- Movement screening when used for the purpose of injury prediction is flawed.
EVOLUTION OF SCREENING
In traditional rehab settings, an orthopedic assessment focused on joint range of motion, manual muscle testing and some activities like sit to stands and single leg balance. Then in the 90s we entered the functional training era where there was a shift away from isolated testing, due to it being viewed as non-functional, and a progressive increase in various movement “quality” based tests. Towards the end of the decade we saw the Functional Movement Screen (FMS) come to fruition and become indoctrinated throughout rehab and performance settings as THE test to implement for injury prediction (1). The test was built to assess “fundamental” movement patterns that were meant to help identify limitations in mobility, stability, and balance, as well as asymmetries, which were theorized to be risk factors across a wide range of injuries (2). Each of the seven movement patterns had scoring criteria from 0 to 3, allowing for a grading to be provided. With the addition of the scoring criteria, the test was meant to be implemented as a screen for injury risk.
We shouldn’t entirely throw away all movement assessments, but instead implement them with a different purpose.
UTILITY OF SCREENING
While the FMS sounds like something that could be very valuable, it is important to first thoroughly evaluate it, demonstrate good validity for the intended purpose, and prove clinical utility before implementing it (3). When we look at the purpose,