Functional Movement Assessment Research Articles

Motor competence assessment in physical education – convergent validity between fundamental movement skills and functional movement assessments in adolescence

ABSTRACT Background The meaningful assessment of motor competence is well positioned for school-based curricular emphasis, through the integration of motor skills and movement patterns in both primary, and second level school physical education. Aligned with the growing interest in holistic motor competence assessment in physical education, the aim of this study was to assess the convergent validity between fundamental movement skills and functional movement assessments in a large cohort of adolescent youth. Method A sample of 583 adolescents, aged between 12 and 16 years old participated in the study. Ten fundamental movement skills were assessed in line with the behavioural components from the Test of Gross Motor Development, and the Get Skilled Get Active resource. Seven specific functional movements were also assessed, using the existing protocol from the widely established Functional Movement Screen. All data were analysed using Bayesian procedures, in which the Bayes factors provided information about the probability of a hypothesis being true. Findings The results indicate that it is very probable (BF10 > 10,000:1) that boys show higher actual motor competence levels in the object control subset of fundamental movement skills, when compared to girls. Moreover, a positive association between the total scores of the Functional Movement Screen and the locomotion subset of fundamental movement skills was found to be very probable (BF10 = 7.737). Discussion This study provides evidence of convergent validity between functional movement and fundamental movement skill assessments in adolescence. This study presents an evidence-informed rationale for physical education pedagogues to move beyond traditional perceptions of movement as being exclusively pertaining to physical skills, to a more holistic concept of motor competence comprising of both movement skills and movement patterns. Conclusion The current study broadens the assessment perspectives of motor competence within physical education, by specifically heightening physical education teachers’ awareness towards the possible complementarity of both locomotion and movement patterns in the psychomotor domain of adolescent learning in physical education.

Predicting Upper Quadrant Musculoskeletal Injuries in the Military: A Cohort Study.

This study aimed to identify characteristics and movement-based tests that predict upper quadrant musculoskeletal injury (UQI) in military personnel over a 12-month follow-up. A prospective observational cohort study of military members (n = 494; 91.9% male) was conducted. Baseline predictors associated with UQI were gathered through surveys and movement-based tests. Survey data included demographic information, injury history, and biosocial factors. Movement-based tests include the following: Y Balance Tests (YBT), Functional Movement Screen, Selective Functional Movement Assessment lumbar multisegmental mobility, modified-modified Schober, side bridge, ankle mobility, modified Sorensen, and passive lumbar extension. Self-reported UQI was collected through monthly online surveys, and 87% completed the follow-up. Univariate associations were determined between potential predictors and UQI. A forward, stepwise logistic regression model was used to identify the best combination of predictors for UQI. Twenty-seven had UQI. Univariate associations existed with three demographic (smoking, >1 previous UQI, baseline upper quadrant function ≤90%), three pain-related (Selective Functional Movement Assessment rotation, side bridge, hurdle step), and six movement-based variables (YBT upper quarter (UQ) superolateral worst score ≤57.75 cm, YBT-UQ composite worst score ≤81.1%, failed shoulder clearance, Sorenson <72.14 s, in-line lunge total score <15, and in-line lunge asymmetry >1). Smoking, baseline upper quadrant function ≤90%, and YBT-UQ composite score ≤81.1% predicted UQI in the logistic regression while controlling for age and sex. Presenting two or more predictors resulted in good specificity (85.6%; odds ratio, 4.8; 95% confidence interval, 2.2-10.8), and at least one predictor resulted in 81.5% sensitivity (odds ratio, 3.2; 95% confidence interval, 1.2-8.7). A modifiable movement-based test (YBT-UQ), perceived upper limb function, and smoking predicted UQI. A specific (two or more) and sensitive (at least one predictor) model could identify persons at higher risk.

Single- Versus Dual-Task Functional Movement Paradigms: A Biomechanical Analysis.

