Functional Movement Assessment Research Articles

Reliability and Validity of Advanced Technologies: Kinotek's 3D Motion Capture System in Functional Movement Assessments

Reliability and Validity of Advanced Technologies: Kinotek's 3D Motion Capture System in Functional Movement Assessments

Automation of Functional Mobility Assessments at Home Using a Multimodal Sensor System Integrating Inertial Measurement Units and Computer Vision (IMU-Vision).

Functional movement assessments are routinely used to evaluate and track changes in mobility. The objective of this study was to evaluate a multimodal movement monitoring system developed for autonomous, home-based, functional movement assessment. Fifty frail and prefrail adults were recruited from the Brigham and Women's Hospital at Home program to evaluate the feasibility and accuracy of applying the multimodal movement monitoring system to autonomously recognize and score functional activities collected in the home. Study subjects completed sit-to-stand, standing balance (Romberg, semitandem, and tandem), and walking test activities in likeness to the Short Physical Performance Battery. Test activities were identified and scored manually and by the multimodal movement monitoring system's activity recognition and scoring algorithms, which were previously trained on lab-based biomechanical data to integrate wearable inertial measurement unit (IMU) and external red-blue-green-depth vision data. Feasibility was quantified as the proportion of completed tests that were analyzable. Accuracy was quantified as the degree of agreement between the actual and system-identified activities. In an exploratory analysis of a subset of functional activity data, the accuracy of a preliminary activity-scoring algorithm was also evaluated. Activity recognition by the IMU-vision system had good feasibility and high accuracy. Of 271 test activities collected in the home, 217 (80%) were analyzable by the activity-recognition algorithm, which overall correctly identified 206 (95%) of the analyzable activities: 100% of walking, 97% of balance, and 82% of sit-to-stand activities (χ2(2) = 19.9). In the subset of 152 tests suitable for activity scoring, automatic and manual scores showed substantial agreement (Kw = 0.76 [0.69, 0.83]). Autonomous recognition and scoring of home-based functional activities is enabled by a multimodal movement monitoring system that integrates inertial measurement unit and vision data. Further algorithm training with ecologically valid data and a kitted system that is independently usable by patients are needed before fully autonomous, functional movement assessment is realizable. Functional movement assessments that can be administered in the home without a clinician present have the potential to democratize these evaluations and improve care access.

Effects of Balance and Proprioceptive Exercises on the Balance of Ice Hockey Players and the Risk of Lower Limb Injuries

Background. Most ice hockey injuries are contact, but about 15% are non-contact musculoskeletal injuries and lower body injuries account for 30-45% of all injuries in ice hockey players. It is believed that proprioception and balance training can improve neuromuscular control, improve its ability to synchronise the muscle joint to improve dynamic stability and improve human performance, so balance and proprioception are suggested exercises as a regular part of training. The aim. To determine the effects of a 6-week balance and proprioception training exercises on balance and lower extremity injury risk in ice hockey players. Material and methods. 20 men were randomly divided into experimental and control groups. Six weeks were applied to the research group balance and proprioception exercises, twice a week for 45 minutes next to their regular training. The control group continued with regular training. Before and after the study, static balance was assessed by the flamingo test, dynamic balance and lower extremity injury risk by the modified star excursion test, and injury risk assessment using the Functional Movement Assessment. Results. In the intervention group after 6 weeks the static balance of the right and left leg improved statistically significantly (p<0,05), the dynamic balance of the right and left leg in the front, posteromedial, posterolateral directions (p<0,05), but functional movement patterns did not change statistically significantly (p>0,05). A statistically significant difference was found between the groups in the dynamic balance of the left and right leg in the front, posteromedial, and posterolateral directions (p<0,05) and the static balance of the right leg (p<0,05). The results of the intervention group were better compared to the control group. Conclusions. After the application of balance and proprioception training exercises, the static and dynamic balance of ice hockey players improved and the risk of injury in ice hockey players decreased. Recommendations. Balance and proprioception exercises should be included in hockey physical training to improve static and dynamic balance and reduce the risk of injury. When performing balance and proprioception exercises, we recommend incorporating a variety of specific movements that are similar to those performed by athletes during training and competition. In order to determine the cause of injuries and their risk, it is very important to carry out regular tests, store them and analyse them. Keywords: balance, proprioception, hockey, injury risk

The effect of a workplace wellness program on disability, function and pain in healthcare providers workers with low back pain-outcomes of 3040 academic health center employees.

