A Report of Minor Research Project Submitted toassumptioncollege.in/fusion/uploads/2017/01/Minor-Project-Report-Dr... · project report in respect of the Minor research project entitled

FUNCTIONAL MOVEMENT SCREENING

TOOL AS A PREDICTOR TO DETERMINE

INJURY RISK IN FEMALE COLLEGE

ATHLETES

DR.JIMMY JOSEPH

(MRP/15-16/KLMG034/UGC-SWRO)

A Report of Minor Research Project

Submitted to

University Grants Commission, New Delhi

March 2018

Functional Movement Screening Tool as Predictor to determine Injury

Risk in Female College Athletes is an approved minor research project

funded by the University Grants Commission (UGC) at Assumption

College Changanacherry, affiliated to Mahatma Gandhi University,

Kottayam

20/05/2018

From

Dr. Jimmy Joseph

Assistant Professor,

Department of Physical Education,

Assumption College, Changanacherry.

To

The Deputy Secretary,

University Grants Commission,

South Western Regional Office,

P. K. Block, Palace Road, Gandhi Nagar,

Bangalore – 560009.

.

Through: The principal, Assumption College, Changanacherry, Kottayam,

Kerala

Sub: Submission of Statement of Expenditure and Utilization Certificate reg:-

Ref: MRP/15-16/KLMGO34/UGC-SWRO , dated 25/04/2016.

Sir

I am submitting the statement of expenditure, Utilization certificate, and

project report in respect of the Minor research project entitled “Functional

Movement Screening Tool as a predictor to determine Injury Risk in Female

College athletes” sanctioned during the XII the plan period. Considering this

please release the remaining amount as early as possible.

Thanking You

Yours faithfully

Dr.Jimmy Joseph

Forwarded

PRINCIPAL

ACKNOWLEDGEMENT

I would like to express my appreciation and deep sense of gratitude

to the Principal, Assumption College, Changanacherry for providing all

the support and encouragement for the effective conduct of this minor

project. With immense pleasure, I am grateful to my Head of the

Department and all the coaches of Assumption College Changanacherry

for their sincere help, advice and supports during the course of study.

I express my deep sense of gratitude to ProfessorDr. T.I. Manoj,

Director of Students Welfare, Kerala Agricultural University, Thrissur for

his sincere help and guidance during the statistical analysis. Without the

financial support from the University Grants Commission, the research

project never have been realized. My sincere thanks to UGC for the

financial support.

Above all, I thank God Almighty for His perennial source of

blessings showered upon me always.

Changanacherry, April 2018 Dr.Jimmy Joseph

NO.AC/MRP/XIIPLAN/14-15/03/2018/KLMG03430/04/2018

To

The Deputy Secretary,

University Grants Commission,

South Western Regional Office,

P. K. Block, Palace Road, Gandhi Nagar,

Bangalore – 560009.

Sub: Submission of Documents of MRP entitled “Functional Movement Screening

Tool as a predictor to determine Injury Risk in Female College athletes”-

regarding.

Ref: UGC reference Letter No. 2396-MRP/15-16/klmg034/UGC-SWRO dated

12/04/2016.

Sir

I am forwarding the audited utilization Certificate and the final report of the UGC

Minor Research Project entitled “Functional Movement Screening Tool as a predictor

to determine Injury Risk in Female College athletes”. Kindly release the final grant

for the project. I am also enclosing herewith the following documents.

Thanking You

Yours faithfully

Principal

Enclosures: 1. Grant Sanction letter from UGC.

2. Annexure III and IV

3. Annexure V – Utilization Certificate,

4. Annexure VI & VII – Final report of work done.

5. Annexure VIII- Certificate from the Principal. (Submission of the

report in the college Library and publication of summary on the web

site).

6. CD of the Final Project report.

ANNEXURE –III

STATEMENT OF EXPENDITURE IN RESPECT OF MINOR RESEARCH

PROJECT

1. Name of the Principal Investigator : Dr. JIMMY JOSEPH

2. Department of PI : Physical Education

Name of College : Assumption College Changanacherry.

3. UGC approval Letter No. and Date :

2396-MRP/15-16/KLMG034/UGC-SWRO dated 25/04/2016

4. Title of the Research Project : Functional Movement Screening Tool

as a predictor to determine Injury Risk

in Female College athletes.

5. Effective date of starting the Project : 10/05/2016

6. a. Period of expenditure from : 10/05/2016to 16/03/2018

b. Details of Expenditure

Sl.

No Item

Amount

Approved Rs.

Expenditure

Incurred Rs.`

1 NON RECURRING GRANT

a Books and Journals 10,000 10808

b Equipment 1,10,000 1,17,691

2 RECURRING GRANT

a Contingency including Special needs 15,000 16000

b Field work expense and Travel 25,000 25534

Total 1,60,000.00 1,70,033.00

7. If as a result of check or audit objection some irregularly is noticed at later

date action will be taken to refund, adjust or regularize the objected amounts.

8. It is certified that the grant of Rs.1,60,000/- (rupees one lakh sixty thousand

only) received from the UniversityGrants Commission under the scheme of

support for Minor Research Project entitled “Functional Movement Screening

Tool as a predictor to determine Injury Risk in Female College athletes.” vide

UGC letter No. 2396-MRP/15-16/KLMG034/UGC-SWRO dated 25/04/2016

has been fully utilized for the purpose for which it was sanctioned and in

accordance with the terms and conditions laid down by the University Grants

Commission.

Signature of Principal Investigator Principal

ANNEXURE – IV

UNIVERSITY GRANTS COMMISSION

BAHADURSHAH ZAFAR MARG

NEW DELHI- 110002

STATEMENT OF EXPENDITURE INCURRED ON FIELD WORK

Name of the Principal Investigator : Dr. Jimmy Joseph

Certified that the above expenditure is in accordance with the UGC norms for mionor

research project.

Signature of the Principal Investigator Principal

ANNEXURE – V



NEW DELHI- 110002

27/03/2018

UTILIZATION CERTIFICATE

Certified that the grant Rs.1.60,000/- (Rupees One Lakh Sixty

Thousand only) received from the university Grants Commission under

the scheme of support for Minor Research Project entitled “Functional

Movement Screening Tool as a predictor to determine Injury Risk in Female

College athletes” vide UGC letter No. 2396-MRP/15-16/KLMG034/UGC-SWRO

dated 25/04/2016 has been fully utilized for the purpose for which it was

sanctioned and in accordance with the terms and conditions laid down by the

University Grants Commission.

Signature of the

Principal Investigator Principal Statutory Auditors

ANNEXURE –VI



NEW DELHI- 110002

Annual/ Final Report of the work done on the

Minor Research Project.

(Report to be submitted within 6 weeks after completion of each year)

1. Report No. 1st /Final : Report No. 1/Final

2. UGC Reference No. F :

2396-MRP/15-16/KLMG034/UGC-SWRO dated 25/04/2016

3. Period of Report : From May/2016to March 2017

4. Title of Research Project : FUNCTIONAL MOVEMENT SCREENING

TOOLAS A PREDICTOR TO DETERMINE

INJURY RISK IN FEMALE COLLEGE

ATHLETES.

5.

a. Name of the Principal

Investigator : Dr.Jimmy Joseph

b. Department : Physical Education

c. College where work

has progressed : Assumption College Changanacherry

6. Effective date of starting of the

Project : 25 /04/2016

7. Grant approved and Expenditure

incurred during the period of the

Report. :

a. Total amount approved Rs. : 1,60,000/-

b. Total Expenditure Rs. : 1,70,033/-

c. Report of the work done : Attached Exclusive Summary and one

bound copy of project report.

1. Brief objective of the Project : To determine Functional Movement Screening

Tool as a predictor to determine injury risk in

female college athletes of Kerala. To find out any

significant differences exists in composite and

individual test scores of Functional Movement

Screen (FMS) among athletes belonging to

different disciplines. Also to determine the

fundamental movement patterns in an effort to

determine the weak link in an athletes

movements based on the tests using the

Functional Movement Screen (FMS).

2. Work done so far and results

achieved and Publications, if any

resulting from the work : It will be published during the academic year

2018-2019

3. Has the progress been according

to original plan of work and towards

achieving the objective.

If not state reasons : The project truly has been according to the

original plan of work in achieving the

objective of the study.

4. Please enclose a summary of the

finding of the study. One bound copy

of the final report of the work done

may also be sent to the concerned

Regional office of the UGC : Summary of findings is given in

Annexure VII.

5. Any other information : Nil.

SIGNATURE OF THE PRINCIPAL PRINCIPAL

INVESTIGATOR

30-04/2018

CERTIFICATE

This is to certify that Dr.Jimmy Joseph Principal Investigator UGC Minor

Research Project No. 2396-MRP/15-16/KLMG034/UGC-SWRO dated 25/04/2016

titled “Functional Movement Screening Tool as a predictor to

determine injury risk in female college athletes” has published the final

report of the project on the college website www.assumptioncollege.in and

has submitted a copy of the final report of the project to the library of

Assumption College Changanacherry for reference.

PRINCIPAL

http://www.assumptioncollege.in/

ANNEXURE –VII



NEW DELHI- 110002

PERFORMA FOR SUBMISSION OF INFORMATION AT THE TIME OF

SENDING THE FINAL REPORT OF THE WORK DONE ON THE

PROJECT

1. Title of the Project : Functional Movement Screening Tool as

a predictor to determine injury risk in

female college athletes.

2. Name and address of the

Principal Investigator : Dr. Jimmy Joseph, Assistant Professor,

Department of Physical Education

3. Name and address of the institution : Assumption College Changanacherry.

4. UGC approval letter No and Date

: 2396-MRP/15-16/KLMG034/UGC-SWRO dated 25/04/2016.

5. Date of Implementation : 10/05/2016

6. Tenure of the Project : 2 Years.

7. Total grant allocated : 1,60,000/-

8. Total grant received : 1,40,000/-

9. Final expenditure : 1,70,033/-

10. Title of the Project : Functional Movement Screening Tool as

a predictor to determine injury risk in

female college athletes.

11. Objectives of the Project

a. To find out any significant differences exists in composite and individual

test scores of Functional Movement Screen (FMS) among athletes belonging

to different disciplines.

b. To find out any significant differences exists in composite and individual

test scores of Functional Movement Screen (FMS) among athletes belonging

to different disciplines.

12. Whether objectives were achieved: Yes. Detailed report attached.

13. Achievements from the project :

The results revealed that, there is significant differences exist between in

selected disciplines on total score of FMS. The further analysis also confirms

that, total mean score on movement screen test score of Athletics was the

highest with 17.11 and significantly higher in comparison to that of the Handball

players (M= 15.00). It may help to conclude that, the composite movement

screen score of athletics participants is higher in comparison to that of players of

Handball but no significant difference were found with other groups. At the

same time no significant difference were observed in composite scores between

other selected disciplines. Compare to other disciplines athletics participants

undergoes variety of movement patterns, it may be reason for athletics

participants shows the better composite mean score in FMS. The female

handball players participated in this study shows the lowest mean score of 15.

The individualistic score analysis of the female handball players may to bring

about some conclusions regarding the low composite scores in FMS. The study

conducted by Michael et. al (2015) indicate that athletes with an FMS™

composite score of 14 or less combined with a self-reported history of previous

injury are at 15 times increased risk for injury compared to athletes scoring

higher on the FMS™. The finding of a low FMS™ composite score being

predictive of injury risk is consistent with the findings of other published

studies, however, the results of this present study are more generalizable to a

larger sector of the athletics population.

14. Summary of the Findings:

The FMS specifically is a series of seven tests that look at movement patterns in

an individual. Each movement or pattern of movements receives a rating from 0 to

3 based upon the quality of the movement. After all portions of the screen are

complete the participant receives a score out of a potential 21 points. The

components test within the FMS gives insight on areas of the kinetic chain that need

to be addressed for proper movement to be restored. The FMS incorporates

components of flexibility, mobility, and stability to assess how a person can control

their movement as a whole. Another aspect of identifying athletic potential is the

use of anthropometric measures. Previous literature has investigated the relationship

between participant’s physical characteristics and their levels of performance. To

this point, one of the most revealing anthropometric measures is that of body

composition, however to our knowledge there has been little association between

FMS scores and body composition in previous literature. We hypothesize that

individuals with more lean body mass will have the ability to complete the FMS

with a higher score. We also believe that participants with higher FMS scores

would yield higher athletic performance results. We would like to discover which of

these variables would be better predictors of each other and find out if the total FMS

score has more value than addressing dysfunctional movement patterns.

The purpose of the study was to determine Functional Movement

Screening Tool as a predictor to injury risk in female collegiate athletes of Kerala.

The objectives of the study include (1) To find out any significant differences

exists in composite and individual test scores of Functional Movement Screen

(FMS) among athletes belonging to different disciplines. (2) To study the

fundamental movement patterns in an effort to determine the weak link in an

athlete’s movements based on the tests using the Functional Movement Screen

(FMS).

The sample consists of 92 athletes. The athletes belong to Assumption

College Changanacherry, Kottayam, and Kerala. All the Athletes (N=92) were

trained females. The athletes were the members of Athletics, Basketball, Handball

and Volleyball teams of Assumption College.