Laboratory-based movement assessments are commonly performed without cognitive stimuli (ie,single-task) despite the simultaneous cognitive processing and movement (ie,dual task) demands required during sport. Cognitive loading may critically alter human movement and be an important consideration for truly assessing functional movement and understanding injury risk in the laboratory, but limited investigations exist. To comprehensively examine and compare kinematics and kinetics between single- and dual-task functional movement among healthy participants while controlling for sex. Cross-sectional study. Laboratory. Patients (or Other Participants): Forty-one healthy, physically active participants (49% female; 22.5 ± 2.1y; 172.5 ± 11.9cm; 71.0 ± 13.7kg) enrolled in and completed the study. All participants completed the functional movement protocol under single- and dual-task (subtracting by 6s or 7s) conditions in a randomized order. Participants jumped forward from a 30-cm tall box and performed (1)maximum vertical jump landings and (2)dominant and (3)nondominant leg, single-leg 45° cuts after landing. The authors used mixed-model analysis of variances (α = .05) to compare peak hip, knee, and ankle joint angles (degrees) and moments (N·m/BW) in the sagittal and frontal planes, and peak vertical ground reaction force (N/BW) and vertical impulse (Ns/BW) between cognitive conditions and sex. Dual-task resulted in greater peak vertical ground reaction force compared with single-task during jump landing (mean difference = 0.06N/BW; 95% confidence interval [CI], 0.01 to 0.12; P = .025) but less force during dominant leg cutting (mean difference = -0.08N/BW; 95% CI, -0.14 to -0.02; P = .015). Less hip-flexion torque occurred during dual task than single task (mean difference = -0.09N/BW; 95% CI, -0.17 to -0.02). No other outcomes were different between single and dual task (P ≥ .053). Slight, but potentially important, kinematic and kinetic differences were observed between single- and dual-task that may have implications for functional movement assessments and injury risk research. More research examining how various cognitive and movement tasks interact to alter functional movement among pathological populations is warranted before clinical implementation.

Functional movement assessment with the Test of Infant Motor Performance.

The purpose of this article is to review research on the Test of Infant Motor Performance, a functional assessment of movement capabilities with age standards for infants from 34 weeks postmenstrual age through 17 weeks post term (corrected age). The Test of Infant Motor Performance was normed on a U.S. population-based sample to support its use as a tool for diagnosing delayed motor development in early infancy. The test is one of the preferred methods for parents of babies in special care nurseries to learn about their infant's development. The test was used in a variety of clinical trials to document effects of early therapy and can be used as a short-term outcome measure for other interventions expected to impact functional motor performance.

Investigation of Research Trends in the Selective Functional Movement Assessment (SFMA)

Investigation of Research Trends in the Selective Functional Movement Assessment (SFMA)

The Effect of Exercise Intervention Based Upon the Selective Functional Movement Assessment in an Athlete With Non-specific Low Back Pain: A Case Report and Pilot Study.

ObjectivesTo illustrate the effectiveness of the Selective Functional Movement Assessment (SFMA) as a guide to exercise intervention on chronic non-specific low back pain (CNLBP).MethodsA 23-year-old male volleyball athlete with CNLBP was evaluated using the SFMA to assess the degree of physical dysfunctions. And then two-stage exercise protocol was designed based on the results of SFMA. The athlete conducted the exercise intervention for 8 weeks, 1 h each time, three times a week. Transverse abdominal muscles and multifidus muscle thickness, the degree of low back pain, and the degree of physical dysfunctions were measured at pre-intervention, midintervention, and post-intervention.ResultsBased on the results of SFMA, the exercise protocol in the first 4-week session was designed mainly to develop the mobility of ankle, hip, and chest and the stability of lumbar, hip, and knee, in order to improve core strength and gluteal muscle strength. The second 4-week session was an advanced stage with the increase of exercise load on the basis of flexibility and stability; its main purpose was to loosen the hamstring muscles and continue strengthening the core stability and finally help the participant to establish the correct movement pattern and solve the problems of dysfunctions. After 8-week exercise intervention, all movement patterns became functional/non-painful except the deep squat pattern; the Quebec Back Pain Disability Scale score decreased from 11 to 2; visual analog scale score decreased from 4 to 2; the thicknesses of the transverse abdominis muscles (right side: 0.2 vs. 0.31 cm, left side: 0.22 vs. 0.33 cm) and multifidus muscles (right side: 2.09 vs. 2.26 cm, left side: 2.15 vs. 2.29 cm) were both increased.ConclusionIn this case, the SFMA helped to recognize problems related to mobility and stability on the hip joint, thoracic spine, and even areas far away from the lumbar spine in an athlete with CNLBP that were not seen with more conventional examination procedures. The improvements of physical function, the increase in deep core muscles thickness, and the released pain after exercise intervention all verified the effectiveness of SFMA to qualitatively analyze movement patterns at examination and to direct subsequent exercise intervention.

The Relationship Between Functional Movement, Dynamic Stability, and Athletic Performance Assessments in Baseball and Softball Athletes.

