Injury History, Sex, and Performance on the Functional Movement Screen and Y Balance Test

Abstract

Context Research is limited regarding the effects of injury or surgery history and sex on the Functional Movement Screen (FMS) and Y Balance Test (YBT). Objective To determine if injury or surgery history or sex affected results on the FMS and YBT. Design Cross-sectional study. Setting Athletic training facilities. Patients or Other Participants A total of 200 National Collegiate Athletic Association Division I female (n = 92; age = 20.0 ± 1.4 years, body mass index = 22.8 ± 3.1 kg/m2) and male (n = 108; age = 20.0 ± 1.5 years, body mass index = 27.0 ± 4.6 kg/m2) athletes were screened; 170 completed the FMS, and 190 completed the YBT. Intervention(s) A self-reported questionnaire identified injury or surgery history and sex. The FMS assessed movement during the patterns of deep squat, hurdle step, in-line lunge, shoulder mobility, impingement-clearing test, straight-leg raise, trunk stability push-up, press-up clearing test, rotary stability, and posterior-rocking clearing test. The YBT assessed balance while participants reached in anterior, posteromedial, and posterolateral directions. Main Outcome Measure(s) The FMS composite score (CS; range, 0–21) and movement pattern score (range, 0–3), the YBT CS (% lower extremity length), and YBT anterior, posteromedial, and posterolateral asymmetry (difference between limbs in centimeters). Independent-samples t tests established differences in mean FMS CS, YBT CS, and YBT asymmetry. The Mann-Whitney U test identified differences in FMS movement patterns. Results We found lower overall FMS CSs for the following injuries or surgeries: hip (injured = 12.7 ± 3.1, uninjured = 14.4 ± 2.3; P = .005), elbow (injured = 12.1 ± 2.8, uninjured = 14.3 ± 2.4; P = .02), and hand (injured = 12.3 ± 2.9, uninjured = 14.3 ± 2.3; P = .006) injuries and shoulder surgery (surgery = 12.0 ± 1.0, no surgery = 14.3 ± 2.4; P < .001). We observed worse FMS movement pattern performance for knee surgery (rotary stability: P = .03), hip injury (deep squat and hurdle: P < .042 for both), hip surgery (hurdle and lunge: P < .01 for both), shoulder injury (shoulder and hand injury: P < .02 for both), and shoulder surgery (shoulder: P < .02). We found better FMS movement pattern performance for trunk/back injury (deep squat: P = .02) and ankle injury (lunge: P = .01). Female athletes performed worse in FMS movement patterns for trunk (P < .001) and rotary (P = .01) stability but better in the lunge (P = .008), shoulder mobility (P < .001), and straight-leg raise (P < .001). Anterior asymmetry was greater for male athletes (P = .02). Conclusions Injury history and sex affected FMS and YBT performance. Researchers should consider adjusting for confounders.

Functional Movement Screen Factorial Validity and Measurement Invariance Across Sex Among Collegiate Student-Athletes

“…However, the results of the current study suggest that the issues of FMS measurement invariance emerge at the level of individual Copyright ª 2016 National Strength and Conditioning Association A C C E P T E D movement patterns. Interestingly, the movement patterns with poor factor loadings identified in the primary analysis of the current study (i.e., SM, ASLR, TPSU) mirror the movement patterns which consistently demonstrated sex differences in previous literature (1,4,31,33). This finding is consistent with the FMS literature which demonstrates significant sex differences in movement pattern scores yet a lack of sex differences in sum scores (1,4,31,33).…”

“…Interestingly, the movement patterns with poor factor loadings identified in the primary analysis of the current study (i.e., SM, ASLR, TPSU) mirror the movement patterns which consistently demonstrated sex differences in previous literature (1,4,31,33). This finding is consistent with the FMS literature which demonstrates significant sex differences in movement pattern scores yet a lack of sex differences in sum scores (1,4,31,33). The measurement invariance findings of the current study are also consistent with recent FMS research which suggests that the FMS demonstrated moderate levels of accuracy in predicting female Coast Guard cadets' injury risk and low accuracy in predicting male cadets' injury risk (25).…”

Relationships between the Functional Movement Screen Score and Y-Balance Test Reach Distances

“…There was no significant difference between these groups in the aggregate FMS score; however female athletes reached further than general college students in all directions in the YBT [13]. Another study administered the FMS and the YBT in 200 NCAA Division I athletes and found that individuals with a self-reported history of injury or surgery had significantly lower aggregate FMS scores [14]. They also reported that female athletes had lower scores on some of the individual tests within the FMS (TSPU and RS) and higher scores on other tests (ILL, SM, and ASLR [14]).…”

“…Another study administered the FMS and the YBT in 200 NCAA Division I athletes and found that individuals with a self-reported history of injury or surgery had significantly lower aggregate FMS scores [14]. They also reported that female athletes had lower scores on some of the individual tests within the FMS (TSPU and RS) and higher scores on other tests (ILL, SM, and ASLR [14]). However, they did not observe statistically significant differences in the YBT reach distances between individuals with and without a self-reported history of injury or surgery, nor between male and female participants [14].…”

“…They also reported that female athletes had lower scores on some of the individual tests within the FMS (TSPU and RS) and higher scores on other tests (ILL, SM, and ASLR [14]). However, they did not observe statistically significant differences in the YBT reach distances between individuals with and without a self-reported history of injury or surgery, nor between male and female participants [14]. The YBT reach distances and FMS scores have also been combined in the Move2Perform algorithm [15].…”