The Functional Movement Screen (FMS) is an innovative system used to

evaluate movement pattern quality for clients or athletes. The beauty of the

Functional Movement Screen is that a personal trainer, athletic trainer or strength

and conditioning coach can learn the system and have a simple and quantifiable

method of evaluating basic movement abilities. The FMS only requires the

ability to observe basic movement patterns already familiar to the coach or

trainer. The key to the Functional Movement Screen is that it consists of a

series of simple tests with a simple grading system. The FMS allows a trainer or

coach to begin the process of functional movement pattern assessment in

individuals without recognized pathology. The FMS is not intended to diagnose

orthopedic problems but rather to demonstrate limitations or asymmetries in

healthy individuals with respect to basic movement patterns and eventually

correlate them with outcomes.

The Functional Movement Screen provides a strength and conditioning

coach or personal trainer with an evaluation option that relates closely to what

the athlete or client will actually do in training. In a sense, the tests are improved

by working on variations of the skills tested. The FMS allows evaluation with

tools and movement patterns that readily make sense to both the client and the

trainer or coach. The test is comprised of seven fundamental movement patterns

Deep Squat, Hurdle Step Test, In Line – Lunge Test, Shoulder Mobility Test,

Active Straight Leg Raise, Trunk Stability Push up and Rotary Stability Test

that require a balance of mobility and stability.

The data were analysed by using SPSS Version 20.0 (SPSS Inc., Chicago,

IL). Different descriptive statistics are computed to describe the nature of the data.

These statistics will provide the various measures of the sample. Analysis of

variance performed for finding out the difference exists between the selected

disciplines and Chi– square was performed to test the equality between selected test

items in the Functional Movement Screen among the participants of selected

disciplines.

15. Contributions to the society :

a. There was an attempt evaluate movement pattern quality of the athletes.

b. It helps to identify the significant differences exist between the athletes of

different disciplines.

c. The fundamental movement patterns in an effort to determine the weak link

in an athlete’s movements

d. Helps to predictive the injury risk.

e. Create awareness about the need for conducting the FMS test with an

interval.

16. Whether any Phd. Enrolled/ produced out of the project: Nil

17. No of Publications out of the project : Will publish during 2018-2019.

DECLARATION

I hereby declare that the Minor Project Report titled “Functional Movement

Screening Tool as a predictor to determine injury risk in female college athletes”

(2396-MRP /1516/ KLMG034/ UGC-SWRO dated 25/04/2016) are the outcome of

the investigations carried out by me at Assumption College Chagancherry, Kottayam,

Kerala according to the plan and proposal and guidelines of the University Grants

Commission and same has not been submitted earlier.

30th

April 2018 Dr. Jimmy Joseph

Principal Investigator

CONTENTS

Sl. No Title Page No.

1. INTRODUCTION 1

Statement of the Problem

Limitations

Definitions and explanation of terms

Significance of the Study

2. REVIEW OF RELATED LITERATURE 11

3. METHODS AND MATERIALS 19

4. ANALYSIS OF DATA AND RESULT OF THE STUDY 37

Data Analysis

Discussions of Findings

5. SUMMARY CONCLUSIONS AND RECOMMENDATIONS 70

Summary

Conclusion

Recommendations

6. BIBLIOGRAPHY

1

CHAPTER - I

INTRODUCTION

In all sports, coaches are looking for athletes who will have long and

prolificcareers. Depending on the sport, the way someone is assessed on their

potential will bespecific to their sport. For instance, football players utilize their

explosive jumping powerduring competition so it would be relevant to test them in

vertical jump performance. Golfers however, do not utilize jumping during

competition so testing vertical jumpheight would not hold the same level of relevance.

Soccer players have to endure longerperiods of running and would benefit from

performing better on a timed mile and a halfrun. Different sports have different ways

to assess athletic potential; the functionalmovement screen (FMS)!is a suggested

method of assessing human movement patternscommon to all athletes. In theory FMS

results can be applied across any sport but it isstill unknown as to what extent it is

related to athletic performance.

The FMS specifically is a series of seven tests that look at movement patterns

inan individual. Each movement or pattern of movements receives a rating from 0 to

3based upon the quality of the movement. After all portions of the screen are

complete theparticipant receives a score out of a potential 21 points. The components

test within theFMS gives insight on areas of the kinetic chain that need to be

addressed for propermovement to be restored. The FMS incorporates components of

flexibility, mobility, andstability to assess how a person can control their movement

as a whole. Another aspect ofidentifying athletic potential is the use of anthropometric

measures. Previous literaturehas investigated the relationship between participant’s

physical characteristics and theirlevels of performance. To this point, one of the most

2

revealing anthropometric measuresis that of body composition, however to our

knowledge there has been little associationbetween FMS scores and body composition

in previous literature. We hypothesize thatindividuals with more lean body mass will

have the ability to complete the FMS with ahigher score. We also believe that

participants with higher FMS scores would yieldhigher athletic performance results.

We would like to discover which of these variableswould be better predictors of each

other and find out if the total FMS score has morevalue than addressing dysfunctional

movement patterns.

Participation in sports often results in traumatic and overuse injuries.It has

been estimated that 50 to 80% of these injuries are overuse in nature and affect the

lower extremity. Although, the risk of musculoskeletal injury is multifactorial.

Recently there has been increased recognition of muscular imbalances, poor

neuromuscular control and core instability as potential risk factors for athletic injury..

It has also been demonstrated that previous injury is a prominent risk factor for future

injuries. Kiesel et al. hypothesize that complex changes in motor control may result

from injury which may be detected using movement oriented tests that challenge a

multitude of systems at once.

Participation in athletics includes an inherent risk of becoming injured based

uponthe nature of the games and activities of the players. Current literature reports

thatapproximately seven million high school students are participating in sports in the

United States (Rechel, Yard, & Comstock, 2008). Of these athletes, 1.4million

injuries weresustained during the 2005-2006 sport seasons (Rechel et aI., 2008). The

volume of injuries reported in this setting, along with the fact that manyof the more

significant sports-related injuries may lead to long-term physical impairment(Powell

& Barber-Foss, 1999), warrants research into the possibility of utilizing pre-

3

participation screening methods that are able to identify athletes that are at a high risk

of becoming injured. If such determinations could be made, sports medicine

professionals could intervene to correct biomechanical deficits in an effort to promote

safe participation and reduce the incidence of injury.

In the realm of athletics the tide has shifted from recruiting players based on

their performance to a more forward thinking approach of potential and worth. This

has created a market for being able to predict accurately the physical and mental

criteria that allow an athlete have a prolific and durable career. Functional Movement

Screening (FMS) has been adopted over the years by multiple sporting venues to do

just that. According to research in the field presently the FMS test can not only screen

for ongoing physical deficiencies in the kinetic chain but also predict chances of

missing playing time due to injury in the future. One of the first implications of the

tool’s applicability was shown by (Kiesel, 2007) when he found a probability rate of

injury based on lower FMS scores. With the amount of current use in the athletic field

of FMS testing, it’s crucial to explore its limits and bounds.

Predicting Injury in Sport

As technology advances and research into health and wellness progresses,

theamount of objective tools used by consumers to assess physical fitness will

continue togrow. An interesting aspect of these phenomena is the claims of such tools

to help predicthigher occurrence of injury in sport. For instance, claims have been

made that athleteswith higher percent body fat are at risk for sustaining more

musculoskeletal injuries dueto the higher stress on the tissues. Tools like the Bod Pod

and hydrostatic weighing oreven electrical impedance can help illustrate objective

measures. Another instance is theuse of algorithms to predict VO2 max from running

4

or biking certain parameters in agiven amount of time. Usually having a higher V02

max correlates with being in topphysical shape and with having a significant chance

of less injuries but that is far fromthe case. Although not its original application when

developing the functional movementscreen, injury prevalence has been a focus of

more clinicians as literature continues todevelop.

Risk Factors of Injury

Previous Injury

One variable that has been identified as a significant risk factor for injury is a

history of previous injury (Emery, Meeuwisse, & Hartmann, 2005). Research reports

an increase of four to five fold in the likelihood of reinjury at the site of previous

injury for high school cross country, football, soccer and cheer (Murphy, Connolly,

&Beynnon, 2003; Emery et aI., 2005; Caine, Maffulli, & Caine, 2008). This may be

related to deficiencies resulting from the initial injury including increased ligamentous

laxity, altered range of motion, or decreased muscle strength or balance (Knowles et

aI., 2006; Caine et aI., 2008).

Ligamentous Laxity

The primary function of ligaments is to guide joint motion and, in the context

of injury, they also serve to control excessive joint motion. Ligamentous laxity

describes the stiffness qualities within a joint's connective tissues, which can be

evaluated through specific ligamentous and capsular tests that are administered by

health care practitioners relying on the end-feel (the quality of ligamentous resistance

at the end range of joint motion) to grade the tests. Results quantifying end-feel are

based on a four-point scale with zero indicating normal, one, a firm, two, a soft, and

5

three, an empty end-feel. Grades one through three may also be accompanied by pain.

The actual quality of this parameter is determined by testing bilaterally to compare the

injured to the uninjured joint. A firm end-feel indicates slight stretching of the

ligament with an end-feel close to that of the healthy side. A soft end-feel indicates

partial tearing of the ligamentous fibers with an increased glide of the joint surfaces

upon one another or the joint line gapping significantly when compared to the

contralateral side. An empty end-feel is consistent with complete tearing of the

ligament with excessive joint motion during the testing.

Range ofMotion

Range of motion (ROM) testing is another common assessment during a

patient evaluation. These measurements should be compared bilaterally and to

normative data for the joint (Starkey & Ryan, 2002). ROM can be determined via

gross observation by the practitioner or by using a goniometer. Goniometric ROM

testing requires the identification of the approximate axis ofjoint rotation so the

fulcrum of the goniometer can be placed at this location. Next, the stationary and

movement arms are placed on the proximal and distal segments, parallel to the

respective bones. Once the joint is moved through its full ROM, the amount of motion

can be easily measured in degrees on the goniometer.

Muscle Strength

Muscle strength, defined as the external force that a muscle or group of

musclescan produce, is measured clinically using manually-resisted ROM testing

through thejoint's full range. These tests can be used to assess a specific joint ROM,

Multiplantarjoint motion, or a muscle group. During manual resistance, the limb is

6

stabilized proximalto the joint to prevent compensatory motions while resistance is

provided against thedistal joint segment.

Statement of the Problem

The purpose of the study was to determine Functional Movement Screening

Tool as a predictor to injury risk in female collegiate athletes of Kerala.

Objectives

1. To find out any significant differences exists in composite and individual test

scores of Functional Movement Screen (FMS) among athletes belonging to

different disciplines.

2. To study the fundamental movement patterns in an effort to determine the

weak link in an athletes movements based on the tests using the Functional

Movement Screen (FMS).

Delimitations

1. The study was delimited to female college athletes studying in different

colleges under Mahatma Gandhi University, Kottayam only.

2. The study was further delimited totrained female Athletes, Basketball,

Handball and Volleyball players studying in Assumption College

Changanacherry.

3. The study was also delimited to FMS comprised of a series of tests, Deep

Squat, Hurdle Step Test, In Line – Lunge Test, Shoulder Mobility Test, Active

Straight Leg Raise, Trunk Stability Push up and Rotary Stability Test.

4. The study was also delimited to 92 female college athletes studying in

Assumption College Changanacherry.

7

Limitations

1. For the purpose of this project it was chosen to look specifically at

anthropometricsand FMS scores in predicting athletic performance and injury

rates in female college athletes in Kerala.

2. One of the larger limitations of this study is the participant groups select for

the study. Only female sports students participating in Athletics, Basketball,

Handball and Volleyball at the collegiate level making it difficult to be able to

apply these exact findings across the genders.

3. All the participants were tested are actively participating in Athletics,

Basketball, Handball and Volleyball at the college and Inter collegiate level.

4. The FMS scores were collected was in a rotational station basis, unlike any of

the previous studies on FMS. It could be said that the FMS data collection is

not as accurate as it could be but various literature has shown individuals who

were both trained and non-trained are capable of producing similar FMS

scores regardless of their training levels.

Definitions of Terms

Abrasions: Injuries that result from a fall on a hard surface that causes outer layers of

skin to rub off.

Achilles Tendon Rupture: The exact cause of rupture of the Achilles tendon is not

known. As with Achilles tendonitis, tight or weak calf muscles may contribute to the

potential for a rupture.

8

Ankle Sprains: The most common of all ankle injuries, an ankle sprain occurs when

there is a stretching and tearing of ligaments surrounding the ankle joint.

Anterior Cruciate Ligament(ACL) Injuries : ACL partial or complete tears can

occur when an athlete changes direction rapidly, twists without moving the feet, slows

down abruptly, or misses a landing from a jump.

Blisters: A fluid-filled sack on the surface of the skin that commonly occurs on the

hands, or the feet.

Clavicle Fractured (Broken Shoulder) : A shoulder fracture typically refers to a

total or partial break to either the clavicle (collar bone) or the neck of the humerus

(arm bone). It generally is from an impact injury, such as a fall or blow to the

shoulder.

Concussion: A concussion is typically caused by a severe head trauma where the

brain moves violently within the skull so that brain cells all fire at once, much like a

seizure.

Delayed-Onset Muscle Soreness: Muscle pain, stiffness or soreness that occurs 24-

48 hours after unaccustomed, or particularly intense exercise.