Stapleton, DT, Boergers, RJ, Rodriguez, J, Green, G, Johnson, K, Williams, P, Leelum, N, Jackson, L, and Vallorosi, J. The relationship between functional movement, dynamic stability, and athletic performance assessments in baseball and softball athletes. J Strength Cond Res 35(12S): S42-S50, 2021-Despite recent popularity, the relationship between movement quality and measures of athletic performance remains inconclusive. This investigation sought to clarify the relationships between measures of movement quality and measures of athletic performance in baseball and softball athletes. Thirty-eight National Collegiate Athletic Association Division I baseball (n = 23; age 20.00 ± 1.38 years, lower-extremity [LE] limb length 93.91 ± 4.37, upper-extremity [UE] limb length 92.37 ± 4.48) and softball (n = 15; age 19.93 ± 1.28 years, LE limb length 89.43 ± 4.67, UE limb length 84.61 ± 4.39) athletes completed the Functional Movement Screen (FMS) and the Y Balance Test for the lower and upper extremities (YBTLQ and YBTUQ, respectively). Performance assessments were proagility (PA), vertical jump (VJ), and rotational medicine ball throw to the right and left (RMTR and RMTL, respectively). No significant correlations were seen between any of the composite scores of movement quality and athletic performance in baseball athletes; shoulder mobility was weakly correlated with PA (rs = 0.442, p = 0.035). Composite FMS was negatively correlated with RMTR (rs = -0.753) in softball athletes. In addition, in softball athletes, RMTR was negatively correlated with in-line lunge (rs = -0.544, p = 0.04), trunk stability push-up (rs = -0.761, p = 0.002), anterior YBTLQ reach (r = -0.628), and posterolateral YBTLQ reach (r = -0.683); VJ was correlated with posterolateral YBTLQ reach (r = 0.531) and superolateral (SL) YBTUQ reach (r = 0.591), and PA was negatively correlated with posterolateral YBTLQ (r = -0.60) and SL YBTUQ reach (r = -0.557). The differences in correlations of movement quality and athletic performance between baseball and softball athletes suggest movement quality influences performance differently in female athletes and male athletes.

Assessing Injury Susceptibility At Marine Corps Recruit Depot, San Diego, California

Individuals enlisting at the Marine Corps Recruit Depot (MCRD) San Diego undergo a physically demanding training regimen. As such, musculoskeletal injury (MSKI) rates during training remain high and account for costly increases in attrition and delays in graduation, thereby impacting force readiness. Earlier injury detection is needed, and functional movement tests such as the functional movement screen (FMS), Y-balance test lower quarter (YBT-LQ) and ankle dorsiflexion range of motion (AD-ROM) can provide predictive value for MSKI incidence. PURPOSE: To test the hypothesis that functional movement assessments are beneficial tools for movement analysis and injury prediction. METHODS: Male MCRD recruits (N = 407; mean ± SD: age, 20 ± 2 y; height, 174.5 ± 7.3 cm; weight, 76.1 ± 11.4 kg) underwent testing of FMS, YBT-LQ, and AD-ROM prior to beginning training. Injury incidence during training and graduation outcomes were tracked by instructors. RESULTS: Twelve recruits (3%) were dropped from their class due to a lower body stress fracture or strain, delaying graduation for eight, and separating four from enlistment. A one-way analysis of variance revealed statistical group differences (MSKI vs no MSKI) for the FMS hurdle step (HS; F(1,400) = 4.314, p = 0.038) and trunk stability (TS; F(1,394) = 14.600, p = 0.000) assessments, with lower scores in the MSKI group (HS: 1.9 ± 0.5 vs 2.2 ± 0.5, TS: 1.3 ± 1.2 vs 2.4 ± 0.9). During the YBT-LQ anterior direction, the MSKI group showed a greater difference (F(1,394) = 6.536, p = 0.011) between legs (5.5 ± 4.7 cm vs 3.3 ± 2.8 cm). For both leg-ankle-foot complexes, the MSKI group demonstrated higher AD-ROM scores (right: 44.1 ± 4.7° vs 40.5 ± 6.5°; left: 43.3 ± 5.4° vs 41.6 ± 6.5°) with the right side trending toward significance (F(1, 399) = 3.692, p = 0.055). CONCLUSIONS: MCRD recruits who incurred a lower body MSKI during training had a movement analysis of inferior lower body mobility and stability, weaker core stabilization, and poorer single limb stance and imbalance. The increase in ankle flexibility observed in the MSKI group may be a risk factor for overuse Achilles tendon injuries. Results not only apply to MCRD recruits, but could also apply to recruits in other military branches, athletic communities, and first responders seeking screening tools for movement analysis and injury prediction.

