Evaluation of the Functional Movement Screen (FMS) in Identifying Active Females Who are Prone to Injury. A Systematic Review

Abstract

Background: The validity of the Functional Movement Screen (FMS) in identifying active females who are predisposed to injury has not been specifically reviewed. This study aims to synthesize the literature on the ability of the FMS to identify at-risk active females. Methods: Six online databases, including PubMed, Medline, Web of Science, Science Direct, SPORTDiscus and Google Scholar, were searched for the period of April 2006 to September 2021. Out of the 61 potential references, 17 were reviewed in detail with respect to the inclusion criteria; ten were ultimately included. The risk of bias, applicability and level of the studies were then identified using the QUADAS-2 and a checklist for assessing methodological quality. The following data were obtained from the included studies: year of publication, title, study type, participants’ demographic, sample size, FMS cutoff point, injury definition, statistical analyses used, FMS results and study level. Results: Generally, the quality of eight studies was poor to moderate due to both small sample sizes and short follow-up periods. Except for a study on military members, all studies were carried out on team sports players. The overall bias of the studies was low, but there was an unclear amount of bias for participant selection. Two studies reported no predictive validity for the FMS, while three defended its predictive validity; the rest partially supported the FMS as a valid diagnostic tool. The reliability of the recommended cutoff point was confirmed, though cutoffs higher than 14 were significantly associated with the predictive ability of the FMS. Conclusion: Although the FMS is reliable for clinical practice, and the current literature shows promise regarding the predictive ability of the FMS among active females, concerns remain regarding its validity in identifying at-risk females. Given the lack of clarity in the literature on the use of the FMS in females, further well-organized studies with larger sample sizes and longer monitoring periods are highly recommended. The sensitivity and specificity of the recommended cutoff of ≤ 14 has considerably decreased , and higher cutoff values should be applied to increase the FMS predictive ability. Level of evidence The level of evidence was determined to be 2b.