(1) Identification of musculoskeletal risk factors for healthcare providers suffering low back pain (LBP) and the creation of risk profiles for those individuals and (2) analyze the impact of a workplace wellness program on healthcare providers who suffer from low back pain. A total of 3040 employees at an academic healthcare center underwent a computer-adaptive survey of health-related quality of life (HRQOL), biometric tests, and a disability and functional movement assessment as part of the workplace wellness program (WWP). Clinical interventions with a rehabilitation specialist were offered to employees identified as at risk for low back pain. Data collected were analyzed using descriptive methods and multivariable regressions to address the study objectives. Of the 3040 healthcare providers enrolled in this study, 77% identified with non-specific LBP with greater weakness, numbness, reduced flexibility, and physical activity. The major predictive risk factors for LBP were Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference score, PROMIS fatigue, previous work injury, flexibility, numbness, PROMIS social function, level of education, and BMI. Healthcare providers with LBP who completed the WWP improved in most dimensions of HRQOL and disability and functional outcomes. A high proportion of healthcare providers suffer from LBP as a result of the nature of their work. Disability and functional outcomes measurements and PROMIS results quantitatively assess healthcare providers with LBP. Organizations can develop injury mitigation programs to target employees at high risk of LBP using the risk factors we identify. Completion of the WWP was associated with improvements in disability, HRQOL and functional measures.

Novice Inter-Rater Reliability on the Selective Functional Movement Assessment (SFMA) After a 4-Hour Training Session.

The Selective Functional Movement Assessment (SFMA) is a whole-body movement classification system that identifies non-optimal movement performance requiring further assessment. There needs to be more evidence specifying the training time required to obtain SFMA reliability for entry-level health care practitioners. The primary intent of this study was to determine SFMA inter-rater reliability between two third-year physical therapy students following an in-person three-hour training and one-hour follow-up training with a certified SFMA physical therapist. The secondary purpose was to compare rater scores of the composite criterion 50-point checklist and rater categorization using the top-tier movements in real-time assessments of healthy participants. Inter-rater reliability study. Two novice raters received training on assessing movement using the SFMA. Participants included non-pregnant healthy adults screened for general exercise, participants were excluded for history of orthopedic surgery within the prior six months. Three independent raters, including two novice and one SFMA-certified rater, individually assessed the top-tier movements in separate rooms in real-time. Participants were randomly assigned a start location, and raters were blinded to each other's criterion 50-point checklist and categorical scoring. Statistical analysis included a paired t-test, a repeated measures ANOVA, and a two-way, mixed absolute agreement ICC. Twenty-five participants (23.4 years ± 1.9; 72% female) completed the SFMA top-tier movements. Significant differences were identified with novice raters identifying fewer non-optimal movement patterns than the certified clinician. The intraclass correlation coefficient (ICC2,1) was moderate (0.60, p<0.001) for all three raters on the 50-point criterion checklist scoring. Third year physical therapy students were able to demonstrate moderate inter-rater reliability assessing healthy individuals using the 50-point criterion checklist. Variation between novice raters may reflect the amount of previous exposure assessing movement and suggests that some may require more time learning and practicing in order to identify non-optimal movement patterns that may require further assessment. 3b©The Author(s).

Predicting Subsequent Injury after Being Cleared to Return to Work from Initial Lumbar or Lower Extremity Injury.