Functional Movement And Subjective Well-being Assessments Of Female Track And Field Athletes: Pre- And Post-indoor Season

Track and Field (TF) is a sport that includes short- and long-distance running events and field events. Because of these diverse events, TF athletes employ a wide range of energy system demands and specific skills/techniques during performances. PURPOSE: To evaluate functional movements and subjective well-being of NCAA Division I, TF female athletes when measured before and after a 7-week indoor season to identify the benefits and detriments of competing during an indoor season (January to March). METHODS: Participants completed pre- and post-season measures: the Functional Movement Screen (FMS; Cook, 2010), the Y-Balance Test (YBT; Plisky et al., 2009), Physical Activity Enjoyment Scale-Trait (PACES-T; Kendzierski & DeCarlo, 1991), and the Satisfaction with Life Scale (SWLS; Diener et al., 1985). Athletes (N=21 completed all testing; 3 dropped out due to injury; Mean age ± S.D., 20.0 ± 1.4 yrs) were grouped by event: throwers (shot put, weight throw), distance runners, and other competitors (sprinters, hurdlers, and jumpers). For all dependent variables, 3 (Group) by 2 (Time) ANOVAs and Pearson correlations were calculated. RESULTS: Although there were no group differences, athletes’ total FMS scores improved significantly pre- (14.8 ± 2.5) to post-season (15.6 ± 2.2; p = .03). Scores from each pre- to post-season FMS test were analyzed using Wilcoxon signed-rank tests. Scores for the Deep Squat (p = .025) and Right Shoulder Mobility (p = .007) improved significantly. However, scores for the Left Hurdle Step (hip flexion and extension; p = .034) decreased over the indoor season. The YBT posteromedial reach distance was significantly greater when pushing with the left leg (p < .05) perhaps reflecting the right-leg dominance for most athletes (83% were right leg dominant). The relatively high scores on PACES-T and SWLS did not change after the season (post-season: 102.5 ± 17.4; 27.1 ± 5.1, respectively). PACES-T was related to SWLS both at pre-season (r = .50) and post-season (r = .60; p’s < .01). CONCLUSIONS: In support of the physiological and psychological benefits of college TF participation, these Division I athletes improved their total FMS scores pre- to post-season. They also reported high exercise enjoyment and satisfaction with life scores despite participating in a demanding indoor, competitive season.

Functional movement assessment by means of inertial sensor technology to discriminate between movement behaviour of healthy controls and persons with knee osteoarthritis

BackgroundApart from biomechanical alterations in movement patterns, it is known that movement limitations in persons with knee osteoarthritis (PwKOA) are related to an individual’s perception and belief regarding pain and disability. To gain more insights into the functional movement behaviour of PwKOA in a clinical setting, inertial sensor technology can be applied. This study first aims to evaluate the ability of inertial sensors to discriminate between healthy controls (HC) and PwKOA. Secondly, this study aims to determine the relationship between movement behaviour, pain-related factors and disability scores.MethodsTwelve HC and 19 PwKOA were included. Five repetitions of six functional movement tasks (walking, forward lunge, sideward lunge, ascent and descent stairs, single leg squat and sit-to-stand) were simultaneously recorded by the inertial sensor system and a camera-based motion analysis system. Statistically significant differences in angular waveforms of the trunk, pelvis and lower limb joints between HC and PwKOA were determined using one-dimensional statistical parametric mapping (SPM1D). The Knee injury and Osteoarthritis Outcome Score and TAMPA scale for Kinesiophobia were used to evaluate the relationship between discriminating joint motion, pain-related factors and disability using spearman’s correlation coefficients.ResultsPwKOA had significantly less trunk rotation, internal pelvis rotation and knee flexion ROM during walking. Additionally, the reduced knee flexion (i.e. at the end of the stance phase and swing phase) was related to increased level of perceived pain. During the sideward lunge, PwKOA had significantly less knee flexion, ankle plantarflexion and hip abduction. This decreased hip abduction (i.e. during stance) was related to higher fear of movement. Finally, PwKOA had significantly less knee flexion during the forward lunge, single leg squat and during ascent and descent stairs. No significant correlations were observed with disability.ConclusionsInertial sensors were able to discriminate between movement characteristics of PwKOA and HC. Additionally, significant relationships were found between joint motion, perceived pain and fear of movement. Since inertial sensors can be used outside the laboratory setting, these results are promising as they indicate the ability to evaluate movement deviations. Further research is required to enable measurements of small movement deviations in clinically relevant tasks.