Hamstring Pull, Tear, or Strain: Hamstring injuries are common among runners.

The hamstring muscles run down the back of the leg from the pelvis to the lower leg

bones, and an injury can range from minor strains to total rupture of the muscle.

Knee Pain: Knee pain is extremely common in athletes. In order to treat the cause of

the pain, it is important to have an evaluation and proper diagnosis. Common reasons

for knee pain in athletes include the following.

Iliotibial (IT) Band Friction Syndrome: Knee pain that is generally felt on the

outside (lateral) aspect of the knee or lower thigh often indicates Iliotibial (IT) Band

Friction Syndrome.

9

Muscle Cramps: A cramp is a sudden, tight and intense pain caused by a muscle

locked in spasm. You can also recognize a muscle cramp as an involuntary and

forcibly contracted muscle that does not relax.

Overtraining Syndrome: Overtraining syndrome frequently occurs in athletes who

are training for competition or a specific event and train beyond the body's ability to

recover.

Plantar Fasciitis: Plantar fasciitis is the most common cause of pain on the bottom of

the heel and usually defined by pain during the first steps of the morning.

Shin Splints: Shin Splints describes a variety of generalized pain that occurs in the

front of the lower leg along the tibia (shin bone). Shin Splints are considered a

cumulative stress injury.

Shoulder Tendinitis, Bursitis, and Impingement Syndrome: These conditions

similar and often occur together. If the rotator cuff and bursa are irritated, inflamed,

and swollen, they may become squeezed between the head of the humerus and the

acromion.

Sprains: These are acute injuries that vary in severity but usually result in pain,

swelling, bruising, and loss of the ability to move and use the joint.

Stress Fracture: Stress fractures in the leg are often the result of overuse or repeated

impacts on a hard surface.

Tendonitis: Tendonitis is a common sports injury that often occurs from overuse.

Tendonitis can cause deep, nagging pain that is caused by inflammation of tendons.

Treating tendonitis consists of rest, medication, physical therapy or changes to

equipment or technique.

Tennis Elbow (Lateral Epicondylitis): the number one reason people see their

doctor for elbow pain. It is considered a cumulative trauma injury that occurs over

10

time from repeated use of the muscles of the arm and forearm that lead to small tears

of the tendons.

Torn Rotator Cuff: A common symptom of a rotator cuff injury is aching, and

weakness in the shoulder when the arm is lifted overhead.

Significance of the study

If able to establish the predictive value of FMS in predicting the chances of

injuries in female college athlete will help screen the athletes early before starting of the

season. Moreover, the FMS will help to find which area is more vulnerable for injuries,

the knowledge gained through may help the trainers to do necessary precaution to avoid

the chances of injury. The knowledge gained through will help to reduce the doctor visits

and hospitalization. As an undesired but inevitable consequence, sports related injuries

have increased significantly, results of the study may help decrease it. To date, there

are no published normative values for score on the FMS on the female athlete

population in India. The use of FMS™ in the adolescent school aged population can

be enhanced by the availability of reference values, as well permitting evaluation of

functional mobility and stability in this group. Female athlete' scores can be compared

to the normative reference values.

11

CHAPTER – II

REVIEW OF RELATED LITERATURE

Bahr R. (2016) addresses if and how a periodic health examination to screen

for risk factors for injury can be used to mitigate injury risk. The key question asked

is whether it is possible to use screening tests to identify who is at risk for a sports

injury-in order to address the deficit through a targeted intervention programme. The

paper demonstrates that to validate a screening test to predict and prevent sports

injuries, at least 3 steps are needed. First, a strong relationship needs to be

demonstrated in prospective studies between a marker from a screening test and injury

risk (step 1). Second, the test properties need to be examined in relevant populations,

using appropriate statistical tools (step 2). Unfortunately, there is currently no

example of a screening test for sports injuries with adequate test properties. Given the

nature of potential screening tests (where test performance is usually measured on a

continuous scale from low to high), substantial overlap is to be expected between

players with high and low risk of injury.Therefore, although there are a number of

tests demonstrating a statistically significant association with injury risk, and

therefore help the understanding of causative factors, such tests are unlikely to be able

to predict injury with sufficient accuracy. The final step needed is to document that an

intervention programme targeting athletes identified as being at high risk through a

screening programme is more beneficial than the same intervention programme given

to all athletes (step 3). To date, there is no intervention study providing support for

screening for injury risk.

R.G Lockie, et al. (2015) investigated the relationships between the Functional

Movement Screen (FMS) and athletic performance in female athletes. This study

http://www.ncbi.nlm.nih.gov/pubmed/?term=Lockie%20R%5Bauth%5D

12

analyzed the relationships between FMS (deep squat; hurdle step [HS]; in-line lunge

[ILL]; shoulder mobility; active straight-leg raise [ASLR]; trunk stability push-up;

rotary stability) scores, and performance tests (bilateral and unilateral sit-and-reach

[flexibility]; 20-m sprint [linear speed]; 505 with turns from each leg; modified T-test

with movement to left and right [change-of-direction speed]; bilateral and unilateral

vertical and standing broad jumps; lateral jumps [leg power]). Nine healthy female

recreational team sport athletes (age = 22.67 ± 5.12 years; height = 1.66 ± 0.05 m;

body mass = 64.22 ± 4.44 kilograms) were screened in the FMS and completed the

afore-mentioned tests. Percentage between-leg differences in unilateral sit-and-reach,

505 turns and the jumps, and difference between the T-test conditions, were also

calculated. Spearman's correlations (p ≤ 0.05) examined relationships between the

FMS and performance tests. Stepwise multiple regressions (p ≤ 0.05) were conducted

for the performance tests to determine FMS predictors. Unilateral sit-and-reach

positive correlated with the left-leg ASLR (r = 0.704-0.725). However, higher-scoring

HS, ILL, and ASLR related to poorer 505 and T-test performance (r = 0.722-0.829).

A higher-scored left-leg ASLR related to a poorer unilateral vertical and standing

broad jump, which were the only significant relationships for jump performance.

Predictive data tended to confirm the correlations. The results suggest limitations in

using the FMS to identify movement deficiencies that could negatively impact athletic

performance in female team sport athletes.

Gray Cook (2014) who is a practicing physical therapist with no shortage of

relevantdegrees and certifications in the kinesiology field as well as Lee Burton, who

has adoctorate in health promotion and wellness and is also Athletic Trainer

Certified,developed the FMS test (Cook, 2006). During the development of the FMS

test, Graywas interested in a holistic approach of movement systems that humans

13

develop from asearly as infancy and how they can become dysfunctional over time

(Cook, 2006). Hefocused on the motor learning process and the types of kinetic chain

dysfunctions thatpeople, especially athletes, acquire over time. For the athletic

population or even thephysically fit, these deficiencies in movement patterns can

leave the body exposed foracute or chronic musculoskeletal injury.

The goal of FMS testing is to assess a person’s movement patterns and

identify their asymmetries that can optimistically be addressed and corrected through

muscle training. These asymmetries usually include but are not limited to, tight, weak,

or injured muscles, and poor coordination of muscle activation. This leaves room for

compensatory movements facilitated by improper musculoskeletal mechanics, which

increases risk of injury (Cook, 2006). In other research that looked at fitness tests in

military training facilities, the FMS score was found to help identify those more at

risk for injury in conjunction with other physical measures (Lisman, 2013).

The Functional Movement Screen itself is a series of seven different tests

found tobest display the movement patterns of human kinetics and these test put a

numericalvalue to assess how well a person can functionally control their body’s

movement. TheSeven different tests are made up of a deep squat, straight leg raise, in-

line lunge, Singleleg hurdle step, shoulder mobility reach, trunk push up, and core

stability test. There areseveral other tests incorporated in the FMS such as the lumbar

flexion and extension testsas well as the shoulder impingement test, which rule out the

experience of pain in thesehigh-risk injury areas. A clinician who has experience in

the participant matter usuallyadministers the screen and each of the seven physical

tests is scored on a scale of 0 to 3.Scoring is as follows; Receiving a 0 on a test would

indicate the participant experiencespain during the movement, a 1 would indicate the

participant can complete the movementbut with highly noticeable compensation and

14

dysfunctional movement, a 2 would indicatenot quite perfect completion of the

movement but limited compensation or dysfunctionalmovement, and a 3 would

indicate nearly perfect movement with no compensatorytechniques or dysfunctions to

complete the task (Cook, 2006). Since tests such as thestraight leg-raise, hurdle step,

inline lunge, shoulder mobility reach, and core stabilitytest, all have bilateral

components to them; the lower of the two scores for each test isused in calculating the

total FMS score. The final score is out of 21 total points and thehigher the score,

theoretically the better the participants functional movement pattern issaid to be.

As for mentioned, the FMS test produces a value of 21 to rate how well a

personcan functionally move, which is the simplest manner in which the Functional

MovementScreen can be used. More experienced administrators can put a participant

through a testand point out specific musculoskeletal asymmetries during each

individual physicalexam. After the exam an in depth plan can be developed to help

the participant correctthe dysfunctional patterns. As shown in research, an off-season

intervention-trainingprogram can be shown to increase FMS scores and reduce the

amount of asymmetries inathletes (Kiesel, 2009). With amount of potential

implications that FMS testing can havewith athletics and injury rates, it’s important to

examine it from every aspect beforeadopting it as the gold standard for movement

patterns in human kinetics.

In another study, 8 novice doctorate physical therapist students observed

andassessed 64 active duty members via the FMS test. The examiners showed again

to havea high intra and inter reliability rates at 0.76 and 0.74 ICC respectively

(Teyhen, 2012).This again notes the variability in the experience needed to produce

accurate testingresults however in this study the PT students did undergo a 20 hour

training session fromother trained PT’s prior to evaluation. It’s difficult to tell if the

15

reliability would havebeen impacted from the training session but it would be

uncommon that a clinician wouldbe using the Functional Movement Screen without

having any knowledge or training ofthe tool beforehand.Elias et al looked into inter-

rater reliability of FMS scores but focused strictly oninexperienced physiotherapists

and the use of video analyses. The results showed highinter-reliability of the 20

physiotherapist examiners at an ICC of 0.90 however, the abilityto view the video

multiple times before rating the participants functional movements ledinvestigators to

believe rates were inflated (Elias, 2013). Not only does video make iteasier to focus

on different parts of the body during each of the seven tests but it allowsyou to review

the movements multiple times. Perhaps capturing video of the FunctionalMovement

Screen for each participant can be developed into the gold standard foranalysis. It

should also be noted that the 5 participants were elite squash players who mayhave

better functional movement patterns that are easier to rate.

Butler et al. (2013) examined whether low FMS scores are predictive of

injuryin firefighters. Similar to Kiesel et al. an ROC curve analysis illustrated that an

FMS score of ≤14 discriminated between those at a greater risk for injury and those

who were not.If low FMS scores can predict injury, off-season conditioning might be

used to restore dysfunctional mechanics to reduce risk. Kiesel et al. found that 52% of

players on a professional football team were able to improve their score from below to

above the established threshold score for injury risk (≤14) in a seven week off-season

conditioning program.

Elias et al (2013) looked into inter-rater reliability of FMS scores but focused

strictly on inexperienced physiotherapists and the use of video analyses. The results

showed highinter-reliability of the 20 physiotherapist examiners at an ICC of 0.90

however, the abilityto view the video multiple times before rating the participants

16

functional movements ledinvestigators to believe rates were inflated (Elias, 2013).

Not only does video make iteasier to focus on different parts of the body during each

of the seven tests but it allowsyou to review the movements multiple times. Perhaps

capturing video of the FunctionalMovement Screen for each participant can be

developed into the gold standard foranalysis. It should also be noted that the 5

participants were elite squash players who mayhave better functional movement

patterns that are easier to rate.

Chorba et al.(2010) found that a score of 14 or less on the FMS resulted in an

approximate 4 fold increase in the risk of lower extremity injuries in female collegiate

soccer, volleyball and basketball athletes. It was concluded that compensatory

movement patterns in female collegiate athletes can increase the risk of injury and

that these patterns can be identified by using the FMS. O’Connor et al. looked at a

population of US Marines and found that a score less than or equal to 14 on the FMS

demonstrated a limited ability to predict all traumatic or overuse musculoskeletal

injuries (sensitivity: 0.45, specificity: 0.71), while the same cut-off value was able to

predict injuries lasting more than three weeks in duration (sensitivity: 0.12,

specificity: 0.94).

Kiesel et al. (2007) demonstrated using an receiver operating characteristic

(ROC) curve that a score of 14 or less on the FMS was associated with an 11-fold

increase injury risk when they examined the relationship between FMS scores of 46

professional football athletes and the incidence of serious injury (injury lasting three or

more weeks in duration). They concluded that poor fundamental movement is a risk

factor for injury in football players and that players with dysfunctional movement

patterns, as measured by the FMS, are more likely to suffer an injury than those scoring

higher on the FMS.

17

Ferreira et al, (2010) investigated the relationship between of 52 college

studentsvertical jump performance and both squat jump and countermovement jump

tests whileloaded with lower percentage of their 1 RM squat. Drop vertical jump was

theinvestigated variable because it has been shown in research to show the most transfer

ofpower in a short amount of time. DVJ involves a participant stepping off a box

from40cm in height and landing and jumping back into the air as quickly as possible.

