title: Predicting sport and occupational lower extremity injury risk through movement quality screening: a systematic review.
abstract: BACKGROUND
  Identification of risk factors for lower extremity (LE) injury in sport and military/first-responder occupations is required to inform injury prevention strategies.
  
  
  OBJECTIVE
  To determine if poor movement quality is associated with LE injury in sport and military/first-responder occupations.
  
  
  METHODS
  5 electronic databases were systematically searched. Studies selected included original data; analytic design; movement quality outcome (qualitative rating of functional compensation, asymmetry, impairment or efficiency of movement control); LE injury sustained with sport or military/first-responder occupation. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. 2 independent authors assessed the quality (Downs and Black (DB) criteria) and level of evidence (Oxford Centre of Evidence-Based Medicine model).
  
  
  RESULTS
  Of 4361 potential studies, 17 were included. The majority were low-quality cohort studies (level 4 evidence). Median DB score was 11/33 (range 3-15). Heterogeneity in methodology and injury definition precluded meta-analyses. The Functional Movement Screen was the most common outcome investigated (15/17 studies). 4 studies considered inter-relationships between risk factors, 7 reported diagnostic accuracy and none tested an intervention programme targeting individuals identified as high risk. There is inconsistent evidence that poor movement quality is associated with increased risk of LE injury in sport and military/first-responder occupations.
  
  
  CONCLUSIONS
  Future research should focus on high-quality cohort studies to identify the most relevant movement quality outcomes for predicting injury risk followed by developing and evaluating preparticipation screening and LE injury prevention programmes through high-quality randomised controlled trials targeting individuals at greater risk of injury based on screening tests with validated test properties.
authors.affiliation: Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada.|Glen Sather Sports Medicine Clinic, University of Alberta, Edmonton, Alberta, Canada.|Faculty of Kinesiology, Sport Injury Prevention Research Centre, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Jackie L
authors.initials: JL
authors.lastname: Whittaker
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton, UK.|Arthritis Research UK Centre for Exercise, Sport and Osteoarthritis, Nottingham, UK.
authors.forename: Nadine
authors.initials: N
authors.lastname: Booysen
authors.affiliation: Constortium for Health and Military Performance, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: de la Motte
authors.affiliation: John W. Scott Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Liz
authors.initials: L
authors.lastname: Dennett
authors.affiliation: Department of Physical Therapy and Athletic Training, College of Health and Rehabilitation Sciences, Sargent College, Boston University, Boston, Massachusetts, USA.
authors.forename: Cara L
authors.initials: CL
authors.lastname: Lewis
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton, UK.|Arthritis Research UK Centre for Exercise, Sport and Osteoarthritis, Nottingham, UK.
authors.forename: Dave
authors.initials: D
authors.lastname: Wilson
authors.affiliation: Arthritis Research UK Centre for Exercise, Sport and Osteoarthritis, Nottingham, UK.|Department for Health, Bath University, Bath, UK.
authors.forename: Carly
authors.initials: C
authors.lastname: McKay
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton, UK.|Arthritis Research UK Centre for Exercise, Sport and Osteoarthritis, Nottingham, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Warner
authors.affiliation: Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: Darin
authors.initials: D
authors.lastname: Padua
authors.affiliation: Faculty of Kinesiology, Sport Injury Prevention Research Centre, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Department of Pediatrics, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Emery
authors.affiliation: Faculty of Kinesiology, Sport Injury Prevention Research Centre, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Faculty of Health Sciences, University of Southampton, Southampton, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Stokes
mesh_terms: D056352:Athletes; D001265:Athletic Injuries / Q000175:diagnosis*; D006801:Humans; D007869:Leg Injuries / Q000175:diagnosis*; D008889:Military Personnel; D009068:Movement; D012307:Risk Factors; D013177:Sports
keywords: Functional movement screen; Injuries; Lower extremity; Risk factor