The purpose of this study is to develop a model to predict re-injury after being cleared to return to full duty from an initial injury. This was a prediction model derivation cohort study. Military service members cleared for unrestricted full duty after sustaining a musculoskeletal injury were enrolled from three large military hospitals. Medical history, demographics, psychological profile, physical performance (Y-Balance Test™, Functional Movement Screen™, Selective Functional Movement Assessment, triple hop, closed chain ankle dorsiflexion, 2-mile run, 75% bodyweight carry time), and past injury history were assessed. Monthly text messages, medical records and limited duty databases were used to identify injuries resulting in time lost from work in the following year. Four hundred fifty participants (65 females), ages 18 to 45 yr were analyzed. Fifteen variables were included in the final model. The area under the curve was 0.74 (95% confidence interval, 0.69-0.80), indicating good performance. The calibration score of the model was 1.05 (95% confidence interval, 0.80-1.30) indicating very good performance. With an injury incidence in our cohort of 38.0%, the treat all net benefit was 0.000, and the net benefit of our predictive model was 0.251. This means 25 additional soldiers out of every 100 were correctly identified as high risk for injury compared with not using a prediction model at all. This multivariable model accurately predicted injury risk after returning for full duty and was better than not using a prediction model at all (an additional 25 of every 100 tactical athletes were correctly identified). This model provides guidance for proper decision making about when these individuals are not ready to return to full duty, with higher risk of a subsequent injury.

Outcomes of Calvarial and Soft-Tissue Reconstruction with Latissimus Dorsi-Rib Osteomyocutaneous Free Flap.

The latissimus dorsi-rib osteomyocutaneous free flap (LDRF) has been used for autologous reconstruction of large composite calvarial and scalp defects. In this study, the authors aim to present clinical and patient-reported outcomes after LDRF reconstruction. An anatomical study was conducted to evaluate the distribution of the connecting perforators between the thoracodorsal and intercostal systems. An institutional review board-approved retrospective review of 10 patients who underwent LDRF with one or two ribs for treatment of cranial defects was conducted. Patient-reported outcomes regarding quality of life, neurologic status, and functional status were evaluated using validated surveys. One-way analysis of variance and post hoc Tukey tests were used for anatomical outcomes. Preoperative and postoperative scores were compared using paired t tests. The tenth rib (4.65 ± 2.01) followed by the ninth rib (3.7 ± 1.63) had the highest number of perforators. A combination of the ninth and eleventh ribs exhibited maximal perforator number and pedicle length. All patients had stable LDRF reconstructions. Eight patients completed both preoperative and postoperative questionnaires; Median clinical follow-up was 48 months (range, 34 to 70 months). Scores trended toward improvement but did not reach statistical significance on the Karnofsky Performance Scale ( P = 0.22), the Functional Independence Measure (Motor, P = 0.52; Cognitive, P = 0.55), or the Headache Disability Index ( P = 0.38). The minimum clinically important difference was surpassed, demonstrating improvement of function for 71% of patients on the Barthel Index and 63% on the Selective Functional Movement Assessment test. The LDRF can improve cognitive and physical functional status in complex patients with prior failed reconstructions for composite scalp and skull defects. Therapeutic, IV.

D106. Outcomes of Calvarial and Soft Tissue Reconstruction with Latissimus Dorsi Rib Osteomyocutaneous Free Flap

