Asymmetry or a low FMS individual test score was a better predictor of MSI than the composite FMS score.

Changes in many aspects of physical capacity and athletic performance have been documented through the course of a competitive season in collegiate athletes. Movement pattern quality as measured by the functional movement screen (FMS) has recently been linked to performance and injury risk. The purpose of this study was to document the changes in functional movement patterns over a competitive season. Fifty-seven National Collegiate Athletic Association Division II athletes were screened using the FMS as part of the pre and post participation examination for their competitive seasons in 2012. Composite and individual FMS test scores for the preseason and postseason were compared with identified significant changes. The scores were also analyzed for changes in the number of asymmetries present and the frequency of a score of 1 in any of the tests. There were no significant interactions in the main effects for time or sport in the composite FMS scores. However, 4 individual tests did show significant change. The deep squat (Z = -3.260, p = 0.001) and in-line lunge scores (Z = -3.498, p < 0.001) improved across all athletes, and the active straight leg raise (Z = -2.496, p = 0.013) and rotary stability scores (Z = -2.530, p = 0.011) worsened across all athletes. A reduction in the number of asymmetries (χ = 4.258, p = 0.039) and scores of 1 (χ = 26.148, p < 0.001) were also found. Changes in individual fundamental movement patterns occur through the course of a competitive season.

Purpose The all-soft tissue quadriceps tendon (QT) autograft is becoming increasingly popular for ACL reconstruction (ACLR); however, studies reporting strength recovery and early outcomes after QT autograft are limited with patient samples composed of predominantly males. The primary purpose was to characterize early, sex-specific recovery of strength, range of motion (ROM), and knee laxity in a large cohort of patients undergoing primary ACLR with standardized harvest technique of the all-soft tissue QT autograft. The secondary purpose was to examine the influence of demographic factors and clinical measures on 6-month quadriceps strength. Methods Patients 14-25 years who underwent primary, unilateral ACLR with all-soft tissue QT autografts were prospectively followed. Knee laxity and ROM were collected at 6 weeks, 3 and 6 months; while, quadriceps normalized torques and limb symmetry indices (LSI) were collected at 3 and 6 months using isokinetic dynamometry at 60°/s. Two-way ANOVAs with repeated measures were conducted to determine recovery over time and between sexes. Stepwise linear multiple regressions were conducted to determine predictors of 6-month quadriceps strength. Results Three-hundred and twenty patients were included (18 ± 3 years; 156 males:164 females; BMI = 24 ± 4 kg/m 2 ) with no early graft failures within the study period. For strength, there were significant main effects of time (p < 0.001) and sex (p < 0.001), indicating similar improvement from 3 to 6 months with males demonstrating greater quadriceps LSI (6 months: 72.1 vs 63.3%) and normalized strength (6 months: 2.0 vs 1.6 Nm/kg). A significantly higher proportion of females had knee extension ROM deficits ≥ 5° compared to males at 6 weeks (61 vs 39%; p = 0.002). Female sex and 3-month extension ROM deficits were identified as significant predictors of 6-month quadriceps LSI (R 2 = 0.083; p < 0.001). Female sex, BMI, and 6-week extension ROM deficits were identified as significant predictors of 6-month normalized quadriceps strength (R 2 = 0.190; p < 0.001). Conclusions Females had decreased quadriceps strength and greater extension ROM deficits at 3 and 6 months following ACLR using all-soft tissue QT autografts. Female sex, higher BMI, and loss of extension ROM were independent predictors of poorer quadriceps strength at 6 months. There were no early graft failures, and laxity remained within normal ranges for both males and females. Surgeons and rehabilitation clinicians should be aware of the increased risk of postoperative loss of extension ROM in females and its implications on quadriceps strength recovery. Level of evidence III.

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