Utility of FMS to understand injury incidence in sports: current perspectives

Abstract

The Functional Movement Screen (FMS) is a popular movement screen used by rehabilitation, as well as strength and conditioning, professionals. The FMS, like other movement screens, identifies movement dysfunction in those at risk of, but not currently experiencing, signs or symptoms of a musculoskeletal injury. Seven movement patterns comprise the FMS, which was designed to screen fundamental movement requiring a balance between stability and mobility. The 7 movement patterns are summed to a composite FMS score. For an instrument to have wide applicability and acceptability, there must be high levels of reliability, validity, and accuracy. The FMS is certainly a reliable tool, and can be consistently scored within and between raters. Although the FMS has high face and content validity, the criterion validity (discriminant and convergent) is low. Additionally, the FMS does not appear to be studying a single construct, challenging the use of the summed composite FMS score. The accuracy of the FMS in screening for injury is also suspect, with low sensitivity in almost all studies, although specificity is higher. Finally, within the FMS literature, the concepts of prediction and association are conflated, combined with flawed cohort studies, leading to questions about the efficacy of the FMS to screen for injury. Future research on the use of the FMS, either the composite score or the individual movement patterns, to screen for injury or injury risk in adequately powered, well-designed studies are required to determine if the FMS is appropriate for use as a movement screen.