PURPOSE: The latissimus dorsi-rib osteomyocutaneous free flap (LDRF) has been used for autologous reconstruction of large composite calvarial and scalp defects. In this study, we aim to present patient-reported and clinical outcomes for patients treated with LDRF. METHODS: An anatomical study was conducted to evaluate the distribution of the connecting perforators between the thoraco-dorsal and intercostal system. An IRB-approved retrospective review of ten patients who underwent LDRF and one or two ribs for treatment of cranial defects was conducted. Patient-reported outcomes regarding quality of life, neurological and functional status were evaluated. One-way analysis of variance (ANOVA) and post hoc Tukey’s tests were used for anatomical outcomes. Preoperative and postoperative scores were compared using paired t-tests. RESULTS: The 10th rib (4.65± 2.01) followed by 9th rib (3.7±1.63) had the highest number of perforators. A combination of the 9th and 11th ribs exhibited maximal perforator number and pedicle length. All patients had stable LDRF reconstructions. Eight patients completed both pre and postoperative questionnaires; Median clinical follow-up was 48 [34-70] months. Scores trended toward improvement but did not reach statistical significance on the Karnofsky Performance Scale (p=0.22), Functional Independence Measure (FIM; Motor p=0.52, Cognitive p=0.55), and Headache Disability Index (p=0.38). The minimum clinically important difference (MCID) was surpassed, demonstrating improvement of function for 71% of patients on the Barthel Index and 63% on the Selective Functional Movement Assessment test (SFMA). CONCLUSION: The LDRF can improve cognitive and physical functional status in complex patients with prior failed reconstructions for composite scalp and skull defects.

Selective Functional Movement Assessment (SFMA) Reliability and Proposal of Its Use in Sports.

The Selective Functional Movement Assessment (SFMA) is a functional movement assessment method to observe movement restrictions in individuals with known musculoskeletal disorders, although it has also been used to evaluate healthy athletes of different sports. The present paper aimed to evaluate the applicability of SFMA in a clinical setting and to verify whether a student can correctly perform it. An introductory and explanatory email was sent to the subjects, containing the instructions needed to produce a video with SFMA evaluation movements. SFMA methodology was then used to analyze the received videos. The results between interobserver and intraobserver agreement were compared to the literature, considered the gold standard methods. Twenty-eight subjects (17.71 ± 1.96 years aged) were rated. The functional non-painful scenario (FN) has been assigned more frequently by all raters. The student's intra-rater reliability proved to be moderate (Kappa coefficient 0.49). Results for inter-rater reliability showed that the reliability degree between the senior physiotherapist and student before and after their educational path is good (Kappa coefficient 0.60 and 0.62, respectively). The results of this study showed SFMA intra-rater reliability to be moderate, while inter-rater reliability can be considered good. These characteristics make it a valuable tool for sport's needs, even when used by students.

PROBLEMAS E ESTRATÉGIAS PARA A PREVENÇÃO DE LESÕES DO TORNOZELO NO FUTEBOL

ABSTRACT Introduction: The most significant reasons for the frequent ankle injuries in soccer players are the great rivalry and the multiple efforts required by the sport. Objective: Explore the actual scenario of sports injuries in the ankle joint in soccer players, raising adequate prevention strategies. Methods: 22 professional soccer players were randomly divided into experimental and control groups. A controlled experiment lastingsix6 weeks was developed. The experimental group added complementary ankle training in the daily training, while the control group had no changes, according to the usual training plan. Rear (PL) and frontal (AT) balance indexes, functional movement assessment (FMS,) and ankle injury cause (CAI) were collected, analyzed, and compared before and after the intervention. Results: After training, the experimental group’s PL score increased from 106.81±5.33 to 117.69±6.44; AT score increased from 61.94±6.17 to 70.36±5.37; CAI score increased from 22.33±3.58 to 25.38±3.18. Total FMS test score increased from 15.36±1.38 to 18.84±1.99, with trunk flexions standing out (from 2.10±0.43 to 2.57±0.37). On the other hand, the changes in the control group were not statistically significant. Conclusion: The presented complementary ankle training effectively prevented injuries in soccer players and can be applied to reduce sports complications in players in training. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Validity and feasibility of remote measurement systems for functional movement and posture assessments in people with axial spondylarthritis.