An investigation of the ability of wearable technology to aid physiotherapists in assessing jump-landing movement compared to video recording

Functional movement assessment is essential in screening individuals for risk of injury and planning physiotherapy. The Landing error scoring system (LESS) is a valid and reliable paper-based tool used in assessing the risk of knee injury, which requires evaluating multiple joints across two planes using two video cameras, whilst participants land from a jump. The LESS involves of 17 items concern detecting any faulty movements (errors), then counting these errors as an overall score of the LESS. This is seldom used in physiotherapy clinics and sport fields because of the space required to place cameras, lack of obtaining related clinical movement outcomes objectively, and the privacy of the subjects. Wearable sensors which quantify accurate clinical movement outcomes and generate a 3D avatar recording could be a potential tool for movement analysis in physiotherapy. This study aimed to compare avatar to video recording in assessing jump-landing movements.

Efecto de un programa de intervención basado en reaprendizaje motor sobre el control postural en adultos con hemiparesia

ObjectiveTo establish the impact of an intervention programme based on motor relearning on postural control in adults with hemiparesis. Material and methodA prospective non-randomised single-masked clinical trial with control group was conducted. The sample was collected intentionally, and consisted of adults of both sexes with hemiparesis between 18 to 60 years old. Thirty-four individuals from the control group (conventional intervention) and 35 individuals from the experimental group (task-oriented motor re-learning) were analysed. Both groups were involved in physiotherapy programmes 3 times a week for 6 weeks. Tinetti Balance Scale, Sensory Organization Test, Timed Get Up and Go test, Functional Movement Assessment and quality of basic and selective movement patterns assessment were applied. Analysis of intra-sample and inter-sample differences was performed. ResultsAn average difference of 3cm was found in Functional Movement Assessment (P=.035) and 2.43 points in the quality of lower limb movement patterns (P=.011), in favour of the experimental group. The other tests did not show significant differences (P>.05). ConclusionsThis programme is more effective at improving postural anti-gravitational control and the quality of selective lower limb patterns compared to a conventional physiotherapeutic programme. However, in the intra-sample analysis, it was evidenced that it produces significant changes in stability during gait, anti-gravitational postural control, balance, sensory organisation and in the quality of hand movement patterns, lower limb, seated mobility-kneeling, biped, walking, biped and global movements.

Functional Movement Assessments Are Not Associated with Risk of Injury During Military Basic Training.

Musculoskeletal injuries (MSK-I) in the U.S. military accounted for more than four million medical encounters in 2017. The Military Entrance Processing Screen to Assess Risk of Training (MEPSTART) was created to identify MSK-I risk during the first 180 days of military service. Active duty applicants to the United States Army, Navy, Air Force, and Marine Corps between February 2013 and December 2014 who consented completed a behavioral and injury history questionnaire and the MEPSTART screen [Functional Movement Screen (FMS), Y-Balance Test (YBT), Landing Error Scoring System (LESS), and Overhead Squat assessment (OHS)] the day they shipped to basic training. Male (n = 1,433) and Female (n = 281) applicants were enrolled and MSK-I were tracked for 180 days. Binomial logistic regression and multivariate Cox proportional hazards modeling were used to assess relationships among MEPSTART screens and MSK-I independent of age, BMI, sex, Service, injury history, and smoking status. Analyses were finalized and performed in 2017. The only functional screen related to injury was the LESS score. Compared to those with good LESS scores, applicants with poor LESS scores had lower odds of MSK-I (OR = 0.54, 95% CI = 0.30-0.97, p = 0.04), and a lower instantaneous risk of MSK-I during the first 180 d (HR = 0.58, 95%CI = 0.34-0.96, p = 0.04). However, secondary receiver operator characteristic (ROC) analyses revealed poor discriminative value (AUC = 0.49, 95%CI = 0.43-0.54). Functional performance did not predict future injury risk during the first 180 days of service. Poor LESS scores were associated with lower injury risk, but ROC analyses revealed little predictive value and limited clinical usefulness. Comprehensive risk reduction strategies may be preferable for mitigating MSK-I in military training populations.

