The Functional Movement Screen as an injury prediction tool for German physical education and exercise science students: a prospective cohort-study

 

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Abstract

Background Several studies have evaluated the applicability of the Functional Movement Screen (FMS) as a screening tool for injury prediction. However, only few studies investigate gender differences for FMS as a screening tool for female and male college students.

Objective To evaluate gender differences in FMS single items and the overall score. In addition, the applicability of FMS as a diagnostic tool for injury prevention of German exercise students will be investigated.

Method N = 99 college students performed an FMS at the beginning of the semester. Injuries were recorded for the entire term. Gender differences of FMS single items were assessed using the Mann-Whitney-U-Test. Differences in injury prediction were calculated using logistic regression. If the model was statistically significant, diagnostic accuracy was calculated using receiver operating characteristic (ROC) curves and the area under the curve (AUC). The Youden index was used to identify a cut-off score. 2 × 2 contingency tables, sensitivity and specifity, positive/negative predictive values, and likelihood ratios were assessed.

Results There were significant gender differences for Deep Squat, Shoulder Mobility, Trunk Stability Push Up, and Active Straight Leg Raise. The logistic regression showed that the composite score was statistically significant in clarifying the model for females (p = 0.005, R_N ² = 0.14), but not for males (p = 0.18, R_N ² = 0.04). The ROC curve indicated acceptable injury prediction in females (AUC: 0.66, p = 0.02) and poor injury prediction in males (AUC: 0.40, p = 0.19). The cut-off score of ≤ 16 for females resulted in a sensitivity of 63 % and specificity of 54 %. No cut-off score was calculated for males.

Conclusion Females performed better on flexibility items, while males scored higher on strength exercises. Results of the study indicate low predictive accuracy. Therefore, no solid recommendation can be made for the use of the FMS as an injury screening tool for either female or male German exercise science students.

Zusammenfassung

Hintergrund Mehrere Studien haben den Functional-Movement-Screen (FMS) als Screening-Instrument für die Vorhersage von Verletzungen untersucht. Wenige Studien gehen auf Geschlechterunterschiede des FMS als Screening-Instrument für Hochschulstudierende ein.

Ziel Evaluation von geschlechtsspezifischen Unterschieden bei FMS-Einzelitems sowie des Gesamtscore. Zudem wird die Einsetzbarkeit des FMS als Diagnostiktool zur Verletzungsprophylaxe von deutschen Sportstudierenden untersucht.

Methode N = 99 College-Studierende führten zu Beginn des Semesters einen FMS durch. Verletzungen wurden für das gesamte Semester erfasst. Geschlechterunterschiede der FMS-Einzelitems wurden mit dem Mann-Whitney-U-Test ermittelt. Unterschiede bei der Vorhersage von Verletzungen wurden mit logistischer Regression berechnet. Bei statistisch signifikanten Modellen wurde die diagnostische Genauigkeit mittels Receiver-Operating-Characteristic-Kurven (ROC-Kurven) und area under the curve (AUC) berechnet. Der Youden-Index wurde verwendet, um einen optimalen Cut-off-Score für Frauen und Männer zu schätzen. Zur Beurteilung des Verletzungsrisikos wurden Sensitivität und Spezifität, positiv und negativ prädiktive Werte, 2 × 2-Kontingenztabellen und das Risikoverhältnis berechnet.

Ergebnisse Es zeigten sich signifikante Geschlechterunterschiede in den FMS-Einzelitems Deep Squat, Shoulder Mobility, Trunk Stability Push Up und Active Straight Leg Raise. Die logistische Regression zeigte, dass der Gesamtscore statistisch signifikant zur Klärung des Modells für Frauen (p = 0,005, R_N ² = 0,14), aber nicht für Männer (p = 0,18, R_N ² = 0,04) beitragen konnte. Die ROC-Kurven bildeten eine gerade noch akzeptable Vorhersage für Verletzungen bei Frauen (AUC: 0,66, p = 0,02) und eine schlechte Vorhersage für Verletzungen bei Männern (AUC: 0,40, p = 0,19) ab. Für Frauen ergab ein Cut-off-Score von ≤ 16 eine Sensitivität von 63 % und Spezifität von 54 %. Da die AUC für Männer unter 50 % lag, wurde für diese kein Cut-off-Score berechnet.

Schlussfolgerung Frauen hatten bei Flexibilitätsübungen bessere Werte, Männer bei Kraftübungen. Die Ergebnisse der Studie deuten auf eine geringe Vorhersagegenauigkeit hin, sodass keine solide Empfehlung für den Einsatz des FMS als Screening-Instrument für Verletzungen weder für weibliche noch für männliche deutsche Studierende der Sport- und Bewegungswissenschaften gegeben werden kann.

Publication History

Received: 29 October 2020

Accepted: 22 March 2021

Article published online:
24 June 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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