This study aimed to estimate the criterion validity of functional movement and posture measurement using remote technology systems in people with and without Axial spondylarthritis (axSpA). Validity and agreement of the remote-technology measurement of functional movement and posture were tested cross-sectionally and compared to a standard clinical measurement by a physiotherapist. The feasibility of remote implementation was tested in a home environment. There were two cohorts of participants: people with axSpA and people without longstanding back pain. In addition, a cost-consequence analysis was performed. Sixty-two participants (31 with axSPA, 53% female, age = 45(SD14), BMI = 26.6(SD4.6) completed the study. In the axSpA group, cervical rotation, lumbar flexion, lumbar side flexion, shoulder flexion, hip abduction, tragus-to-wall and thoracic kyphosis showed a significant moderate to strong correlation; in the non-back pain group, the same measures showed significant correlation ranging from weak to strong. Although not valid for clinical use in its current form, the remote technologies demonstrated moderate to strong correlation and agreement in most functional and postural tests measured in people with AxSA. Testing the CV-aided system in a home environment suggests it is a safe and feasible method. Yet, validity testing in this environment still needs to be performed.

TRIAGEM FUNCIONAL DO MOVIMENTO NO TESTE DE APTIDÃO FÍSICA EM ADOLESCENTES COLEGIAIS

ABSTRACT Introduction: Functional Movement Screening is a qualitative triage of human movement based on a classification and scoring system which includes seven tests to evaluate basic movement patterns where muscle limitations or asymmetries are identified. Its scale has 21 points, with 14 being the limit of normality. Adolescence is critical to improving athletic ability, and the validity of applying this screening technique to discover potential injuries is questioned. Objective: To verify the validity of functional movement screening on the early detection and correction of dysfunctional movements to implement physical fitness in adolescents. Methods: Functional movement screening was performed on students from a school. According to the screening requirements, functional movement examinations were performed before (October 2017) and after (December 2017) intervention with individual demand functional training. Results: After functional training, students’ physical fitness increased from 13.00±0.44 to 14.77±0.28 points (p&lt;0.05). Conclusion: The results of functional movement assessment can analyze the physical problems of adolescents in universities and colleges. Targeted functional training can effectively improve the physical fitness of adolescents in schools and colleges. Evidence Level II; Therapeutic Studies – Investigating the results.

Functional Movement Assessments To Evaluate Dynamic Postural Control In Persons With Chronic Ankle Instability

More than 700,000 people sprain their ankles daily, with chronic ankle instability (CAI) occurring in as many as 70% of these individuals. Few research studies have examined the relationship between Functional Movement Screen™ (FMS) and dynamic postural stability in persons with CAI. PURPOSE: To identify differences among measures of dynamic postural stability, FMS-lower extremity scores, and active range of motion (AROM) in those with and without CAI. A secondary purpose was to identify risk factors that predispose individuals to CAI. METHODS: 23 volunteers (12 women, 11 men; age, 22.3 + 2.1 yrs) completed all aspects of this study. We subsequently created 7 triads using a 2:1 ratio, triple matching participants without a history of ankle injury on sex, age, and BMI category with those with CAI. Outcome measures included FMS™ composite score (FMS-CS); FMS™ lower extremity subscore (FMS-LE); Athlete Single Leg Stability Test (ASLST); dorsiflexion, plantar flexion, inversion, and eversion AROM; and Foot and Ankle Disability Index-Sport (FADI-S) score. We used 1-way and 2-way ANOVAs to identify differences between the CASE and CONTROL groups, and the involved and uninvolved limbs of the participants with CAI (p < 0.05). We used binary logistic regression to calculate odds ratios to determine the extent postulated risk factors increased the risk of developing CAI. RESULTS: ANOVA results indicated the CASE group scored significantly lower on the FADI-S (26.7 + 4.1 points) than the CONTROL group (31.0 + 2.7 points) [p = 0.006]. The CASE group had significantly worse (higher) ASLST scores (1.58 + 0.35 degrees) compared to CONTROLS (1.05 + 0.35 degrees) [p = 0.045]. Binary logistic regression analyses indicated that for every 1-point decrease in FADI-S score, the odds of being diagnosed with CAI increased by a factor of 1.5 (p = 0.042). Conversely, for every 1-point increase in Overall Stability Index scores from the ASLST, the odds of being diagnosed with CAI increased by a factor of 0.03 (p = 0.045). CONCLUSIONS: The ASLST scores and FADI-S were significantly worse in the injured ankle of the CASE group compared to their contralateral normal ankle, and the matched ankles from the CONTROL group. A lower FADI-S and a higher ASLST score can be utilized to classify individuals as being more at risk for developing CAI.