Effect of Kinesiology Taping on Upper Torso Mobility and Shoulder Pain and Disability in US Masters National Championship Swimmers: An Exploratory Study

ObjectiveThe purpose of this study was to observe changes in shoulder pain and upper-extremity functional movement after kinesiology taping (KT) in competitive swimmers. MethodsSeventy-six healthy participants competing in the US Masters Swimming 2017 National Championship participated in the study. Participants performed functional movement of shoulder flexion along with Disabilities of the Arm, Shoulder, and Hand index assessments for the shoulder before and 30 minutes after application of KT. ResultsA change in the functional movement assessment was observed after KT application when compared to the pre-KT application (33.56 ± 1.39 cm vs 35.35 ± 1.52 cm, P < .001). A statistical significant change for pain and disability scores of 2.17 was observed (12.29 ± 1.22 vs 10.12 ± 1.16, P < .01). ConclusionFor the participants in this study, KT changed shoulder pain and active functional movement scores significantly in swimmers.

Using the Selective Functional Movement Assessment for the Evaluation of Dancers' Functional Limitations and Dysfunctions: A Critically Appraised Topic.

Clinical Scenario: Dancers participate in a functionally demanding activity. Athletic participation typically requires the completion of a preparticipation examination, which involves a functional movement screen offering insight into potential injury recognition. The Selective Functional Movement Assessment (SFMA) was created to measure the status of movement-pattern-related pain and dysfunction using regionally interdependent movement to aggravate symptoms and exhibit limitations and dysfunctions. Still, a functional assessment has not been identified to recognize potential dysfunctions or limitations in this population. Clinical Question: Does the use of the SFMA improve overall evaluation of dancers by providing more information on a dancer's overall functional ability and limitations? Summary of Key Findings: The literature search discovered 12 studies and 3 books in which 4 studies were included (2 case reviews, 1 case report, and 1 original research study) based on the inclusion and exclusion criteria. Three of the studies provided clinical case studies utilizing the SFMA to improve the patient's dysfunctions, whereas 1 study examined the intrarater and interrater reliability of the SFMA. In 3 studies, participants displayed less movement dysfunction. The authors from 3 of the studies agreed the SFMA was a valuable tool for clinicians to use during evaluations, as it provided a more holistic view of the patient, discovering dysfunctional movement patterns that may better identify the source of injury. Clinical Bottom Line: Low-quality evidence, defined as poorly designed case studies, case series, and cohort studies, exist that supports improvement of overall evaluations when utilizing the SFMA. Although the studies were considered low-quality evidence, each included study displayed an effective use of the SFMA as an overall evaluation that correctly identified dysfunctional movement patterns. Strength of Recommendation: Grade C evidence exists that the SFMA contributes to the functional evaluation used in dancers.

INTRA- AND INTER-RATER RELIABILITY OF THE SELECTIVE FUNCTIONAL MOVEMENT ASSESSMENT (SFMA) IN HEALTHY PARTICIPANTS

The Selective Functional Movement Assessment (SFMA) is a popular assessment tool used to observe and detect components of dysfunctional movement patterns. The goal of the assessment is to identify impairments throughout the kinetic chain that may be contributing to movement dysfunction and/or pain. The purpose of this research was to determine the intra- and inter-rater reliability of the 10 top-tier movements of the SFMA using the categorical scoring system. It was hypothesized the intra- and inter-rater reliability of the SFMA would be acceptable with variations based on the objectivity of the scoring criteria and the experience of the rater. Cross-sectional reliability study. 25 (17 male, 8 female), physically active participants (age: 21.2 ± 1.6years, height: 177.1 ± 10.7cm, weight: 74.9 ± 13.9kg) were independently assessed in real time by three clinicians during two separate visits to the lab using a standard instructional script. Clinicians had varying levels of experience with the SFMA and the two visits occurred a minimum of 48 hours and maximum of seven days apart. Results from each clinician were compared within and between raters using the Kappa coefficient and ratings of absolute agreement. Overall, slight to substantial intra- and inter-rater reliability were observed using the categorical scoring tool, although variations existed depending on the movement pattern. Kappa coefficients for intra-rater reliability ranged from 0.21-1.00, while % absolute agreement ranged from 0.64-1.00. Inter-rater reliability for the same measures ranged from 0.11-0.89 and 0.52-0.96 respectively. Clinicians certified in the SFMA with the greatest amount of experience using the SFMA demonstrated higher intra-rater reliability. Similarly, higher inter-rater reliability was found between certified raters with the most experience. Certified SFMA raters with greater amounts of experience can demonstrate adequate intra- and inter-rater reliability using the categorical scoring method. 2, Reliability study.

