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Athletic development specialists dedicated to the art and science of excellence in movement

More Functional Movement Screen Research

An update on recent Functional Movement Screen research from this year.  Nothing profound but some interesting correlations between FMS scores and BMI, along with new information on interrater reliability.  (For a look at previous FMS research discussion, please go HERE)

Duncan (2012) studied fifty eight 10-11 year olds consisting of normal weight kids and overweight/obese kids. Mean scores were 15.5 (out of 21) for normal weight; 10.6 for obese.  Authors also recorded physical activity levels.  They found that Body Mass Index (BMI) predicted 52.9% of FMS score variation while physical activity predicted 7.3% of FMS score variation.  This is the first formal FMS study on youth, to the best of my knowledge.

Bhk (2012) compiled normative data on middle aged individuals on FMS scores, as much of the formal literature data focuses on athletes.  Much like Duncan, their results found correlations between FMS scores with BMI and physical activity levels.  They also found a correlation between FMS score and age within this middle aged population. 

The correlation between BMI and FMS score raises interesting questions... Does BMI cause poor movement, or does poor movement lead to excess body weight?    Duncan notes,

“[I]t is possible that functional limitation may have existed prior to overweight/obesity. As such, excess weight and/or functional prowess are the result of natural selection since children who are functionally limited will remain inactive and will not develop the fundamental movement patterns that underpin performance to the same level of mastery as children who do not have a functional limitation. In the same way, children who are not functionally limited may more likely enjoy physical activity and thus, engage in more regular practise of the fundamental movement patterns that underpin performance.”

Although the Duncan study was solely upon 10-11 year olds, the same thought process can apply to understand causality in adults.   It’s important to never assume which direction causality runs.  This issue isn’t strictly an FMS issue, though the FMS is one way to track movement quality. 

Another interesting feature of the BMI/FMS connection is the relationship of BMI and FMS to injury prediction.  Though the overall formal literature on the FMS is relatively new, most has focused on the predictive value for injuries.  Independent of the FMS, BMI has been repeatedly identified as a predictor of injury in the literature (McHugh 2006, Tyler 2006, Gomez 1998, Lyman 2001, Quarrie 2001).  Though this three-way connection is hardly ironclad at this point, the two studies above strengthen the relationship between these factors. 

Interrater reliability is another common topic in the FMS research.  Previous studies have demonstrated the interrater reliability of the FMS (Minnick 2010, Schneiders 2011), but Onate (2012) found poor interrater reliability on the Hurdle Step test in a recent study.   In informal conversation, others who have conducted unpublished research have also questioned the interrater reliability of the Hurdle Step.  Nonetheless, their total score results demonstrated high intersession and high interrater reliability.  Individual tasks displayed moderate to high intersession reliability and good to high interrater reliability. 

Anecdotally, I sometimes question interrater reliability in the field, when people are taught by some random trainer at their gym and/or have a salesmanship motive to systematically score high or low (high = trying to be the nice guy; low = make people feel totally screwed up so they’ll feel a greater need to buy training services).   However, because the Hurdle Step comes further downstream in the corrective algorithm, many Hurdle Step issues can resolve before you address the Hurdle Step directly, which perhaps mitigates some conflict in scoring. 

Gribble (2012) looked at INTRA-rater reliability and asked whether it was affected by clinical experience.  This experiment used a sample of raters including experienced Athletic Trainers to students.  Each rater watched a series of FMS videos and assigned a score to the participants.  They watched videos again one week later and re-scored.  Experienced Athletic Trainers demonstrated the highest intrarater reliability, followed by less experienced Athletic Trainers.  Conclusion: "intrarater reliability is strong and seems to strengthen when the individuals have experience using the FMS in addition to clinical experience."  

Another recent study (2012 Teyhen) looked at 64 active duty service members without an injury history.   The average score on the FMS was 15.7 with 15.6% of the participants scoring less than or equal to 14 points.  As with other studies, they examined interrater and intrarater reliability.  Authors noted,

·         FMS composite score demonstrated moderate to good interrater and intrarater reliability with acceptable levels of measurement error.

·         The measures of reliability and measurement error were similar for both intrarater reliability that repeated the assessment of the movement patterns over a 48 to 72 hour period and interrater reliability that had 2 raters assess the same movement pattern simultaneously.

·         The interrater agreement of the FMS component scores were good to excellent (in contrast to Onate above for the Hurdle Step)

Summary

The link between FMS and BMI/obesity has previously had little coverage, but the results make intuitive sense.  Future research is needed to parse the causal relationships.  However, BMI correlations for football players (the subjects of earlier studies) are likely unreliable for other populations, since plenty of football players are fit, but technically obese according to BMI.  Overall, other than questions about the Hurdle Step, the FMS has demonstrated interrater and intrarater throughout the literature this year and previous years.  Given the correlation between activity level and FMS score, it will be interesting to see if future research looks in greater detail at how certain activities may impact the score. 

References

Duncan MJ, Stanley M. Functional movement is negatively associated with weight status and positively associated with physical activity in british primary school children. J Obes. 2012;2012:697563. Epub 2012 Mar 26.

Bhk FP, Koehle MS. Normative Data for the Functional Movement Screen™ in middle-aged adults. J Strength Cond Res. 2012 May 3. [Epub ahead of print]

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.

Teyhen DS, Shaffer SW, Lorenson CL, Halfpap JP, Donofry DF, Walker MJ, Dugan JL, Childs JD.  Functional Movement Screen: A Reliability Study.  J Orthop Sports Phys Ther. 2012 May 14. [Epub ahead of print]

Gribble P, Brigle J, Pietrosimone B, Pfile K, Webster K.  Intrarater Reliability of the Functional Movement ScreenTM.  J Strength Cond Res. 2012 May 15. [Epub ahead of print]

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