Functional movement screen: inter-rater and subject reliability

Abstract

Background A screening test evaluates a functional movement by assessing an athlete's functional limitations, weaknesses, or impairments that may increase the risk of injury for the athlete. Objective To assess the inter-rater reliability and subject variability of the Functional Movement Screen (FMS) and to analyze the use of video scoring as opposed to live scoring. Design A reliability study. Each athlete was tested and retested, 1 week apart by the same rater, who also scored the athlete's fi rst session from a video recording. These video recordings were then scored by fi ve other raters. Setting Human Performance Lab using two standard video cameras (sagittal and frontal views) and SiliconCoach video capture software. Participants 21 female (19.6±1.5 years, 64.4±5.1 kg, 1.7±0.1 m) and 19 male (19.7± 1.0 years, 80.1 ±9.9 kg, 1.9±0.1 m) Varsity athletes from swimming, soccer, volleyball, crosscountry and gymnastics volunteered to participate, along with six raters. Assessment The FMS consists of seven tasks that focus on mobility and stability. Each task is rated out of 3, with pain being an automatic zero, for a total score out of 21. Raters (6) looked for malalignment and asymmetry. Main outcome measurement The Krippendorff alpha (Kalpha) was used to assess the reliability of each of the three tests: inter-rater, test-retest, live versus video. Results The Kalpha for the inter-rater, the test-retest, and the live/video was 0.3806, 0.6161, and 0.9096, respectively. Conclusion Inter-rater reliability results show that clinicians should avoid comparison across multiple raters. It is possible that with more training this value may increase. Fortunately, if a single rater is used, clinicians can be confi dent that a change in the FMS score is due to a change in the athlete as the testretest produced good reliability. This study also demonstrates that streamlining the FMS process with the use of video capture is appropriate.

Evaluation of Functional Limitations in Female Soccer Players and Their Relationship With Sports Level – A Cross Sectional Study

“…Currently several previous reliability studies for the FMS TM using the standard scoring system have been published [21][22][23][24][25][26]. Overall, inter-rater reliability ranged from poor (k a = 0.38 [23]), throughout good (ICC = 0.87 and ICC = 0.89 [22]) to high (ICC = 0.92 [24] and k w = 0.98 [24]), depending on the performed statistical analysis. For intra-rater reliability intra-class correlation coeffi-cients was good and ranged from ICC = 0.6 [23] to ICC = 0.946, respectively to the experience level [26].…”

“…Overall, inter-rater reliability ranged from poor (k a = 0.38 [23]), throughout good (ICC = 0.87 and ICC = 0.89 [22]) to high (ICC = 0.92 [24] and k w = 0.98 [24]), depending on the performed statistical analysis. For intra-rater reliability intra-class correlation coeffi-cients was good and ranged from ICC = 0.6 [23] to ICC = 0.946, respectively to the experience level [26]. Moreover, normative values for in a young, active population were established [27].…”

“…The authors decided to use the FMS TM test in this study based on publications which emphasize that the test may be useful in identifying ''weak links'' in the biokinematic chain, and that it is increasingly often used in the analysis of male and female athletes movement patterns in different sport disciplines [20]. Currently several previous reliability studies for the FMS TM using the standard scoring system have been published [21][22][23][24][25][26]. Overall, inter-rater reliability ranged from poor (k a = 0.38 [23]), throughout good (ICC = 0.87 and ICC = 0.89 [22]) to high (ICC = 0.92 [24] and k w = 0.98 [24]), depending on the performed statistical analysis.…”

Low back pain incidence in New Zealand rowers and its relationship with functional movement patterns

“…Only one study found the inter-rater reliability to be poor (Shultz et al, 2011). In those studies that investigated intra-rater / test-retest reliability of the FMS it was found to range from good (Shultz et al, 2011;Teyhen et al, 2012) to excellent (Onate et al, 2012).…”

“…In this literature review eleven studies were identified that investigated the reliability of different functional movement screening tools (Table 2.3); nine looked specifically at the inter-rater, intra-rater and/or test-retest reliability (Butler, Plisky, & Kiesel, 2012;Frohm et al, 2012;Minick et al, 2010;Onate, Cortes, Welch, & van Lunen, 2010;Onate et al, 2012;Padua et al, 2009;Schneiders et al, 2011;Shultz et al, 2011;Teyhen et al, 2012). One investigated reliability as part of a pilot study imbedded within a correlation study (Smith et al, 2012), and one as part of a thesis into the development, reliability and effectiveness of a screening tool (Kritz, 2012).…”