Relationship of Movement Screens with Past Shoulder or Elbow Surgeries in Collegiate Baseball Players

Upper extremity injuries commonly occur in baseball players, and can often necessitate surgical interventions. Athletes recovering from previous surgeries may be at greater risk of a secondary injury due to potential residual deficits in global movement. Identifying individuals with residual movement dysfunction following surgery during a pre-participation examination may help health care professionals identify baseball players who may be at a greater risk of re-injury in their throwing arms so that appropriate interventions can be developed. The purpose of this study was to assess relationships between history of shoulder or elbow surgeries and Functional Movement Screen™ (FMS™) shoulder mobility scores or Selective Functional Movement Assessment (SFMA) upper extremity patterns in collegiate baseball players. Cohort study. One hundred seventy-six healthy, male, Division III collegiate baseball players (mean age = 19.65 ± 1.52 years) underwent preseason screening using the FMS™ shoulder mobility screen, and SFMA upper extremity patterns. Total FMS™ scores were dichotomized into "good" and "poor" groups (good = 2 or 3, poor = 0 or 1). SFMA scores were dichotomized into "good" and "poor" groups (good = functional non-painful (FN), poor = dysfunctional painful (DP), dysfunctional non-painful (DN), and functional painful (FP). Dichotomized FMS™ and SFMA scores were compared to questionnaire data regarding history of shoulder or elbow surgeries. Thirty participants (17%) reported a previous shoulder or elbow surgery in their dominant arms. Past surgeries in the shoulder or elbow were not related to FMS™ (odds ratio [OR] = 0.74, 95% confidence interval [CI] = 0.30, 1.82), p = 0.52) or SFMA performance (OR = 0.93, 95%CI = 0.38, 2.27, p = 0.88) independent of grade and playing position. History of shoulder or elbow surgery was not related to performance on the FMS™ shoulder mobility test or SFMA upper extremity patterns. Differences in the dates of surgery at the time of testing, and sport-specific adaptations of the upper extremities that are common in baseball players due to the cumulative tissue stress from years of throwing at the collegiate level, may explain these insignificant findings. Level 3.

EFFICACY OF REFLEXIVE NEUROMUSCULAR STABILIZATION DURING TREATMENT OF SCAPULAR DYSKINESIA IN AN OVERHEAD ATHLETE: A CASE REPORT

Shoulder injuries are common amongst overhead athletes. Dysfunctional motor patterns (scapular dyskinesis) may be the cause or result. Improperly treated, they can sideline athletes or reduce quality of life. Current treatment protocols are lengthy and may result in recurrence. Individualization of treatment is key. Functional tests, like the Selective Functional Movement Assessment (SFMA), help discern and properly identify dysfunction, paving the way for interventions like reflexive neuromuscular stabilization (RNS). RNS focuses on restoring proper motor control and may positively influence healing. The purpose of this case report is to describe an evaluation and treatment strategy for scapular dysfunction in an overhead athlete. The subject was a 16-year-old, multi-sport athlete in the high school setting. He presented with upper back pain during his sophomore baseball season. Clinical findings upon examination included but were not limited to irregular scapular positioning as compared bilaterally, dysfunctional scapular movement patterns, soft tissue muscular irritability and loss of glenohumeral (GH) ROM in internal and external rotation, flexion and abduction. Intervention consisted of a combination of positional release therapy and reflexive neuromuscular stabilization aided by some traditional therapeutic modalities. The combination of conservative treatments and RNS provided relief of the subject's symptoms in a shorter time frame, three treatments over the course of six days, than just utilizing traditional protocols. The utilization of the paired treatments resulted in diminished pain, restored ROM and improvement in perceived fluidity (speed and stability) of motion as observed by the clinician. A minimal clinically important difference (MCID) was reported on the disablement of the physically active scale (DPAs) on all follow-up treatments as well as on the numeric pain rating scale (NPRS) after the first and second treatments. The minimal detectable change (MDC) requirement was met on the patient specific functional scale (PSFS) prior to the second and third treatment. The activities measured with the PSFS were: GH flexion, GH abduction and throwing a baseball. In this case report, the use of the SFMA along with a traditional orthopedic examination allowed for proper identification and location of the dysfunctional motor patterns. The coupling of a traditional modality like the moist heat pack, with PRT and RNS proved to be a beneficial treatment combination for this subject as it provided a clinically meaningful resolution of his condition. Even though current literature suggests that treatment for scapular dysfunction is comprised of three phases over the course of ten weeks, clinicians should focus on the individualization of the treatment, possibly utilizing novel interventions like PRT and RNS. 4 Case Report.