Classification of Parkinson’s disease and its stages using machine learning

As digital health technology becomes more pervasive, machine learning (ML) provides a robust way to analyze and interpret the myriad of collected features. The purpose of this preliminary work was to use ML classification to assess the benefits and relevance of neurocognitive features both tablet-based assessments and self-reported metrics, as they relate to Parkinson’s Disease (PD) and its stages [Hoehn and Yahr (H&Y) Stages 1–5]. Further, this work aims to compare perceived versus sensor-based neurocognitive abilities. In this study, 75 participants (n = 50 PD; n = 25 control) completed 14 tablet-based neurocognitive functional tests (e.g., motor, memory, speech, executive, and multifunction), functional movement assessments (e.g., Berg Balance Scale), and standardized health questionnaires (e.g., PDQ-39). Decision tree classification of sensor-based features allowed for the discrimination of PD from healthy controls with an accuracy of 92.6%, and early and advanced stages of PD with an accuracy of 73.7%; compared to the current gold standard tools [e.g., standardized health questionnaires (78.3% accuracy) and functional movement assessments (70% accuracy)]. Significant features were also identified using decision tree classification. Device magnitude of acceleration was significant in 12 of 14 tests (85.7%), regardless of test type. For classification between diagnosed and control populations, 17 motor (e.g., device magnitude of acceleration), 9 accuracy (e.g., number of correct/incorrect interactions), and 8 timing features (e.g., time to between interactions) were significant. For classification between early (H&Y Stages 1 and 2) and advanced (H&Y Stages 3, 4, and 5) stages of PD, 7 motor, 12 accuracy, and 14 timing features were significant. Finally, this work depicts that perceived functionality of individuals with PD differed from sensor-based functionalities. In early-stage PD was shown to be 21.6% lower than sensor-based scores with notable perceived deficits in memory and executive function. However, individuals in advanced stages had elevated perceptions (1.57x) for executive and behavioral functions compared to early-stage populations. Machine learning in digital health systems allows for a more comprehensive understanding of neurodegenerative diseases and their stages and may also depict new features that influence the ways digital health technology should be configured.

Effect of an on-site physical therapy on pain, posture, function and composition, and work-related health status in workers in Korea.

The incidence of work-related musculoskeletal disease is increasing despite automated manufacturing processes. To examine the effect of a customized on-site exercise program on pain, posture, body function, body composition, and work-related health status of workers at an auto-parts factory. Fifty-six participants were randomly divided into one of two groups: experimental (EG), which received a customized exercise program that included manual and exercise therapy from physiotherapy at the workplace; and control (CG), which received customized exercise sheets for a self-directed program at home. The program was performed 3 times per week for 12 weeks. Assessments were performed according to numerical rating scale (NRS), Exbody, Selective Functional Movement Assessment (SFMA), InBody, Short-Form-12 version 2 (SF-12v2), and Work Ability Index (WAI), which were evaluated before and after the program. The EG exhibited significant within-group changes in NRS, Exbody, SFMA, SF-12v2, and WAI; the CG exhibited significant within-group changes only in NRS and SFMA (p < 0.05). There were significant between-group differences in NRS, Exbody, SFMA, and WAI (p < 0.05). An on-site program including manual and exercise therapy directed by a physiotherapist among workers at an auto-parts manufacturer was effective in improving pain levels, posture, body function, and work-related health status.

