb (26%) pain (P<.001). Upper-limb pain was associated with a small increase in injury risk (hazard ratio = 1.59, P = .023). No other FMS pain location influenced injury risk, nor did pain severity (P>.280). The FMS composite score was not associated with injury risk, regardless of pain-scoring approach (P≥.500). CONCLUSION: Pain was common during FMS testing in junior Australian football players and had a notable effect on the FMS composite score, but minimal effect on subsequent injury risk. J Orthop Sports Phys Ther 2020;50(2):75-82. Epub 17 Sep 2019. doi:10.2519/jospt.2020.9168.

High prevalence of dysfunctional, asymmetrical, and painful movement in elite junior Australian Football players assessed using the Functional Movement Screen.

OBJECTIVES: The purpose of this study was to describe the prevalence of dysfunctional, asymmetrical, and painful movement in junior Australian Football players using the Functional Movement Screen (FMS). DESIGN: Cross-sectional study. METHODS: Elite junior male Australian Football players (n=301) aged 15-18 years completed pre-season FMS testing. The FMS consists of 7 sub-tests: deep squat, hurdle step, in-line lunge, shoulder mobility, active straight leg raise, trunk stability push-up (TSPU) and rotary stability. The shoulder mobility, TSPU, and rotary stability tests were combined with an accompanying clearing test to assess pain. Each sub-test was scored on an ordinal scale from 0 to 3 and summed to give a composite score out of 21. Composite scores ≤14 were operationally defined as indicating dysfunctional movement. Players scoring differently on left and right sides were considered asymmetrical. Players reported whether they missed any games due to injury in the preceding 22 game season. RESULTS: Sixty percent of players (n=182) had composite scores ≤14, 65% of players (n=196) had at least one asymmetrical sub-test, and 38% of players (n=113) had at least one painful sub-test. Forty-two percent of players (n=126) missed at least one game in the previous season due to injury. Previous injury did not influence composite score (p=0.951) or asymmetry (p=0.629). Players reporting an injury during the previous season were more likely to experience pain during FMS testing (odds ratio 1.97, 95% confidence interval 1.23-3.18; p=0.005). CONCLUSIONS: Junior Australian Football players demonstrate a high prevalence of dysfunctional, asymmetrical, and painful movement during FMS testing.

Asymmetry during preseason Functional Movement Screen testing is associated with injury during a junior Australian football season.

OBJECTIVES: The Functional Movement Screen (FMS) is a popular screening tool, however, the postulated relationship between prospective injury and FMS scoring remains sparsely explored in adolescent athletes. The aim of the study was to examine the association between pre-season FMS scores and injuries sustained during one regular season competition in elite adolescent Australian football players. DESIGN: Prospective cohort study. METHODS: 237 elite junior Australian football players completed FMS testing during the late pre-season phase and had their weekly playing status monitored during the regular season. The definition of an injury was 'a trauma which caused a player to miss a competitive match'. RESULTS: The median composite FMS score was 14 (mean=13.5±2.3). An apriori analysis revealed that the presence of ≥1 asymmetrical sub-test was associated with a moderate increase in the risk of injury (hazard ratio=2.2 [1.0-4.8]; relative risk=1.9; p=0.047; sensitivity=78.4%; specificity=41.0%). Notably, post-hoc analysis identified that the presence of ≥2 asymmetrical sub-tests was associated with an even greater increase in risk of prospective injury (hazard ratio=3.7 [1.6-8.6]; relative risk=2.8; p=0.003; sensitivity=66.7%; specificity=78.0%). Achieving a composite score of ≤14 did not substantially increase the risk of prospective injury (hazard ratio=1.1 [0.5-2.1]; p=0.834). CONCLUSIONS: Junior Australian football players demonstrating asymmetrical movement during pre-season FMS testing were more likely to sustain an injury during the regular season than players without asymmetry. Findings suggest that the commonly reported composite FMS threshold score of ≤14 was not associated with injury in elite junior AF players.