INTRA-RATER TEST-RETEST RELIABILITY AND RESPONSE STABILITY OF THE FUSIONETICS™ MOVEMENT EFFICIENCY TEST

A new functional movement assessment, known as the Fusionetics- Movement Efficiency (ME) Test, has recently been introduced in the literature. Before the potential clinical utility of the ME Test can be examined, the reliability of this assessment must be established. To examine the intra-rater test-retest reliability of the Fusionetics- ME Test. Cross-sectional. ME Test data were collected among 23 (6 males, 17 females) university students (mean ± SD, age = 25.96 ± 3.16 yrs; height = 170.70 ± 9.96 cm; weight = 66.89 ± 12.67 kg) during sessions separated by 48 hours (Day 1, Day 2). All participants completed the seven sub-tests of the ME Test: 2-Leg Squat, 2-Leg Squat with Heel Lift, 1-Leg Squat, Push-Up, Shoulder Movements, Trunk Movements, and Cervical Movements. Overall ME Test scores and ME Test scores for each individual sub-test were calculated on a scale of 0 - 100 (worst - best) based on commonly observed movement compensations associated with each sub-test. Intraclass correlation coefficients (ICC3,1) statistics indicated that the intra-rater test-retest reliability of the Overall ME Test and individual sub-tests ranged from fair-to-excellent (ICC3,1 range = 0.55 - 0.84). Statistically significant differences in ME Test scores were identified between Day 1 and Day 2 among the 2-Leg Squat with Heel Lift (p = 0.015) and Cervical Movements (p = 0.005) sub-tests. In addition, a large range in the standard error of the measure (SEM) and minimal detectable change values (MDC90% & MDC95%) were identified within individual sub-tests of the ME Test (SEM range = 7.05 - 13.44; MDC90% range = 16.40 - 31.27; MDC95% range = 19.53 - 37.25), suggesting that the response stability varies among these individual sub-tests. Prevalence-adjusted bias-adjusted kappa statistics (κPABA) suggest that 55 of the 60 (92%) individual movement compensations hold moderate-to-almost perfect intra-rater test-retest reliability (κPABA range = 0.30 - 1.00). Excellent intra-rater test-retest reliability of the Overall ME Test score was identified, and thus, clinicians can reliably utilize the Fusionetics- ME Test to assess change in functional movement quality across time. However, caution should be taken if utilizing an individual sub-test to assess functional movement quality over time. 2b.

Can Functional Movement Assessment Predict Football Head Impact Biomechanics?

The purposes of this study was to determine functional movement assessments' ability to predict head impact biomechanics in college football players and to determine whether head impact biomechanics could explain preseason to postseason changes in functional movement performance. Participants (N = 44; mass, 109.0 ± 20.8 kg; age, 20.0 ± 1.3 yr) underwent two preseason and postseason functional movement assessment screenings: 1) Fusionetics Movement Efficiency Test and 2) Landing Error Scoring System (LESS). Fusionetics is scored 0 to 100, and participants were categorized into the following movement quality groups as previously published: good (≥75), moderate (50-75), and poor (<50). The LESS is scored 0 to 17, and participants were categorized into the following previously published movement quality groups: good (≤5 errors), moderate (6-7 errors), and poor (>7 errors). The Head Impact Telemetry (HIT) System measured head impact frequency and magnitude (linear acceleration and rotational acceleration). An encoder with six single-axis accelerometers was inserted between the padding of a commercially available Riddell football helmet. We used random intercepts general linear-mixed models to analyze our data. There were no effects of preseason movement assessment group on the two Head Impact Telemetry System impact outcomes: linear acceleration and rotational acceleration. Head impact frequency did not significantly predict preseason to postseason score changes obtained from the Fusionetics (F1,36 = 0.22, P = 0.643, R = 0.006) or the LESS (F1,36 < 0.01, P = 0.988, R < 0.001) assessments. Previous research has demonstrated an association between concussion and musculoskeletal injury, as well as functional movement assessment performance and musculoskeletal injury. The functional movement assessments chosen may not be sensitive enough to detect neurological and neuromuscular differences within the sample and subtle changes after sustaining head impacts.