Screening on Collect Students: Postural Risk Factors of Spinal Musculoskeletal Problems and Scoliosis

Background: Overuse of electronic products and decrease in levels of physical activity may lead to an increased incidence of spinal health problems in college students. This study aims to 1) identify the incidence of spinal health problems in college students, 2) to explore the key postural factors in development of spinal musculoskeletal dysfunction and scoliosis, and 3) to clarify new strategies for early identification and prevention of scoliosis. Methods: A cross-sectional screening by static posture assessment, selective functional movement assessment (SFMA) and Adam’s Forward Bend Test,was conducted to 306 college students from October to December 2019. Descriptive analysis, Spearman correlation analysis and binomial logistic regression analysis were performed on the collected data. Results: Static postural assessment was completed among 306 college students, 53% of students’ external auditory meatus and acromioclavicular joint were not in the same gravitational line, 45% had forward-head posture, 42% had uneven shoulders. When performing SFMA, we found spinal musculoskeletal dysfunctions, including abnormalities of multi-segment spine flexion (32%), cervical rotation to right (18%), cervical rotation to left (16%), etc. In Adam’s Forward Bend Test, 10.78% had a positive result, which suggested structural or functional scoliosis. Correlation analysis showed that the top three postural factors related to spinal musculoskeletal dysfunctions included uneven shoulders, forward-head, position of thorax and pelvis rotated. And top three postural factors related to scoliosis were spinous processes line deviating from midline, winged scapula and head rotation off midline. Logistic regression analysis displayed that there are two high risk factors for scoliosis, including external auditory meatus and acromioclavicular joint not in the same vertical line (OR = 6.314), and deviation of spinous processes line (OR = 12.743). Conclusions: Poor posture, spinal musculoskeletal dysfunction and scoliosis affect a significant proportion of college students. While their spinal musculoskeletal dysfunction and scoliosis are closely related to poor posture.

Current and Future Trends in Strength and Conditioning for Female Athletes

Participation by female athletes in competitive sport has increased dramatically since the inception of Title IX, although female athletes are represented significantly less than their male counterparts in strength and conditioning (S&C) literature. This is apparent when examining current identified trends in the field, such as implementation of blood flow restriction (BFR) training, functional assessments to predict injuries, or the ever-increasing use of technology in sports. The aim of this review is to examine three prevalent trends in contemporary S&C literature as they relate to female athletes in order to expose areas lacking in research. We conducted journal and database searches to progressively deepen our examination of available research, starting first with broad emerging themes within S&C, followed next by an inquiry into literature concerning S&C practices in females, ending finally with a review of emerging topics concerning female athletes. To this end, 534 articles were reviewed from PubMed, Academic Search Complete, Google Scholar, CINAHL, MEDLINE, and Web of Science. Results demonstrate the utility of implementing BFR, functional movement assessments, and various technologies among this population to expand representation of female athletes in S&C literature, improve athletic capabilities and performance, and decrease potential for injury over time.

Recovery, Rehabilitation, and Return to Full Duty in a Military Population After a Recent Injury: Differences Between Lower-Extremity and Spine Injuries