Theyfound that there was a relationship between the both squat jump and

countermovementjumps and drop vertical jump results per each participant. More

importantly they alsofound that there was a strong correlation (.72) with 1 RM squat

and DVJ results. Again this study puts in perspective statistically how some of the for

mentionedperformance measures are not independent from each other especially ones

that requiresimilar kinetic movement tasks. If a participant can score higher on the FMS

tests that areinvolved with similar movements then perhaps there relationship can be

considered adirect one. Test such as the deep squat, in line lunge, hurdle step, and active

straight leglift, all depend on flexibility and strength of the lower extremities. In most

cases animpressive 1 RM squat requires power and flexibility by the participant. FMS

test can beused as a good indication of a participants potential in their 1 RM squat

which shown byFerreira’s research, correlates directly to vertical jump performance.

In earlier explorations athletic measures were investigated to find its

relationshipwith functional performance measures like bench press and hang cleans.

After analyzingdata from 46 Division I collegiate football players it was shown that

bench-press andhang cleans were good predictors of 40-yd dash times and NFL shuttles

times. This studyaccredits the relationship to the similar explosive movements during

the strength andperformance measures (Davis, 2004). In this case vertical jump had no

predictorincluding percent body fat, which is contradictory to the previously mentioned

18

researchof VJ by Ferreira indicating there is a direct negative correlation between the

two.

Peate et al.2011 determined that firefighters enrolled in an eight week program

to enhance functional movement reduced time lost to injury by 62% when compared

with historical injury rates.If low FMS scores can predict injury, off-season

conditioning might be used to restore dysfunctional mechanics to reduce risk. Kiesel et

al. found that 52% of players on a professional football team were able to improve their

score from below to above the established threshold score for injury risk (≤14) in a

seven week off-season conditioning program. Similarly, Peateet al.11 determined that

fire fighters enrolled in an eight week program to enhance functional movement

reduced time lost to injury by 62% when compared with historical injury rates.

19

CHAPTER – III

METHODS AND MATERIALS

Selection of the Subjects

The sample consists of 92 athletes. The athletes belong to Assumption College

Changanacherry, Kottayam, and Kerala. All the Athletes (N=92) were trained females.

The athletes were the members of Athletics, Basketball, Handball and Volleyball teams

of Assumption College. The details of the study were presented on Table 3.1.

Table 3.1

Details of the subjects of the study

Groups N Total

Athletics 46

Basketball 10

Handball 15 92

Volleyball 21

Selection of the Variable

The Functional Movement Screen(FMS) is an innovative system used to evaluate

movement pattern quality for clients or athletes. The beauty of the Functional Movement

Screen is that a personal trainer, athletic trainer or strength and conditioning coach can

learn the system and have a simple and quantifiable method of evaluating basic

movement abilities. The FMS only requiresthe ability to observe basic movement

patterns already familiar to the coach or trainer. The key to the Functional Movement

Screen is that it consists of a series of simple tests with a simple grading system. The

FMS allows a trainer or coach to begin the process of functional movement pattern

20

assessment in individuals without recognized pathology. The FMS is not intended to

diagnose orthopedic problems but rather to demonstrate limitations or asymmetries in

healthy individuals with respect to basic movement patterns and eventually correlate

them with outcomes.

The Functional Movement Screen provides a strength and conditioning coach or

personal trainer with an evaluation option that relates closely to what the athlete or client

will actually do in training. In a sense, the tests are improved by working on variations of

the skills tested. The FMS allows evaluation with tools and movement patterns that

readily make sense to both the client and the trainer or coach. The test is comprised of

seven fundamental movement patterns Deep Squat, Hurdle Step Test, In Line – Lunge

Test, Shoulder Mobility Test, Active Straight Leg Raise, Trunk Stability Push up and

Rotary Stability Test that require a balance of mobility and stability.

Description of the test items

Deep Squat Test

The first and perhaps most functional portion of the FMS is the ability to perform

a deep squat. Important kinetic chain dysfunctions can be established by simply using the

squat to point out compensation in tight muscles or joints with lacking range of motion

(ROM). In this test the participant is handed the measuring dowel and told to hold it in

both hands overhead, hands approximately shoulder width apart prior to performing the

squat. Once the dowel is over the participant’s head with elbows extended they are asked

to complete a deep squat as best as possible in smooth fashion and to keep both heels

21

touching or close to the floor as possible. If the participant cannot perform the task then

they are asked to move their heels upon the two-inch high measuring board to gain more

ROM in their ankles and hamstrings. If a participant can complete the deep squat in a

smooth and non-compensating manor with their hips dropping below their knees and

hands remaining above their feet, then a participant receives a score of 3 (Figure 1).

When a participant can perform the squat during the next phase beginning with their

heels on the measuring board then a score of 2 is given. A score of 1 is received if the

participant has obvious compensations during squatting and cannot achieve proper depth

of the squat during secondary phase.

The deep squat has been investigated as the test showing the most dysfunctions

clinically. The ability to perform the deep squat requires closed- kinetic chain

dorsiflexion of the ankles, flexion of the knees and hips, extension of the thoracic spine,

and flexion and abduction of the shoulders (Cook, 2006).There are many kinetic chain

patterns addressed during the deep squat and it can indicate lack of flexibility in posterior

muscles as well as a ROM issues at specific joints like the shoulder, ankle, knee, and hip.

22

Figure - 1

Hurdle Step Test

One of the several bilateral screening tests used in the screen is the hurdle step. It

involves multi joint flexibility and emphasizes the coordination of movement while

maintaining balance. The first step of the hurdle step is to measure from the floor up to a

participant’s tibial tuberosity and which is used to set the height of the tubing hurdle. The

individual is then asked to put both feet together just touching the hurdle with their toes.

The participants were instructed to hold a dowel on their shoulders behind their

neck with both hands. The dowel was aligned parallel to the floor before starting the test.

The participant was directed to pick up one leg and cross it over the hurdle and lightly tap

down on the floor with the heel of that same foot. The participant then picks up the same

foot and returns it to its starting position so the opposite leg can then be tested. A 3 is

given for straight alignment of the foot, knee, and hip during the total movement. When a

23

participant receives a 3 they are able to complete the task without deviation in the

aforementioned joints and can clear their foot from touching the rubber hurdle (Figure 2

and 3).Also, testers looked for compensating movements in hip and lumbar spine and the

inability to keep the dowel parallel during the test. A score of 2 is administered if the

participant needs to deviate from smooth movement patterns such as externally rotating

their hip to clear the hurdle to achieve the task. Participants who can’t complete the task

or touched the rubber hurdle while deviating from normal movement patterns received a

one for the portion of the exam. This test scores each limb individually but the lower

score between the two are used in the final calculation of the score.

Figure - 2

24

Figure - 3

25

In-Line Lunge Test

The lunge tests looks more specifically at a participant’s ability to coordinate

movements while maintaining stability within the core. It also looks at the flexibility of

the hip and ankle while challenging stability at the knee being tested. Tibia length is used

to determine the length of the lunge. The participant stands upon the flat measuring board

placing the toe of one foot behind the zero length mark and the heel of their other foot at

a distance equal to the tibia length in front of the zero mark. Next, the dowel is placed

behind the individual with the hand opposite the front foot grasping the dowel at the

cervical level while the hand is holding it at the lumbar spine. The participant was asked

to maintain contact between the dowel and head, thoracic spine, and sacrum throughout

the lunge. The participant is asked to lunge forward to touch their back knee to the board

while keeping the dowel flat against their back. The test can be repeated up to three times

bilaterally to achieve a score of 3 (Figure4).

Perfect form is considered the ability of the participant to touch down their back

knee to the board right behind opposing heel while keeping their balance and functional

posture. A score of 3 would require keeping the dowel against the back while completing

the lunge with no falters in posture. A score of 2 would be given when participants are

unable to keep the dowel on all portions of their back as well as deviation from sagittal

plane in torso or lower shank. A score of 1 is noted when a participant cannot complete a

full lunge or loses their balance during the test. Implications of a poor score can be from

lack of flexibility in hip, ankle, and rectus femoris, and also lacking strength in the

muscles at the hip specifically weak adductors (Cook, 2006).

26

Figure - 4

Shoulder Mobility Test

The shoulder mobility test involves the flexibility and ROM of the muscles and

joints around the shoulder. It requires the participant to reach approximately maximum

ranges of motion in external and internal rotation while abducting and adducting the

shoulder respectively. Implications of this test can give insight on upper body kinetics of

the shoulder including scapular abnormalities. The mobility test can target muscles of the

anterior or posterior aspect of an individuals shoulder in order to address and restore

regular scapular rhythms.

27

The first part of the exam is for the participants to have their hand length

measured by the dowel specific to the FMS testing kit. Length is measured from the

bottom of the wrist to the end of the 3rd phalanx. The dowel is marked by half inches

only. Participants are then asked to assume a maximally adducted, extended, and

internally rotated position with one shoulder and a maximally abducted, flexed, and

externally rotated position with the other (Cook, 2006). During the test participants are

told to maintain thumb inside fist position in each hand while as smoothly as possible

they achieve the maximum positions at each shoulder. Length is measured from the

lowest point at the externally rotated shoulder’s fist against their back to the highest point

at the internally rotated fist (Figure 5). A Score of 3 was obtained if the distance between

points is less then one measured hand length. Distances larger than one hand length but

less then or equal to one and a half of the participant’s hand length receive a score of two.

A score of 1 was given for any participant who was not in between one and a half hand

lengths. This test can be repeated three times bilaterally to achieve a score of 3 but the

lower of the two scores is used for total score.

The first clearing exam of the FMS test is the shoulder impingement exam. After

finishing the shoulder mobility exam the participants are asked to put the tested hand on

the opposing shoulder and max flex at the shoulder. This exam is looking for pain in the

shoulder during the flexion and adducted motion. If a participant experiences pain during

either side of the exam a score of zero is given for the shoulder mobility score only and

evaluation pursues.

28

Figure - 5

Active Straight Leg Raise Test

The active straight leg raise test looks specifically at functional flexibility of the

posterior muscles of the lower extremity as well as core stability during movement. It can

be used to find flexibility discrepancies between the unilateral portions of the lower

extremity and identify possible rotational tendencies at the hip. The test requires the

participant to lay supine on a flat surface with the measuring board perpendicular and

beneath the participant’s knees. The dowel is placed at the midpoint between the

participants mid patella and anterior superior iliac spine (ASIS) perpendicular to the flat

surface. The participant is then instructed to flex the testing leg as high as possible with a

completely dorsiflexed and extended knee, trying to get their malleolus past the dowel

(Figure6). Participants are prompted to avoid the opposing limb from lifting off the

29

measuring board while keeping head in contact with flat surface. This test is repeated

bilaterally up to three times per limb.

A score of 3 was given if the participant lifted his tested leg high enough in hip

flexion to have his malleolus pass the dowel perpendicular to the floor while maintaining

contact with the board and opposing limb. If participants cannot clear their malleolus of

the dowel then the dowel is readjusted and aligned perpendicular to the floor with the

malleolus of the test leg. A score of 2 was given if the new position of the dowel was in

between the mid-thigh and joint line of the opposing knee. A score of 1 was received if

the ankle or dowel is below the knee joint of the opposing knee. Implications of this test

can show serious flexibility issues in the hamstrings as well as ROM dysfunctions at the

opposite hip or lumbar spine.

Figure - 6

30

Trunk Stability Push Up

The second upper body focused test of the FMS is the trunk stability push up.

This test is unique because it has implications for not only upper body strength but core

stabilization and coordination as well. Participants are required to assume a prone

position with hands placed at the top level of their forehead for the initial phase. Hands

are positioned approximately shoulder width apart with feet together (Figure 7). The

participant is asked to extend the knees and dorsiflexed prior to performing a full push

up. Participants are prompted to lift the whole body as one unit in a fluid motion.

Participants who are able to perform the push up as a single unit in the first

position were given a score of 3. If unable to perform the push up in the first position

31

hands are repositioned at the chin and attempted again. Participants received a score of 2

if able to perform a push up with hands at chin level and those who could not were scored

a 1. Clinicians were instructed to pay specific attention to the chest and stomach moving

away from the floor at the same time. This test is only attempted one time in each

position. The trunk stability push up involves the ability of an individual to transfer core

stabilization forces evenly necessary for most sport related activities. It also is an

indicator of upper body strength respective to moving their body weight in an efficient

manner.

The second clearing exam involves looking for pain reported by the participant

performing active lumbar extension. After performing the trunk push up, participants are

instructed to perform a press up while maintaining contact of the hips to the floor. If pain

were reported during the press up then the participant would receive a score of zero for

the trunk stability push up test. This would indicate some type of lumbar dysfunction or

prior injury to the lumbar region requiring evaluation.

Figure - 7

32

Rotary Stability Test

The most challenging test for participants to perform correctly was the bilateral

rotary and stability test. It focused on coordination of limbs moving symmetrically while

maintaining stabilization at the core, hip, and shoulder. Participants were first instructed

to assume a quadruped position on both hands and knees with their shoulder and hip at 90

degrees of flexion. Participants were then prompted to extend the shoulder out in front of

them enough to clear the floor while extending the unilateral hip in the same fashion.

