title: The Functional Movement Screen and Injury Risk: Association and Predictive Value in Active Men.
abstract: BACKGROUND
  The Functional Movement Screen (FMS) is a series of 7 tests used to assess the injury risk in active populations.
  
  
  OBJECTIVE
  To determine the association of the FMS with the injury risk, assess predictive values, and identify optimal cut points using 3 injury types.
  
  
  METHODS
  Cohort study; Level of evidence, 2.
  
  
  METHODS
  Physically active male soldiers aged 18 to 57 years (N = 2476) completed the FMS. Demographic and fitness data were collected by survey. Medical record data for overuse injuries, traumatic injuries, and any injury 6 months after the FMS assessment were obtained. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated along with the receiver operating characteristic (ROC) to determine the area under the curve (AUC) and identify optimal cut points for the risk assessment. Risks, risk ratios (RRs), odds ratios (ORs), and 95% CIs were calculated to assess injury risks.
  
  
  RESULTS
  Soldiers who scored ≤14 were at a greater risk for injuries compared with those who scored >14 using the composite score for overuse injuries (RR, 1.84; 95% CI, 1.63-2.09), traumatic injuries (RR, 1.26; 95% CI, 1.03-1.54), and any injury (RR, 1.60; 95% CI, 1.45-1.77). When controlling for other known injury risk factors, multivariate logistic regression analysis identified poor FMS performance (OR [score ≤14/19-21], 2.00; 95% CI, 1.42-2.81) as an independent risk factor for injuries. A cut point of ≤14 registered low measures of predictive value for all 3 injury types (sensitivity, 28%-37%; PPV, 19%-52%; AUC, 54%-61%). Shifting the injury risk cut point of ≤14 to the optimal cut points indicated by the ROC did not appreciably improve sensitivity or the PPV.
  
  
  CONCLUSIONS
  Although poor FMS performance was associated with a higher risk of injuries, it displayed low sensitivity, PPV, and AUC. On the basis of these findings, the use of the FMS to screen for the injury risk is not recommended in this population because of the low predictive value and misclassification of the injury risk.
authors.affiliation: Directorate of Epidemiology and Disease Surveillance, Army Institute of Public Health, Aberdeen Proving Ground, Maryland, USA Timothy.t.bushman.ctr@mail.mil ttbushman@gmail.com.
authors.forename: Timothy T
authors.initials: TT
authors.lastname: Bushman
authors.affiliation: Directorate of Epidemiology and Disease Surveillance, Army Institute of Public Health, Aberdeen Proving Ground, Maryland, USA.
authors.forename: Tyson L
authors.initials: TL
authors.lastname: Grier
authors.affiliation: Directorate of Epidemiology and Disease Surveillance, Army Institute of Public Health, Aberdeen Proving Ground, Maryland, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Canham-Chervak
authors.affiliation: Directorate of Epidemiology and Disease Surveillance, Army Institute of Public Health, Aberdeen Proving Ground, Maryland, USA.
authors.forename: Morgan K
authors.initials: MK
authors.lastname: Anderson
authors.affiliation: Henry Jackson Foundation, Fort Carson, Colorado, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: North
authors.affiliation: Directorate of Epidemiology and Disease Surveillance, Army Institute of Public Health, Aberdeen Proving Ground, Maryland, USA.
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Jones
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001265:Athletic Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D015331:Cohort Studies; D012090:Cumulative Trauma Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D006306:Health Surveys; D006801:Humans; D008297:Male; D054526:Men's Health; D008875:Middle Aged; D008889:Military Personnel; D009141:Musculoskeletal System / Q000293:injuries*; D016017:Odds Ratio; D010809:Physical Fitness; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: Functional Movement Screen; epidemiology; injury prevention; military training; predictive value