PurposeTo compare readiness to return to duty in soldiers following recent lower-extremity versus spine injury. The secondary purposes were to provide normative data for the Selective Functional Movement Assessment Top Tier movements (SFMA-TTM) and assess the association between SFMA-TTM scores and future injury occurrence, comparing injuries of the lower extremity and thoracic/lumbar spine.MethodsSFMA was rated by trained assessors on 480 U.S. Army soldiers within 2 weeks of being cleared to return to duty after recent lower-extremity or lumbar/thoracic injury. Participants were followed for 1 year to determine incidence of subsequent time-loss injury.ResultsOnly 74.4% of soldiers felt 100% mission capable when returning to full duty (73.6% lower-extremity; 76.5% spine). After 1 year, 37.9% had sustained a time-loss injury, and pain with movement at baseline was associated with higher odds for having an injury (odd ratio 1.53 95% confidence interval 1.04-2.24; P = .032). Almost all (99.8%) had at least 1 dysfunctional pattern, and 44.1% had pain with at least 1 movement (40.3% with previous lower-extremity injury; 54.6% with previous spine injury) after being cleared to return to duty.ConclusionsOne in four patients did not feel 100% mission capable upon being cleared for full duty. Pain with movement was also associated with future injury. Regardless of recent injury type, 99.8% of soldiers returned to full unrestricted duty with at least 1dysfunctional movement pattern and 44.1% had pain with at least 1 of the SFMA-TTM movements.Level of EvidenceLevel III, retrospective comparative cohort study.

Identification of Movement Dysfunction in Cervicogenic Headaches

Background Upper cervical region mainly plays an important role in cervicogenic headaches. The measurement of cervical rotation supposedly a part of cervical spine can be used as a clinical methodology for differential diagnosis. In this study Selective Functional Movement Assessment SFMA scale has been used to identify impaired mobility in cervical spine. Since there are limited studies to identify movement disorders associated with cervical headache further research to determine dysfunctional movement patterns in cervical segment may provide an accurate approach towards diagnosis and treatment of cervicogenic headache.Method Two hundred forty healthy subjects aged 18 to 66 years were assigned to the study after meeting the inclusion and exclusion criteria. Each subject was assessed using seven top-tier SFMA tests to identify any type of pre-existing movement disorder.Result The interpretation of this study is more or less likely in both genders male and female. Subjects with cervicogenic headache showed significant movement dysfunction in cervical flexion CF with dysfunctional painful movement DPM Upper extremity pattern-2 UEP-2 with functionally painful movement FPM and Cervical Extension CE with dysfunctional non-painful movement.Conclusion The study shows that most of cervicogenic headaches are susceptible to musculoskeletal and movement dysfunctions with growing age. The operative use of the SFMA as a system or tool used to qualitatively evaluate movement at initial examination and to direct subsequent intervention choices would be helpful.

The Intra- and Inter-rater Reliability of an Arm Care Screening Tool in High School Baseball Coaches.

BackgroundPreseason movement screening can identify modifiable risk factors, deterioration of function, and potential for injury in baseball players. Limited resources and time intensive testing procedures prevent high school coaches from accurately performing frequent movement screens on their players.PurposeTo establish the intra-rater and inter-rater reliability of a novel arm care screening tool based on the concepts of the Functional Movement Screen (FMS™) and Selective Functional Movement Assessment (SFMA™) in high school coaches.Study DesignMethodological intra- and inter-rater reliability studyMethodsThirty-one male high school baseball players (15.9 years ± 1.06) were independently scored on the Arm Care Screen (ACS) by three examiners (two coaches, one physical therapist) in real-time and again seven days later by reviewing video recordings of each players’ initial screening performance. Results from each examiner were compared within and between raters using Cohen’s kappa and percent absolute agreement.ResultsSubstantial to excellent intra-rater and inter-rater reliability were established among all raters for each component of the ACS. The mean Cohen’s kappa coefficient for intra-rater reliability was 0.76 (95% confidence interval, 0.54-0.95) and percent absolute agreement ranged from 0.82-0.94 among all raters. Inter-rater reliability demonstrated a mean Cohen’s kappa value of 0.89 (95% confidence interval, 0.77-0.99) while percent absolute agreement between raters ranged from 0.81-1.00. Intra- and inter-rater reliability did not differ between raters with various movement screening experience (p>0.05).ConclusionsHigh school baseball coaches with limited experience screening movement can reliably score all three components of the ACS in less than three minutes with minimal training.Level of EvidenceLevel 3, Reliability study