Ideally the movement should take place symmetrically at the hip and shoulder while

maintaining balance at the opposing limbs in contact with the floor. Then the participant

extended the shoulder to try to touch the elbow to the unilateral knee with their hip

moving from extension into flexion toward the middle torso. This movement pattern is

repeated up to three times bilaterally and the lowest of the two scores is used for the

33

calculation of the total score. Participants were given a 3 if they were able to complete

the first phase while keeping balance and spine parallel to the floor (Figure 9).

If unable to complete the first phase of the rotary stability test, participants were

then prompted to complete a diagonal pattern of right arm to left leg or vice versa. During

this pattern participants extended one shoulder to clear the floor while extending the

contralateral hip then moved into shoulder extension and hip flexion to approximate the

shoulder to the opposite knee at mid torso. Again this pattern was repeated up to three

times. A score of 2 was given to those able to complete the secondary diagonal pattern

phase with their spine parallel to the floor and maintaining a fluid movement pattern. A

score of a 1 was given if the participant was unable to complete the diagonal pattern with

a parallel spine to the floor. The rotary stability test indicates the ability of the participant

to transfer forces and weight evenly during asymmetrical movement at the trunk.

Inability to do so can show potential for injury during athletic competition since most

sports require quick reaction to the transfer of forces in asymmetrical patterns.

The last clearing test in the FMS focuses on identifying pain during active lumbar

flexion. After the rotary stability test was performed, the participant was prompted to

assume the quadruped position and then move backwards so that the gluteal region was

approximated with the heels of the participant (Figure 10). The chest should have then

been in contact with thigh and knees. This position places the lumbar spine into normal

ranges of flexion. If the participant reported pain then they received a zero for the rotary

stability test and evaluation is necessary (Cook, 2006).

34

Figure - 9

35

Figure -10

36

Total FMS Score

When all seven tests including three clearing exams were complete, the scores

were summed to determine the participants score out of a total of 21 possible points.

Tests that entailed bilateral scoring used the lower score of the two to calculate each total.

For this study the focus was on the individual scores of each participant and not on the

specific dysfunctions that caused them.

Collection of Data

After obtaining the formal permission from the college authorities and from the

students, the Functional movement screen test was conducted on 92 students studying in

under graduate and post graduate courses in Assumption College Changanacehrry. A

total of 92 female college students they are the members of different sport namely

athletics, basketball, handball and volleyball participated in the test.

Statistical Techniques Employed

The data were analysed by using SPSS Version 20.0 (SPSS Inc., Chicago, IL).

Different descriptive statistics are computed to describe the nature of the data. These

statistics will provide the various measures of the sample. Analysis of variance performed

for finding out the difference exists between the selected disciplines and Chi – square was

performed to test the equality between selected test items in the Functional Movement

Screen among the participants of selected disciplines.

37

CHAPTER IV

ANALYSIS OF DATA AND RESULTS OF THE STUDY

Data analysis


Tool as a predictor to injury risk in female collegiate athletes of Kerala. The objectives

of the study include (1) To find out any significant differences exists in composite and

individual test scores of Functional Movement Screen (FMS) among athletes belonging

to different disciplines. (2) To study the fundamental movement patterns in an effort to

determine the weak link in an athlete’s movements based on the tests using the

Functional Movement Screen (FMS).


Changanacherry, Kottayam, and Kerala. All the Athletes (N=92) were trained females.

The athletes were the members of Athletics, Basketball, Handball and Volleyball teams

of Assumption College.


evaluate movement pattern quality for clients or athletes. The beauty of the Functional

Movement Screen is that a personal trainer, athletic trainer or strength and conditioning

coach can learn the system and have a simple and quantifiable method of evaluating

basic movement abilities. The FMS only requires the ability to observe basic movement

patterns already familiar to the coach or trainer. The key to the Functional Movement

Screen is that it consists of a series of simple tests with a simple grading system. The

FMS allows a trainer or coach to begin the process of functional movement pattern

assessment in individuals without recognized pathology. The FMS is not intended to

diagnose orthopedic problems but rather to demonstrate limitations or asymmetries in

38

healthy individuals with respect to basic movement patterns and eventually correlate

them with outcomes.

The Functional Movement Screen provides a strength and conditioning coach or

personal trainer with an evaluation option that relates closely to what the athlete or

client will actually do in training. In a sense, the tests are improved by working on

variations of the skills tested. The FMS allows evaluation with tools and movement

patterns that readily make sense to both the client and the trainer or coach. The test is

comprised of seven fundamental movement patterns Deep Squat, Hurdle Step Test, In

Line – Lunge Test, Shoulder Mobility Test, Active Straight Leg Raise, Trunk Stability

Push up and Rotary Stability Test that require a balance of mobility and stability.

The data were analysed by using SPSS Version 20.0 (SPSS Inc., Chicago, IL).

Different descriptive statistics are computed to describe the nature of the data. These

statistics will provide the various measures of the sample. Analysis of variance

performed for finding out the difference exists between the selected disciplines and Chi

– square was performed to test the equality between selected test items in the Functional

Movement Screen among the participants of selected disciplines. Table 4.1 displays the

descriptive measures including means and standard deviations for all the participants.

Findings

Table4.1

Descriptive Statistics for Total Score of Functional Movement screen

GROUPS N Mean Std. Deviation

Athletics 46 17.11 2.233

Basketball 10 16.50 2.273

Handball 15 15.00 1.195

Volleyball 21 16.76 1.609

Total 92 16.62 2.080

39

The ANOVA results, shows F-value in the Table 4.2 is significant as its p

value (=.007) is less than 0.05. Thus the null hypothesis of no difference among the

means of different games/athletics may be rejected at 5% level. Since F value is

significant, post hoc test need to be applied for comparing means of groups.

Table4.2

Univariate ANOVA on Total Score of Functional Movement screen

Sum of Squares df Mean Square F Sig.

Between Groups 50.919 3 16.973 4.358 .007

Within Groups 342.766 88 3.895

Total 393.685 91

*Significant at .05level

It can be seen that the difference between athletics and handball (MD = 2.109)

is significant as the p-value for this mean difference is 0.001 which is less than 0.05.

Similarly, the mean difference between handball and Volleyball (MD = 1.762) is also

significant as the p-value for this difference is .010 which is less than 0.05. However,

there is no difference between the means of the Athletics with Basketball and

Volleyball, Basketball with Handball and Volleyball with Basketball and Athletics.

From the Table 4.3, it may be seen that the total mean score on movement

screen test score of Athletics was the highest with 17.11 and significantly higher in

comparison to that of the Handball players (M= 15.00). Thus it may concluded that

the movement screen score of athletics participants is higher in comparison to that of

athletes of Handball but no significant difference were found with other groups.

40

Table4.3

Pairwise comparison of Variables with groups

Group

Mean

Difference (I-J) Std. Error

Sig

(p-value)

Athletics (M=17.11)

Basketball .609 .689 .379

Handball 2.109* .587 .001

Volleyball .347 .520 .506

Basketball (M=16.50)

Athletics -.609 .689 .379

Handball 1.500 .806 .066

Volleyball -.262 .758 .731

Handball (M=15.00)

Athletics -2.109* .587 .001

Basketball -1.500 .806 .066

Volleyball -1.762* .667 .010

Volleyball (M=16.76)

Athletics -.347 .520 .506


Handball 1.762* .667 .010

*. The mean difference is significant at the 0.05 level.

The Squat is a movement needed in most athletic events. It is the ready

position and is required for most power movements involving the lower extremities.

In Functional Movement screen(Cook G. et al., 2002) .The deep squat is a test that

challenges total body mechanics when performed properly. The deep squat is used to

assess bilateral, symmetrical, functional mobility of the hips, knees and ankles. The

dowel held over head assesses bilateral, symmetrical mobility of the shoulders, as

well as the thoracic spine. Table 4.4 displays the descriptive measures including

means and standard deviations of variable deep squat.

Table4.4

Descriptive Statistics of Variable – Deep Squat

GROUPS Mean Std. Deviation N

Athletics 2.30 .591 46

Basketball 2.00 .667 10

Handball 2.07 .258 15

Volleyball 2.38 .498 21

Total 2.25 .547 92

41

The p-values for Groups (Athletics, Basketball, Handball and Volleyball) in

Table 4.6 are more than 0.05. The F-values are not significant at 5% level.Thus the

null hypothesis of no difference among the means of different games/athletics are

accepted at 0.05 level of significance.Hence the F- ratios obtained were not

significant, subsequent Post hoc analysis were not performed.

Table4.6

Univariate ANOVA on Deep Squat between groups and within groups


Dee

p S

qu

at Between Groups 1.625 3 .542 1.860 .142

Within Groups 25.625 88 .291

Total 27.250 91


The hurdle step is designed to challenge the body’s proper stride mechanics

during a stepping motion. In Functional Movement screen(Cook G. et al., 2002) the

movement requires proper coordination and stability between the hip and torso during

the stepping motion, as well as single leg stance stability. The hurdle step assess

bilateral functional mobility and stability of the hip, knees and ankles. Table 4.7

displays the descriptive measures including means and standard deviations of variable

hurdle step.

Table4.7

Descriptive Statistics of Variable – Hurdle Step




Handball 2.33 .488 15


Total 2.43 .668 92

42






Table4.8

Univariate ANOVA on Hurdle Step between groups and within groups


Hu

rdle

Ste

p

Between Groups .428 3 .143 .313 .816


Total 40.609 91


In – Line Lunge test attempts to place the body in a position that will focus on

the stress during rotational decelerating and lateral type movements. In Functional

Movement screen(Cook G. et al., 2002) in- line lunge is a test that places the lower

extremity in a scissored position, challenging the body’s trunk and extremities to resist

rotation and maintain proper alignment. The test assesses hip and ankle mobility and

stability, quadriceps flexibility and knee stability.Table 4.8 displays the descriptive

measures including means and standard deviations of variable In line –lunge.

Table4.8

Descriptive Statistics of Variable In – Line Lunge




Handball 2.33 .488 15


Total 2.72 .453 92

43





Table4.9

Univariate ANOVA on In – Line Lunge between groups and within groups


In –

Lin

e L

un

ge Between Groups 2.742 3 .914 5.055 .003


Total 18.652 91


It can be seen that the difference between athletics and handball (MD = .471)

is significant as the p-value for this mean difference is 0.000 which is less than 0.05.

The difference between Basketball and Handball (MD = .367) is significant as the p –

value for this mean difference is .037. Similarly, the mean difference between

handball and athletics (MD = -.471) is significant as the p value for this difference is

.000, the mean difference between handball and Basketball (MD = -.367) is

significant as the p-value for this difference is .037, the mean difference between

handball and Volleyball (MD = 0.476) is significant as the p-value for this difference

is .001, the mean difference between which is less than 0.05. However, there is no

difference between the means of the Handball with Athletics, Handball with

Basketballand Handball with Volleyball

44

Table4.10

Pairwise comparison of In Line Lunge

Dependent

Variable

Groups

Mean

Difference

(I-J)

Std. Error

Sig.

In L

ine

Lu

nge

Athletics

(2.80)


Handball .471* .126 .000

Volleyball -.005 .112 .963

Basketball

(2.60)

Athletics -.104 .148 .484

Handball .367* .174 .037

Volleyball -.110 .163 .504

Handball

(2.33)

Athletics -.471* .126 .000

Basketball -.367* .174 .037

Volleyball -.476* .144 .001

Volleyball

(2.81)

Athletics .005 .112 .963


Handball .476* .144 .001


The shoulder mobility screen assesses bilateral shoulder range of motion,

combining internal rotation with adduction and external rotation with abduction. It also

requires normal scapular mobility and thoracic spine extension. The ability to perform

the shoulder mobility test requires shoulder mobility in a combination of motions

including abduction/external rotation, flexion/extension and adduction/internal rotation.

It also requires scapular and thoracic spine mobility.Table 4.8 displays the descriptive

measures including means and standard deviations of variable Shoulder mobility.

Table4.11

Descriptive Statistics of Variable Shoulder Mobility




Handball 2.67 .617 15


Total 2.76 .521 92

45






Table4.12

Univariate ANOVA on Shoulder mobility between groups and within groups


Sh

ou

lder

Mo

bil

ity Between Groups .170 3 .057 .203 .894


Total 24.739 91


The active straight-leg raise tests the ability to disassociate the lower extremity

while maintaining stability in the torso. The active straight-leg raise test assesses

active hamstring and gastroc-soleus flexibility while maintaining a stable pelvis and

active extension of theopposite leg. The ability to perform the activestraight-leg raise

test requires functional hamstring flexibility, which is the flexibility thatis available

during training and competition.This is different from passive flexibility, which

ismore commonly assessed. The subject is alsorequired to demonstrate adequate hip

mobilityof the opposite leg as well as lower abdominalstability.Table 4.13 displays

the descriptive measures including means and standard deviations of variable

Shoulder mobility.

