This study aimed to compare functional movement screen (FMS [TM]) scores and Beighton and Horan joint mobility index (BHJMI) scores among pubescence in adolescent athletes. Sixty-six adolescents between the ages of 8 and 14 voluntarily participated in this study. The participants performed the tests of the BHJMI, the tasks of the FMS (TM), and the clearing tests of the FMS (TM). The composite scores of the FMS (TM) and the BHJMI were scored objectively by the same researcher. The subjects were separated into prepubescent, early-pubescent, and postpubescent groups based on the results of the modified pubertal maturation observational scale. A 2 × 3 (gender × pubescence) factorial analysis of variance revealed a main effect for FMS (TM) scores across pubertal groups (p = 0.032) but not in BHJMI composite scores (pre = 2.69 ± 0.40, pub = 1.96 ± 0.40, post = 3.13 ± 0.43, p = 0.131). The postpubescent participants had significantly higher FMS (TM) scores compared with the prepubescent participants (post = 15.91 ± 0.47, pre = 14.28 ± 0.44, p = 0.008) and the early-pubescent participants (pub = 14.55 ± 0.44, p = 0.039). No differences were identified between gender for FMS (TM) scores (male participants = 15.16 ± 0.38, female participants = 14.67 ± 0.35, p = 0.351) or BHJMI scores (male participants = 2.36 ± 0.35, female participants = 2.83 ± 0.32, p = 0.321). No significant interactions were found between gender and pubescence regarding the BHJMI composite scores (p = 0.503) or the FMS (TM) scores (p = 0.216). There was no correlation between FMS (TM) composite scores and BHJMI composite scores (p = 0.89). Our results suggest that the FMS (TM) can discriminate between levels of pubescence and detect alterations during the pubertal growth cycle, whereas the BHJMI may not. A prospective extension of this study to include follow-up of injured participants appears worthwhile to determine if the FMS (TM) can suitably predict injury in the adolescent population.

Clinical Scenario: There is a high incidence of anterior cruciate ligament (ACL) injury in adolescents participating in pivoting sports such as soccer, basketball, and handball. Most ACL injuries in athletes are noncontact injuries, with a mechanism of sudden deceleration, change in direction, or landing from a jump. These mechanisms coupled with an increase in contraction of the quadriceps have been shown as risk factors for ACL injuries. Injuries to the ACL may require surgery, a long rehabilitation, and the potential for reinjury. Studies have shown reductions in lower extremity injury rates using training protocols that focus on landing mechanics, balance training, strength training, and/or agility training. There has been some thought that starting preventive training programs with adolescent athletes may be the most effective approach to reducing adolescent ACL injuries. Focused Clinical Question: Can lower extremity injury-prevention programs effectively reduce ACL injury rates in adolescent athletes? Keywords: youth, preventive training program, knee injury Clinical ScenarioThere is a high incidence of anterior cruciate ligament (ACL) injury in adolescents participating in pivoting sports such as soccer, basketball, and handball. Most ACL injuries in athletes are noncontact injuries, with a mechanism of sudden deceleration, change in direction, or landing from a jump. These mechanisms coupled with an increase in contraction of the quadriceps have been shown as risk factors for ACL injuries. Injuries to the ACL may require surgery, a long rehabilitation, and the potential for reinjury. Studies have shown reductions in lower extremity injury rates using training protocols that focus on landing mechanics, balance training, strength training, and/or agility training. There has been some thought that starting preventive training programs with adolescent athletes may be the most effective approach to reducing adolescent ACL injuries. Focused Clinical QuestionCan lower extremity injury-prevention programs effectively reduce ACL injury rates in adolescent athletes?Summary of Search, "Best Evidence" Appraised, and Key Findings• The literature was searched for studies of level 2 evidence or higher that investigated the effect of injury-prevention training programs on knee-sprain incidence in adolescent athletes.• The literature search returned 10 possible studies related to the clinical question; 4 studies met the inclusion criteria and were included.• Two high-quality cluster randomized controlled trials and 2 prospective cohort studies were included.• Of the included studies, 2 demonstrated reductions of ACL injuries of the intervention group and 2 showed no statistical difference between the intervention group and control group. Clinical Bottom LineThere is moderate evidence to support the use of a supervised injury-prevention training program that focuses on developing neuromuscular control of the lower extremity through neuromuscular strengthening exercises, plyometrics, and proprioception exercises. The prog...