The Functional Movement Screen as a Predictor of Injury in National Collegiate Athletic Association Division II Athletes

Context: The Functional Movement Screen (FMS) is a tool used to assess the quality of human movement. Previous FMS researchers reported a difference between the comprehensive and individual FMS test scores of injured and uninjured participants. Objective: To evaluate the accuracy of the FMS for predicting injury in National Collegiate Athletic Association Division II athletes and to evaluate how an injury definition may affect the prognostic values. Design: Cross-sectional study. Setting: University preparticipation examinations. Patients or Other Participants: A total of 257 collegiate athletes (men = 176, women = 81) between the ages of 18 and 24 years. Main Outcome Measure(s): The athletes were prospectively screened with the FMS and monitored for subsequent injury. The ability of the FMS to accurately predict musculoskeletal injuries, overall injuries, and severe injuries was determined. Results: The receiver operating characteristic curve provided the FMS cut score of <= 15 for the study sample. The areas under the curve were 0.53, 0.56, and 0.53 for musculoskeletal injury, overall injury, and severe injury, respectively. Sensitivity was 0.63 (0.62, 0.61, 0.65), whereas specificity was below 0.50 (0.49, 0.49, 0.45) for all 3 injury definitions of musculoskeletal injury, overall injury, and severe injury, respectively. Relative risk was 1.25 for musculoskeletal injuries, 1.24 for overall injuries, and 1.45 for severe injuries. Conclusions: The overall prognostic accuracy of the FMS offered a slightly better than 50/50 chance of correctly classifying those most at risk for injury. As such, the FMS did not provide discriminatory prediction of musculoskeletal injury, overall injury, or severe injury in National Collegiate Athletic Association Division II athletes. Using the identified optimal cut score produced inadequate validity, regardless of the injury definition. We recommend using the FMS to assess movement quality rather than as a standalone injury-prediction tool until additional research suggests otherwise. Clinicians screening for injury risk should consider multiple risk factors identified in the literature.