46

Table4.13

Descriptive Statistics of Variable – Straight Leg Raise



Basketball 3.00 0.000 10

Handball 2.87 .352 15


Total 2.80 .426 92






Table4.14

Univariate ANOVA on Straight Leg Raise between groups and within groups


Str

aig

ht

Leg

Rais

e

Between Groups .566 3 .189 1.043 .378


Total 16.478 91


The trunk stability push-up tests the ability to stabilize the spine in an anterior

and posterior plane during a closed-chain upper body movement. It assesses trunk

stability in the sagittal plane while a symmetrical upper-extremity motion is

performed. The ability to perform the trunk stability push-up requires symmetric trunk

stability in the sagittal plane during a symmetric upper extremity movement. Many

functional activities require the trunk stabilizers to transfer force symmetrically from

the upper extremities to the lower extremities and vice versa. Movements such as

47

blocking in football and jumping for rebounds in basketball are common examples of

this type of energy transfer. If the trunk does not have adequate stability during these

activities, kinetic energy will be dispersed, leading to poor functional performance as

well as increased potential for micro traumatic injury.Table 4.15 displays the

descriptive measures including means and standard deviations of variable Shoulder

mobility.

Table4.15

Descriptive Statistics of Variable – Trunk Stability Push - Up


Athletics 2.04 1.074 46


Handball .87 .743 15


Total 1.68 1.058 92





Table4.16

Univariate ANOVA on Trunk Stability Push - Up between groups and within

groups


Tru

nk

Sta

bil

ity

Pu

sh -

Up

Between Groups 16.860 3 5.620 5.818 .001


Total 101.859 91


It can be seen that the difference between athletics and handball (MD = 1.177)

is significant as the p-value for this mean difference is .000 which is less than 0.05.

48

Similarly, the mean difference between handball and Volleyball (MD = .752) is also

significant as the p-value for this difference is .026 which is less than 0.05. However,

there is no difference between the means of the Athletics with Basketball and

Volleyball, Basketball with Handball, Basketball with Volleyball and Basketballwith

Athletics. There is no difference with Volleyball and Athletics and Volleyball with

Basketball.

From the Table 4.17, it may be seen that the Trunk Stability Push Up mean

score on movement screen test score of Athletics was the highest with 2.04 and

significantly higher in comparison to that of the Handball players(M= .87).Thus it

may concluded that the movement screen score of athletics participants is higher in

comparison to that of athletes of Handball but no significant difference were found

with other groups.

Table4.17

Pairwise comparison of Trunk Stability Push Up

Dependent

Variable Groups

Mean

Difference

(I-J)

Std. Error Sig.

Tru

nk

Sta

bil

ity

Pu

sh U

p

Athletics

(2.04)


Handball 1.177* .292 .000

Volleyball .424 .259 .105

Basketball

(1.40)

Athletics -.643 .343 .064

Handball .533 .401 .187

Volleyball -.219 .378 .563

Handball

(.87)

Athletics -1.177* .292 .000

Basketball -.533 .401 .187

Volleyball -.752* .332 .026

Volleyball

(1.62)

Athletics -.424 .259 .105


Handball .752* .332 .026


49

The Rotary Stability test is a complex movement requiring proper

neuromuscular coordination and energy transfer from one segment of the body to

another through the torso. The rotary stability test assesses multi-plane trunk stability

during a combined upper and lower extremity motion. The ability to perform the

rotary stability test requires asymmetric trunk stability in both sagittal and transverse

planes during asymmetric upper and lower extremity movement. Many functional

activities require the trunk stabilizers to transfer force asymmetrically from the lower

extremities to the upper extremities and vice versa. Running and exploding out of a

down stance in football and moving and carrying heavy equipment or objects are

examples of this type of energy transfer. If the trunk does not have adequate stability

during these activities, kinetic energy will be dispersed, leading to poor performance

as well as increased potential for injury.Table 4.18 displays the descriptive measures

including means and standard deviations of variable Rotary Stability.

Table4.18

Descriptive Statistics of Variable – Rotary Stability




Handball 1.87 .352 15

Volleyball 2.00 0.000 21

Total 1.97 .232 92






50

Table4.24

Univariate ANOVA on Rotary Stability between groups and within groups


Ro

tary

Sta

bil

ity Between Groups .191 3 .064 1.187 .320


Total 4.902 91


Interpretation based on Deep Squat Cross Tabulation

Table 4.25 displays a Chi-square test of independence was performed to

examine the relation between games and deep squat test score level. The relation

between these variables was significant, 𝑥2 (6, N = 92) = 12.603, p= 0.050. It shows,

functional movement screen test deep squat scores and performance of players belong

to different games are not equal. In total 5.4% (N=5) scored 1, which means that,

limitations may exist with the motions and flexion of the hip. The majority of

participants belonging to the score 2 (64.1%, N= 59) which means that, minor

limitations most often exist either with closed-kinetic chain dorsiflexion of the ankle

or extension of the thoracic spine. Moreover, 30.40% (N=28) participants achieved

the perfect score of 3, which means that, the athletes scored 3 having, upper torso is

parallel with tibia or toward vertical, femur below horizontal, knees are aligned over

feet and dowel aligned over feet.

51

Table 4.25

Interpretation based on Deep Squat Cross Tabulation

Group Deep Squat

Total 1 2 3

Athletics

Count 3 26 17 46

% within Event 6.5% 56.5% 37.0% 100.0%

% within Deep Squat 60.0% 44.1% 60.7% 50.0%

% of Total 3.3% 28.3% 18.5% 50.0%

Basketball

Count 2 6 2 10

% within Event 20.0% 60.0% 20.0% 100.0%


% of Total 2.2% 6.5% 2.2% 10.9%

Handball

Count 0 14 1 15

% within Event 0.0% 93.3% 6.7% 100.0%


% of Total 0.0% 15.2% 1.1% 16.3%

Volleyball

Count 0 13 8 21

% within Event 0.0% 61.9% 38.1% 100.0%


% of Total 0.0% 14.1% 8.7% 22.8%

Total

Count 5 59 28 92

% within Event 5.4% 64.1% 30.4% 100.0%


% of Total 5.4% 64.1% 30.4% 100.0%

Chi-Square = 12.603 df = 6, p = 0.050

Interpretation based on Hurdle Step Cross Tabulation

Table 4.26 displays a chi-square test of independence was performed to examine

the relation between games and Hurdle Step test score level. The relation between these

variables was not significant, 𝑥2 (6, N = 92) = 8.606, p= .197. It shows, functional

movement screen test Hurdle Step scores and performance of players belong to different

games are equal. In total 9.8% (N=9) scored 1, which means that, Contact between foot

and hurdle and loss of balance is noted. 37.0% (N = 34) participants achieved the score of

2 which means they lost the alignment between hips, knees and ankles. The majority of

participants (53.3%, N= 49) achieved the perfect score 3 which means that, the athletes

scored 3 having, a perfect balance on their hips, knees and ankles and it remain aligned in

52

the sagittal plane. No movement is noted in the lumbar spine which means that the

athletes scored 3 maintained a stable torso.

Table 4.26

Interpretation based on Hurdle Step Cross Tabulation

Group Hurdle Step Total 1 2 3

Athletics

Count 6 14 26 46

% within Event 13.0% 30.4% 56.5% 100.0%

% within Hurdle Step 66.7% 41.2% 53.1% 50.0%

% of Total 6.5% 15.2% 28.3% 50.0%

Basketball

Count 1 2 7 10

% within Event 10.0% 20.0% 70.0% 100.0%

% within Hurdle ST 11.1% 5.9% 14.3% 10.9%

% of Total 1.1% 2.2% 7.6% 10.9%

Handball

Count 0 10 5 15

% within Event 0.0% 66.7% 33.3% 100.0%

% within Hurdle ST 0.0% 29.4% 10.2% 16.3%

% of Total 0.0% 10.9% 5.4% 16.3%

Volleyball

Count 2 8 11 21

% within Event 9.5% 38.1% 52.4% 100.0%

% within Hurdle ST 22.2% 23.5% 22.4% 22.8%

% of Total 2.2% 8.7% 12.0% 22.8%

Total

Count 9 34 49 92

% within Event 9.8% 37.0% 53.3% 100.0%

% within In Hurdle Step 100.0% 100.0% 100.0% 100.0%

% of Total 9.8% 37.0% 53.3% 100.0%

Chi-Square = 8.606df = 6, p = .197

Interpretation based on In Line - Lunge Procedure Cross Tabulation


the relation between games and In Line - Lunge test score level. The relation between

these variables was significant, 𝑥2 (3, N = 92) = 13.523, p= 0.004. It shows, functional

movement screen test In Line - Lunge scores and performance of players belong to

different games are not equal. In total 28.3% (N=26) scored 2, which means that,

movements is noted in torso and their feet does not remain the sagittal plane. 71.7% (N =

66) participants achieved the score of 3 which means Dowel contacts remain with L-

spine extension. No torso movement is noted during the test. No athlete were scored 1.

53

This test attempt to place the body in a position that will focus on the stresses stimulated

during rotational, decelerating and lateral type movements. And it assessed the hip and

ankle mobility and stability, quadriceps flexibility and knee stability.

Table 4.27

Interpretation based on In Line - Lunge Procedure Cross Tabulation

Group Total Total 2 3

Athletics

Count 9 37 46

% within Event 19.6% 80.4% 100.0%

% within In Line - Lunge 34.6% 56.1% 50.0%

% of Total 9.8% 40.2% 50.0%

Basketball

Count 3 7 10

% within Event 30.0% 70.0% 100.0%


% of Total 3.3% 7.6% 10.9%

Handball

Count 10 5 15

% within Event 66.7% 33.3% 100.0%


% of Total 10.9% 5.4% 16.3%

Volleyball

Count 4 17 21

% within Event 19.0% 81.0% 100.0%


% of Total 4.3% 18.5% 22.8%

Total

Count 26 66 92

% within Event 28.3% 71.7% 100.0%


% of Total 28.3% 71.7% 100.0%

Chi-Square = 13.523df = 3, p = 0.004

Interpretation based on Shoulder Mobility Procedure Cross Tabulation

Table 4.28 displays a chi-square test of independence was performed to

examine the relation between games and Shoulder Mobility test score level. The

relation between these variables was not significant, 𝑥2 (6, N = 92) = 4.963, p = 0.549.

It shows, functional movement screen test Shoulder Mobility scores and performance

of players belong to different games are equal. In total only 4.3% (N=4) scored 1,

which means the Fists are not within one and half hand lengths. 15.2% (N = 14)

participants achieved the score of 2 which their Fists are within one and half hand

54

lengths. The majority of (80.4%, N= 74) participants achieved the perfect score 3

which means that, the athletes scored their Fists are within one hand length. The

shoulder mobility screen assessed bilateral shoulder range of motion, combining

internal rotation with adduction and extension, and external rotation with abduction

and flexion. It also requires normal scapular mobility and thoracic spine extension.

Table 4.28

Interpretation based on Shoulder Mobility Procedure Cross Tabulation

Group

Shoulder Mobility

Total 1 2 3

Athletics

Count 3 4 39 46

% within Event 6.5% 8.7% 84.8% 100.0

% % within Shoulder Mobility 75.0% 28.6% 52.7% 50.0%

% of Total 3.3% 4.3% 42.4% 50.0%

Basketball

Count 0 2 8 10

% within Event 0.0% 20.0% 80.0% 100.0


% of Total 0.0% 2.2% 8.7% 10.9%

Handball

Count 1 3 11 15

% within Event 6.7% 20.0% 73.3% 100.0


% of Total 1.1% 3.3% 12.0% 16.3%

Volleyball

Count 0 5 16 21

% within Event 0.0% 23.8% 76.2% 100.0


% of Total 0.0% 5.4% 17.4% 22.8%

Total

Count 4 14 74 92

% within Event 4.3% 15.2% 80.4% 100.0

% % within Shoulder Mobility 100.0% 100.0% 100.0% 100.0

% % of Total 4.3% 15.2% 80.4% 100.0

% Chi-Square = 4.963 df = 6 , p = 0.549

Interpretation based on Active Straight Leg Raise Procedure Cross Tabulation


the relation between games and Active Straight Leg Raise test score level. The relation

between these variables was not significant, 𝑥2 (6, N = 92) = 4.104, p= 0.663. It shows,

functional movement screen test Active Straight Leg Raise scores and performance of

players belong to different games are equal. Only 1.1% (N=1) scored 1, which means

55

that, after raising the leg the ankle resides below mid-patella/joint line. 17.4% (N = 16)

participants achieved the score of 2 which after raising the leg the ankle resides between

mid – thigh and mid – patella/joint line. The majority of participants belonging to the

score 3 (81.5%, N= 75) participants achieved the perfect score which means that, the

athletes scored 3 their ankle /Dowel resides between mid-thigh and ASIS. It measured the

ability to disassociate the lower extremity while maintain stability in torso. The active

straight leg raise test assessed active hamstring and gastroc – soleus flexibility while

maintain a stable pelvis and active extension of the opposite leg.

