Evidence Based Application of the Functional Movement Screen: Part 3 - FITNESS PAIN FREE

Evidence Based Application of the Functional Movement Screen: Part 3

NFL: Miami Dolphins at Buffalo BillsI think the articles selected in the previous segments were a pretty accurate representation of the populations studied by the FMS for injury prevention.  If you missed the previous articles, I’d recommend going back and reading them before moving onto this segment:

Now that we can identify at risk populations the next question becomes, can we utilize a specific corrective exercise routine to improve FMS scores?  Here’s the research:

FUNCTIONAL MOVEMENT TEST SCORES IMPROVE FOLLOWING A STANDARDIZED OFF-SEASON INTERVENTION PROGRAM IN PROFESSIONAL FOOTBALL PLAYERS (7)

  • n = 62 professional american football players
  • 7 week program
  • Program contained specific mobility and stability exercises
  • 41 players initially had asymmetry, down to 31 by the end of 7 weeks.
  • The best predictor of poor FMS improvements over the course of the program a was low deep squat score initially.
  • The corrective exercise program did significantly improve FMS score

USING THE FUNCTIONAL MOVEMENT SCREEN TO EVALUATE THE EFFECTIVENESS OF TRAINING (5)

  • n = 60 firefighters
  • 12 weeks of training
  • 3 separate groups
  • 1 group with instruction on how to perform exercises properly (3 x 1.5 hour session/week).  The emphasis in this group was movement quality with evidence based intervention that have been shown to prevent injury in other populations.  An example the authors used was ensuring subjects maintained proper knee position during exercises.
  • 1 group with a similar program but no instruction on movement quality.  This group had an emphasis on improving exercise performance such as aerobic capacity and max strength etc.  This group did have an instructor to ensure participants utilized safe technique.
  • 1 control group with no intervention

Results:

  • All groups showed a significant improvement in FMS score, even the control group that had no intervention.
  • There was no significant difference between either of the intervention groups post-training.  

Considerations:

  • Was improvement based on test proficiency?  Did these patients improve simply because they were exposed to the test once and now were proficient in performing the test properly?  You would assume that the intervention groups would have improved over the control group.
  • Is it necessary to add specific corrective exercises to promote injury prevention when a standard performance improving program had similar improvements in FMS scored when compared to the corrective exercise group?
  • What corrective exercises were performed?  I could not find a description of specific exercises that were used in order to improve FMS scores.
  • Were the exercises utilized consistent with exercises utilized in previous studies (The aforementioned american football study) to improve FMS?

yogaFUNCTIONAL FITNESS IMPROVEMENTS AFTER A WORKSITE-BASED YOGA INITIATIVE (4)

  • N = 108 firefighters, 77 participants completed study
  • age = 22 to 60 years old with a mean age of 40.6 years old
  • 75% of patients engaged in moderately vigorous activity 4-7 days per week during the intervention and prior to the intervention.  In other words this was a fairly “fit” population.
  • 6 week program
  • Patients engaged in a yoga program consisting of pranayama (breathing), asana (postures), and savasana (relaxation)
  • Pre-yoga FMS mean score = 13.3

Results:

  • There was a significant improvement in FMS scores after 6 weeks of yoga
  • Post-yoga FMS mean score = 16.5
  • Subjects reported less musculoskeletal pain following the program

Considerations:

  • Is yoga the best way to improve FMS scores?
  • There was no control group.  In other words there was no group to compare against the intervention group.  Remember that in the study prior the control group (that performed no exercise intervention) improved their scores significantly.  Would these participants have improved their FMS scores just by virtue of having done the test once previously as shown in previous research?
  • Is yoga a superior way to improve FMS scores when compared to the programs used in other studies?

Does a training program improve FMS scores above a control group?

  • With the evidence available we can’t say with much certainty that performing corrective exercises will improve FMS scores above a control group.  On top of that we don’t really know of the best ways to improve FMS.  Are the improvements in FMS scores due to a given training program or simply based on performing the FMS several times and knowing how to improve your test score.