Table 4.29

Interpretation based on Active Straight Leg Raise Procedure Cross Tabulation

Group

Active Straight Leg Raise

Total 1 2 3

Athletics

Count 1 16 75 92

% within Event 1 9 36 46

% withinActive Straight Leg

Raise

2.2% 19.6% 78.3% 100.0%

% of Total 100.0

%

56.3% 48.0% 50.0%

Basketball

Count 1.1% 9.8% 39.1% 50.0%



Raise

0.0% 0.0% 100.0

%

100.0%

% of Total 0.0% 0.0% 13.3% 10.9%

Handball

Count 0.0% 0.0% 10.9% 10.9%


% within 0.0% 13.3% 86.7% 100.0%

% of Total Active Straight Leg

Raise

0.0% 12.5% 17.3% 16.3%

Volleyball

Count 0.0% 2.2% 14.1% 16.3%



Raise

0.0% 23.8% 76.2% 100.0%

% of Total 0.0% 31.3% 21.3% 22.8%

Total

Count 1 16 75 92

% within Event 1.1% 17.4% 81.5% 100.0%


Raise

100.0

%

100.0% 100.0

%

100.0%

% of Total 1.1% 17.4% 81.5% 100.0%

Chi-Square = 4.104 df = 6 , p = 0.663

56

Interpretation based on Trunk Stability Push - up Procedure Cross Tabulation


examine the relation between games and Trunk Stability Push- up test score level. The

relation between these variables was significant, 𝑥2 (6, N = 92) = 29.113, p = 0.001. It

shows, functional movement screen test Trunk Stability Push- up scores and

performance of players belong to different games are not equal. In total 19.6%

(N=18) scored 1, which means that, the female athletes participated in the test were

unable to perform one repetition with thumbs aligned with clavicle. Moreover 17.4 %

(N =16) scored 2 which means that, the female athletes participated in the test were

able to perform one repetition with thumbs aligned with clavicle. The majority of

participants belonging to the score 38.0% (N=35) participants achieved the perfect

score of 3, which means that, the female athletes scored 3 performed one repetition

with thumbs aligned with chin. The trunk stability push up tested the ability to

stabilize the spine in an anterior and posterior plane during a closed – chain upper

body movement. It assessed trunk stability in the sagittal plane while a symmetrical

upper –extremity motion is performed.

57

Table 4.30

Interpretation based on Trunk Stability Push - up Procedure Cross Tabulation

Group

Trunk Stability Push - up

Total 0 1 2 3

Athletics

Count 8 8 1 18 19

% within Event 17.4% 17.4% 2.2% 39.1% 41.3%

% withinTrunk

Stability Push - up 44.4% 44.4% 6.3% 51.4% 82.6%

% of Total 8.7% 8.7% 1.1% 19.6% 20.7%

Basketball

Count 2 2 3 4 1

% within Event 20.0% 20.0% 30.0% 40.0% 10.0%

% withinTrunk


% of Total 2.2% 2.2% 3.3% 4.3% 1.1%

Handball

Count 5 5 7 3 0

% within Event 33.3% 33.3% 46.7% 20.0% 0.0%

% withinTrunk


% of Total 5.4% 5.4% 7.6% 3.3% 0.0%

Volleyball

Count 3 3 5 10 3

% within Event 14.3% 14.3% 23.8% 47.6% 14.3%

% withinTrunk


% of Total 3.3% 3.3% 5.4% 10.9% 3.3%

Total

Count 18 18 16 35 23

% within Event 19.6% 19.6% 17.4% 38.0% 25.0%

% withinTrunk


% of Total 19.6% 19.6% 17.4% 38.0% 25.0%

Chi-Square = 29.113df = 6,p = 0.001

Interpretation based on Rotary Stability Procedure Cross Tabulation


examine the relation between games and Rotary Stability test score level. The relation

between these variables was significant, 𝑥2 (6, N = 92) = 13.574, p = 0.035. It shows,

functional movement screen test Rotary Stability scores and performance of players

belong to different games are not equal. In total only 4.3% (N=4) scored 1, which

58

means that, the female athletes participated in the test were unable to perform one

correct unilateral repetition while keeping spine parallel to board. It means Inability to

perform diagonal repetitions. The majority of participants 94.6% (N =94) scored 2

which means that, the female athletes participated in the test were unable to perform

one correct unilateral repetition while keeping spine parallel to board but they

performed one correct diagonal repetition while keeping spine parallel to board. Knee

and elbow touch in line over the board. Only 1.1% (N=1) participant achieved the

perfect score of 3, which means that, the female athletes scored 3 performed one

correct unilateral repetition while keeping spine parallel to board. Knee and elbow

touch in line over the board. The rotary stability test assessed multi-plane trunk

stability during a combined upper and lower extremity motion. It is a complex

movement requiring proper neuromuscular coordination and energy transfer from one

segment of the body to another through the torso.

Table4.31

Interpretation based on Rotary Stability Procedure Cross Tabulation

Group Rotary Stability

Total 1 2 3

Athletics

Count 1 45 0 46 % within Event 2.2% 97.8% 0.0% 100.0% % withinRotary Stability 25.0% 51.7% 0.0% 50.0% % of Total 1.1% 48.9% 0.0% 50.0%

Basketball

Count 1 8 1 10 % within Event 10.0% 80.0% 10.0% 100.0% % within Rotary Stability 25.0% 9.2% 100.0% 10.9% % of Total 1.1% 8.7% 1.1% 10.9%

Handball


Volleyball


Total


Chi-Square = 13.574 df = 6 , p = 0.035

59

Discussion of Findings

It seems more and more of today’s individuals are working harder to become

stronger and healthier. These individuals are constantly working to improve their

activities by increasing their flexibility, strength, endurance, and power. A

tremendous amount of athletes and individuals are performing high-level activities

even though they are inefficient in their fundamental movements. These individuals

create poor movement patterns, train around a pre-existing problem or simply do not

train their weakness during their strength and conditioning programs. In today’s

evolving training and conditioning market, athletes and individuals have access to a

huge arsenal of equipment and workout programs; however, the best equipment and

programs cannot produce if the fundamental weaknesses are not exposed.

The idea is to individualize each workout program based on the person’s weak

link. This weak link is a physical or functional limitation. In order to isolate the weak

link, the body’s fundamental movement patterns should be considered. Most people

will not begin strength and conditioning or rehabilitative programs by determining if

they have adequate movement patterns. This makes it essential to assess an

individual’s fundamental movements prior to beginning a rehabilitative or strength

and conditioning program. By looking at the movement patterns and not just one area,

a weak link can be identified. This will enable the individual, strength and

conditioning coach, athletic trainer or fitness professional to focus on that area. If this

weak link is not identified, the body will compensate, causing inefficient movements.

It is this type of inefficiency that can cause a decrease in performance and an increase

in injuries.

60

The Functional Movement Screen and training system attempts to pinpoint

these weak links and alleviate them. This system is a process that identifies the weak

link in the movement pattern and then assigns exercises to correct it. When this is

accomplished, the individual or athlete will have greater movement efficiency, which

will lead to improved performance and hopefully a decrease in injury potential. This

system consists of The Functional Movement Screen, Core Training and Reactive

Neuromuscular Training. Cook et al. (2002)


selected disciplines on total score of FMS. The further analysis also confirms that,

total mean score on movement screen test score of Athletics was the highest with

17.11 and significantly higher in comparison to that of the Handball players (M=

15.00). It may help to conclude that, the composite movement screen score of

athletics participants is higher in comparison to that of players of Handball but no

significant difference were found with other groups. At the same time no significant

difference were observed in composite scores between other selected disciplines.

Compare to other disciplines athletics participants undergoes variety of movement

patterns, it may be reason for athletics participants shows the better composite mean

score in FMS. The female handball players participated in this study shows the lowest

mean score of 15. The individualistic score analysis of the female handball players

may to bring about some conclusions regarding the low composite scores in FMS.

The study conducted by Michael et. al (2015) indicate that athletes with an FMS™

composite score of 14 or less combined with a self-reported history of previous injury

are at 15 times increased risk for injury compared to athletes scoring higher on the

FMS™. The finding of a low FMS™ composite score being predictive of injury risk

61

is consistent with the findings of other published studies, however, the results of this

present study are more generalizable to a larger sector of the athletics population.

The results of this study have many practical clinical applications. Identifying

individuals at risk for injury can lead to intervention strategies that address

fundamental movement patterns and potentially decrease injury risk. In addition to

identifying athletes at risk for injury, movement screening may also play a role in

determining when an athlete can safely return to sport with a lower risk of re‐ injury.

Currently there is no consensus regarding what factors need to be addressed to safely

return an athlete to sports participation after injury. Full sports participation requires

the integration of upper and lower extremity motion, strength and motor control. The

FMS™ is a unique screening tool that integrates all of these components reliably in a

short amount of time. The FMS™ demonstrates adequate predictive power for the

development of future injury and integration of this screening test into return to play

guidelinesshould be considered. This study findings are consistent with previous

studies that demonstrate that an FMS score ≤ 14 is associated with increased risk of

injury. For maximal predictive power, an FMS score ≤ 14 combined with previous

injury provides the greatest indicator of future injury risk. The difference between a

composite FMS score of 13 or 14 can be very minimal and how to approach the cutoff

for potential intervention is completely up to the coaching and medical staff.

A chi-square test of independence was performed to examine the relation

between games and deep squat test score level. The relation between these variables

was not significant, it shows, functional movement screen test deep squat scores and

performance of players belong to different games are equal. The ability to perform

the Deep Squat requires closed-kinetic chain dorsiflexion of the ankles, flexion of the

knees and hips, and extension of the thoracic spine, as well as flexion and abduction

62

of the shoulders. Poor performance of this test can be the result of several factors.

Limited mobility in the upper torso can be attributed to poor glenohumeral and/or

thoracic spine mobility. Limited mobility in the lower extremity including poor

closed-kinetic chain dorsiflexion of the ankles or poor flexion of the hips may also

cause poor test performance. In total 5.4% (N=5) scored 1, which means that,

limitations may exist with the motions and flexion of the hip. The majority of

participants belonging to the score 2 (64.1%, N= 59) which means that, minor

limitations most often exist either with closed-kinetic chain dorsiflexion of the ankle

or extension of the thoracic spine. Moreover, 30.40% (N=28) participants achieved

the perfect score of 3, which means that, the athletes scored 3 having, upper torso is

parallel with tibia or toward vertical, femur below horizontal, knees are aligned over

feet and dowel aligned over feet. When an athlete achieves a score less than III, the

limiting factor must be identified. Clinical documentation of these limitations can be

obtained by using standard goniometric measurements. Previous testing has identified

the fact that when an athlete achieves a score of II, minor limitations most often exist

either with closed-kinetic chain dorsiflexion of the ankle or extension of the thoracic

spine. When an athlete achieves a score of I or less, gross limitations may exist with

the motions mentioned above as well as flexion of the hip.

The results of chi-square test of independence between games and Hurdle Step

test score level was significant. It shows that, functional movement screen test Hurdle

Step scores and performance of players belong to different games are not equal.

Performing the hurdle step test requires stance-leg stability of the ankle, knee and hip,

as well as maximal closed-kinetic chain extension of the hip. The hurdle step also

requires step-leg open-kinetic chain dorsiflexion of the ankle and flexion of the knee

and hip. In addition, the athlete must also display adequate balance because the test

63

imposes a need for dynamic stability. Poor performance during this test can be the

result of several factors. It may simply be due to poor stability of the stance leg or

poor mobility of the step leg. Imposing maximal hip flexion of one leg while

maintaining apparent hip extension of the opposite leg requires the athlete to

demonstrate relative bilateral, asymmetric hip mobility. In total 9.8% (N=9) scored 1,

which means that, contact between foot and hurdle and loss of balance is noted.

37.0% (N = 34) participants achieved the score of 2 which means they lost the

alignment between hips, knees and ankles. The majority of participants (53.3%, N=

49) achieved the perfect score 3 which means that, the athletes scored 3 having, a

perfect balance on their hips, knees and ankles and it remain aligned in the sagittal

plane. No movement is noted in the lumbar spine which means that the athletes scored

3 maintained a stable torso.

The results of chi-square test of independence was performed to examine the

relation between games and In Line - Lunge test score level. The relation between

these variables was not significant. It shows, functional movement screen test In Line

- Lunge scores and performance of players belong to different games are equal. The

ability to perform the in-line lunge test requires stance leg stability of the ankle, knee

and hip as well as apparent closed kinetic-chain hip abduction. The in-line lunge also

requires step-leg mobility of hip abduction, ankle dorsiflexion, and rectus femoris

flexibility. The athlete must also display adequate balance due to the lateral stress

imposed.

Poor performance during this test can be the result of several factors. First, hip

mobility may be inadequate in either the stance leg or the step leg. Second, the stance-

leg knee or ankle may not have the required stability as the athlete performs the lunge.

Finally, an imbalance between relative adductor weakness and abductor tightness in

64

one or both hips may cause poor test performance. There may also be limitations in

the thoracic spine region which may inhibit the athlete from performing the test

properly.

In total 28.3% (N=26) scored 2, which means that, movements is noted in

torso and their feet does not remain the sagittal plane. 71.7% (N = 66) participants

achieved the score of 3 which means Dowel contacts remain with L- spine extension.

No torso movement is noted during the test. No athlete were scored 1. This test

attempt to place the body in a position that will focus on the stresses stimulated during

rotational, decelerating and lateral type movements. And it assessed the hip and ankle

mobility and stability, quadriceps flexibility and knee stability. When an athlete

achieves a score less than III, the limiting factor must be identified. Clinical

documentation of these limitations can be obtained by using standard goniometric

measurements of the joints as well as muscular flexibility tests such as the Thomas

test or Kendall’s test for hip flexor tightness. Previous testing has identified that when

an athlete achieves a score of II, minor limitations often exist with mobility of one or

both hips. When an athlete scores Ior less, a relative asymmetry between stability and

mobility may occur around one or both hips.