And now maybe the most important question…

Does an improvement in FMS score correlate with decreased injury risk?

In other words, we know low FMS scores put you more at risk for injury.  We also know that we can improve FMS scores.  However, does an improvement in FMS score create a decreased risk of injury?  Or does an improvement in FMS score solely represent an improvement in the ability to perform the FMS test and get a higher score?

Currently there is no evidence showing that improving performance on the FMS correlates to decreased injury risk.  We don’t know if these corrective exercise programs are actually going to do what they are proposed to do.  Hopefully we see some research in this area soon.  In my mind this is the most important variable to study.  Does an intervention aimed at improving FMS scores actually decrease injury risk? or are we just spinning our wheels by trying to apply these injury prevention programs?

That’s it for now.  In the next part we’ll summarize the key points.  I also want to apply a bit of brainstorming and figure out how the FMS fits and doesn’t fit into our coaching and clinical practice.

I’ve been doing bird dogs the entire time I was writing this article,

Dan Pope

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REFERENCES:

  1. Bhk FP, Koehle MS. Normative Data for the Functional Movement Screen in middle-aged adults. J Strength Cond Res. 2012 May 3.

  2. Butler RJ, Contreras M, Burton LC, Plisky PJ, Kiesel KB. Modifiable Risk Factors Predict injuries in Firefighters during Training Academies. Work. in press.

  3. Chorba RS, Chorba DJ, Bouillon LE, Overmyer CA, Landis JA. Use of a functional movement screening tool to determine injury risk in female collegiate athletes. N Am J Sports Phys Ther. 2010 Jun;5(2):47- 54.

  4. Cowen VS. Functional fitness improvements after a worksite-based yoga initiative. J Bodyw Mov Ther. 2010;14:50-4.

  5. Frost DM, Beach TA, Callaghan JP, McGill SM. Using the Functional Movement ScreenTM to evaluate the effectiveness of training. J Strength Cond Res. 2012 Jun;26(6):1620-30.

  6. Gribble P, Brigle J, Pietrosimone B, Pfile K, Webster K. Intrarater Reliability of the Functional Movement Screen. J Strength Cond Res. 2012 May 15.

  7. Kiesel KB, Plisky PJ, Butler RJ. Functional movement test scores improve following a standardized off-season intervention program in professional football players. Scand J Sci Med Sports. 2011; 287- 292.

  8. Kiesel K, Plisky PJ, Voight M. Can serious injury in professional football be predicted by a preseason Functional Movement Screen? N Am J Sports Phys Ther. 2007; 2(3):76-81.

  9. Kiesel KB, Plisky PJ, Butler RJ. Fundamental movement limitations and asymmetries relate to injury risk in professional football players. in review.

  10. O’Connor FG, Deuster PA, Davis J, Pappas CG, Knapik JJ. Functional movement screening: predicting injuries in officer candidates. Med Sci Sports Exerc. 2011 Dec;43(12):2224-30.

  11. Onate JA, Dewey T, Kollock RO, Thomas KS, Van Lunen BL, DeMaio M, Ringleb SI. Real-time intersession and interrater reliability of the functional movement screen. J Strength Cond Res. 2012 Feb;26(2):408-15.

  12. Parchmann CJ, McBride JM. Relationship between functional movement screen and athletic performance. J Strength Cond Res. 2011 Dec;25(12):3378-8.

  13. Schneiders AG, Davidsson A, Hörman E, Sullivan SJ. Functional movement screen normative values in a young, active population. Int J Sports Phys Ther. 2011 Jun;6(2):75-82.

  14. Smith CA, Chimera NJ, Wright N, Warren M. Interrater and Intrarater Reliability of the Functional Movement Screen. J Strength Cond Res. 2012 Jun 11.

  15. Teyhen DS, Shaffer SW, Lorenson CL, Halfpap JP, Donofry DF, Walker MJ, Dugan JL, Childs JD. The Functional Movement Screen: a reliability study. J Orthop Sports Phys Ther. 2012 Jun;42(6):530-40.

 

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