The results of chi-square test of independence to examine the relation between

games and Shoulder Mobility test score level was not significant. It shows, functional

movement screen test Shoulder Mobility scores and performance of players belong to

different games are equal. The ability to perform the shoulder mobility test requires

shoulder mobility in a combination of motions, including abduction/external rotation,

flexion/extension and adduction/internal rotation. It also requires scapular and

thoracic spine mobility.

65

Poor performance during this test can be the result of several causes, one of

which is the widely accepted explanation that increased external rotation is gained at

the expense of internal rotation in overhead throwing athletes. Excessive development

and shortening of the pectoralis minor or latissimusdorsi muscles can cause postural

alterations of forward or rounded shoulders. Finally, a scapulothoracic dysfunction

may be present, resulting in decreased glenohumeral mobility secondary to poor

scapulothoracic mobility or stability.

In total only 4.3% (N=4) scored 1, which means the fists are not within one

and half hand lengths. 15.2% (N = 14) participants achieved the score of 2 which

their fists are within one and half hand lengths. The majority of (80.4%, N= 74)

participants achieved the perfect score 3 which means that, the athletes scored their

fists are within one hand length. The shoulder mobility screen assessed bilateral

shoulder range of motion, combining internal rotation with adduction and extension,

and external rotation with abduction and flexion. It also requires normal scapular

mobility and thoracic spine extension.

The results of chi-square test of independence between games and Active

Straight Leg Raise test score level was not significant. It shows, functional movement

screen test Active Straight Leg Raise scores and performance of players belong to

different games are equal. The ability to perform the active straight leg raise test

requires functional hamstring flexibility, which is the flexibility that is available

during training and competition. This is different from passive flexibility, which is

more commonly assessed. The athlete is also required to demonstrate adequate hip

mobility of the opposite leg as well as lower abdominal stability. Poor performance

during this test can be the result of several factors. First, the athlete may have poor

functional hamstring flexibility. Second, the athlete may have inadequate mobility of

66

the opposite hip, stemming from iliopsoas inflexibility associated with an anteriorly

tilted pelvis. If this limitation is gross, true active hamstring flexibility will not be

realized. A combination of these factors will demonstrate an athlete’s relative

bilateral, asymmetric hip mobility. Like the hurdle step test, the active straight leg

raise test reveals relative hip mobility. However, this test is more specific to the

limitations imposed by the muscles of the hamstrings and the iliopsoas.

Only 1.1% (N=1) scored 1, which means that, after raising the leg the ankle

resides below mid-patella/joint line, when an athlete scores I or less, relative hip

mobility limitations are gross. 17.4% (N = 16) participants achieved the score of 2

which after raising the leg the ankle resides between mid – thigh and mid –

patella/joint line, when an athlete achieves a score of II, minor asymmetric hip

mobility limitations or moderate isolated, unilateral muscle tightness may exist. The

Thomas test can be used to identify iliopsoas flexibility. Previous testing has

identified that when an athlete achieves a score of II, minor asymmetric hip mobility

limitations or moderate isolated, unilateral muscle tightness may exist. The majority

of participants belonging to the score 3 (81.5%, N= 75) participants achieved the

perfect score which means that, the athletes scored 3 their ankle /Dowel resides

between mid-thigh and ASIS. It measured the ability to disassociate the lower

extremity while maintain stability in torso. The active straight leg raise test assessed

active hamstring and gastroc – soleus flexibility while maintain a stable pelvis and

active extension of the opposite leg. The Thomas test can be used to identify iliopsoas

flexibility. Previous testing has identified that when an athlete achieves a score of II,

minor asymmetric hip mobility limitations or moderate isolated, unilateral muscle

tightness may exist.

67

When an athlete achieves a score less than III, the limiting factor must be

identified. Clinical documentation of these limitations can be obtained by using

standard goniometric measurements of the joints as well as muscular flexibility tests

such as Kendall’s test for pectoralis minor and latissimusdorsi tightness. Previous

testing has identified that when an athlete achieves a score of II, minor postural

changes or shortening of isolated axio-humeral or scapulo-humeral muscles exist.

When an athlete scores Ior less, a scapulothoracic dysfunction may exist.

The results of chi-square test of independence to examine the relation between

games and Trunk Stability Push- up test score level was significant. It shows,

functional movement screen test Trunk Stability Push- up scores and performance of

players belong to different games are not equal.The ability to perform the trunk

stability push-up requires symmetric trunk stability in the sagittal plane during a

symmetric upper extremity movement. Many functional activities in sport require the

trunk stabilizers to transfer force symmetrically from the upper extremities to the

lower extremities and vice versa. Movements such as rebounding in basketball,

overhead blocking in volleyball, or pass blocking in football are common examples of

this type of energy transfer. If the trunk does not have adequate stability during these

activities, kinetic energy will be dispersed, leading to poor functional performance as

well as increased potential for micro traumatic injury.

In total 19.6% (N=18) scored 1, which means that, the female athletes

participated in the test were unable to perform one repetition with thumbs aligned

with clavicle. Moreover 17.4 % (N =16) scored 2 which means that, the female

athletes participated in the test were able to perform one repetition with thumbs

aligned with clavicle. The majority of participants belonging to the score 38.0%

(N=35) participants achieved the perfect score of 3, which means that, the female

68

athletes scored 3 performed one repetition with thumbs aligned with chin. The trunk

stability push up tested the ability to stabilize the spine in an anterior and posterior

plane during a closed – chain upper body movement. It assessed trunk stability in the

sagittal plane while a symmetrical upper –extremity motion is performed. Poor

performance during this test can be attributed simply to poor stability of the trunk

stabilizers. When an athlete achieves a score less than III, the limiting factor must be

identified. Clinical documentation of these limitations can be obtained by using

Kendall’s test for upper and lower abdominal strength.

The results chi-square test of independence to examine the relation between

games and Rotary Stability test score level was significant. It shows, functional

movement screen test Rotary Stability scores and performance of players belong to

different games are not equal. The ability to perform the rotary stability test requires

asymmetric trunk stability in both sagittal and transverse planes during asymmetric

upper and lower extremity movement. Many functional activities in sport require the

trunk stabilizers to transfer force asymmetrically from the lower extremities to the

upper extremities and vice versa. Running and exploding out of a down stance in

football and track are common examples of this type of energy transfer. If the trunk

does not have adequate stability during these activities, kinetic energy will be

dispersed, leading to poor performance as well as increased potential for injury.

In total only 4.3% (N=4) scored 1, which means that, the female athletes

participated in the test were unable to perform one correct unilateral repetition while

keeping spine parallel to board. It means Inability to perform diagonal repetitions.

The majority of participants 94.6% (N =94) scored 2 which means that, the female

athletes participated in the test were unable to perform one correct unilateral repetition

while keeping spine parallel to board but they performed one correct diagonal

69

repetition while keeping spine parallel to board. Knee and elbow touch in line over

the board. Only 1.1% (N=1) participant achieved the perfect score of 3, which means

that, the female athletes scored 3 performed one correct unilateral repetition while

keeping spine parallel to board. Knee and elbow touch in line over the board. The

rotary stability test assessed multi-plane trunk stability during a combined upper and

lower extremity motion. It is a complex movement requiring proper neuromuscular

coordination and energy transfer from one segment of the body to another through the

torso. Poor performance during this test can be attributed simply to poor asymmetric

stability of the trunk stabilizers. When an athlete achieves a score less than III, the

limiting factor must be identified. Clinical documentation of these limitations can be

obtained by using Kendall’s test for upper and lower abdominal strength.

70

CHAPTER V

SUMMARY CONCLUSIONS AND RECOMMENDATIONS

Summary

The FMS specifically is a series of seven tests that look at movement patterns

in an individual. Each movement or pattern of movements receives a rating from 0 to

3 based upon the quality of the movement. After all portions of the screen are

complete the participant receives a score out of a potential 21 points. The components

test within the FMS gives insight on areas of the kinetic chain that need to be

addressed for proper movement to be restored. The FMS incorporates components of

flexibility, mobility, and stability to assess how a person can control their movement

as a whole. Another aspect of identifying athletic potential is the use of

anthropometric measures. Previous literature has investigated the relationship

between participant’s physical characteristics and their levels of performance. To this

point, one of the most revealing anthropometric measures is that of body composition,

however to our knowledge there has been little association between FMS scores and

body composition in previous literature. We hypothesize that individuals with more

lean body mass will have the ability to complete the FMS with a higher score. We

also believe that participants with higher FMS scores would yield higher athletic

performance results. We would like to discover which of these variables would be

better predictors of each other and find out if the total FMS score has more value than

addressing dysfunctional movement patterns.


Tool as a predictor to injury risk in female collegiate athletes of Kerala. The

objectives of the study include (1) To find out any significant differences exists in

71

composite and individual test scores of Functional Movement Screen (FMS) among

athletes belonging to different disciplines. (2) To study the fundamental movement

patterns in an effort to determine the weak link in an athlete’s movements based on

the tests using the Functional Movement Screen (FMS).


Changanacherry, Kottayam, and Kerala. All the Athletes (N=92) were trained

females. The athletes were the members of Athletics, Basketball, Handball and

Volleyball teams of Assumption College.


evaluate movement pattern quality for clients or athletes. The beauty of the Functional

Movement Screen is that a personal trainer, athletic trainer or strength and

conditioning coach can learn the system and have a simple and quantifiable method of

evaluating basic movement abilities. The FMS only requires the ability to observe

basic movement patterns already familiar to the coach or trainer. The key to the

Functional Movement Screen is that it consists of a series of simple tests with a

simple grading system. The FMS allows a trainer or coach to begin the process of

functional movement pattern assessment in individuals without recognized pathology.

The FMS is not intended to diagnose orthopedic problems but rather to demonstrate

limitations or asymmetries in healthy individuals with respect to basic movement

patterns and eventually correlate them with outcomes.

The Functional Movement Screen provides a strength and conditioning coach

or personal trainer with an evaluation option that relates closely to what the athlete or

client will actually do in training. In a sense, the tests are improved by working on

variations of the skills tested. The FMS allows evaluation with tools and movement

patterns that readily make sense to both the client and the trainer or coach. The test is

72

comprised of seven fundamental movement patterns Deep Squat, Hurdle Step Test, In

Line – Lunge Test, Shoulder Mobility Test, Active Straight Leg Raise, Trunk

Stability Push up and Rotary Stability Test that require a balance of mobility and

stability.

The data were analysed by using SPSS Version 20.0 (SPSS Inc., Chicago,

IL). Different descriptive statistics are computed to describe the nature of the data.

These statistics will provide the various measures of the sample. Analysis of variance

performed for finding out the difference exists between the selected disciplines and

Chi – square was performed to test the equality between selected test items in the

Functional Movement Screen among the participants of selected disciplines.


selected disciplines on total score of FMS. The further analysis also confirms that,

total mean score on movement screen test score of Athletics was the highest with

17.11 and significantly higher in comparison to that of the Handball players (M=

15.00). It may help to conclude that, the composite movement screen score of

athletics participants is higher in comparison to that of players of Handball but no

significant difference were found with other groups. At the same time no significant

difference were observed in composite scores between other selected disciplines.

Compare to other disciplines athletics participants undergoes variety of movement

patterns, it may be reason for athletics participants shows the better composite mean

score in FMS. The female handball players participated in this study shows the lowest

mean score of 15. The individualistic score analysis of the female handball players

may to bring about some conclusions regarding the low composite scores in FMS.

The study conducted by Michael et. al (2015) indicate that athletes with an FMS™

composite score of 14 or less combined with a self-reported history of previous injury

73

are at 15 times increased risk for injury compared to athletes scoring higher on the

FMS™. The finding of a low FMS™ composite score being predictive of injury risk

is consistent with the findings of other published studies, however, the results of this

present study are more generalizable to a larger sector of the athletics population.

Conclusions

1. It may help to conclude that, the composite movement screen score of athletics

participants is higher in comparison to that of players of Handball but no

significant difference were found with other groups.

2. The functional movement screen test deep squat scores and performance of

players belong to different games are equal.

3. The functional movement screen test Hurdle Step scores and performance of

players belong to different games are equal.

4. The functional movement screen test In Line - Lunge scores and performance

of players belong to different games are equal.

5. The functional movement screen test Shoulder Mobility scores and

performance of players belong to different games are equal.

6. The functional movement screen test Active Straight Leg Raise scores and

performance of players belong to different games are equal.

7. The functional movement screen test Trunk Stability Push- up scores and

performance of players belong to different games are not equal.

8. The functional movement screen test Rotary Stability scores and performance

of players belong to different games are not equal.

74

Recommendations

In the light of the conclusions drawn, the following recommendations are made.

1. An awareness programme shall be conducted for the athletic community to

understand the importance functional movement screen test.

2. Training should be given to the coaches and trainers for conducting the

functional movement screen test.

3. Future studies should focus on interventions that improve FMS scores and

determine if this improved movement results in a lower risk injury.

4. It will also be important to organize future studies on a large group of different

sports.

5. In future more attention should be paid to the score of each task rather than the

sum of scores when interpreting the functional movement screen scores.

6. Sports medicine experts and Physiotherapist support should be extend to the

injured athlete the functional movement screen test.

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APPENDIX - A

SCORING SHEET