Slow RT was associated with increased injury risk, and combining poor RT and low FMS scores significantly increased the injury predictive value. Additional research is warranted to further clarify what combination of PFT and FMS tests are most suitable for predicting injuries.
Functional movement screening (FMS) is a musculoskeletal assessment that is intended to fill a gap between preparticipation examinations and performance tests. Functional movement screening consists of 7 standardized movements involving multiple muscle groups that are rated 0-3 during performance; scores are combined into a final score, which is intended to predict injury risk. This use of a sum-score in this manner assumes that the items are unidimensional and scores are internally consistent, which are measures of internal reliability. Despite research into the FMS' predictive value and interrater reliability, research has not assessed its psychometric properties. The present study is a standard psychometric analysis of the FMS and is the first to assess the internal consistency and factor structure of the FMS, using Cronbach's alpha and exploratory factor analysis (EFA). Using a cohort of 877 male and 57 female Marine officer candidates who performed the FMS, EFA of polychoric correlations with varimax rotation was conducted to explore the structure of the FMS. Tests were repeated on the original scores, which integrated feelings of pain during movement (0-3), and then on scores discounting the pain instruction and based only on the performance (1-3), to determine whether pain ratings affected the factor structure. The average FMS score was 16.7 ± 1.8. Cronbach's alpha was 0.39. Exploratory factor analysis availed 2 components accounting for 21 and 17% and consisting of separate individual movements (shoulder mobility and deep squat, respectively). Analysis on scores discounting pain showed similar results. The factor structures were not interpretable, and the low Cronbach's alpha suggests a lack of internal consistency in FMS sum scores. Results do not offer support for validity of the FMS sum score as a unidimensional construct. In the absence of additional psychometric research, caution is warranted when using the FMS sum score.
This study investigated associations between heat intolerance, as determined by performance on a heat tolerance test (HTT), and anthropometric measurements (body surface-to-mass ratio, percent body fat, body mass index, and waist circumference) and cardiorespiratory fitness (maximal oxygen uptake [VO2max]). Relationships between predictive variables and specific physiological measurements recorded during the HTT were examined. A total of 34 male and 12 female participants, recruited from the military community, underwent anthropometric measurements, a maximal aerobic exercise test, and a standardized HTT, which consisted of walking on a treadmill at 5 km/h at 2% grade for 120 minutes at 40°C and 40% relative humidity. VO2max negatively correlated with maximum core temperature (r = -0.30, p < 0.05) and heart rate (HR) (r = -0.48, p < 0.01) although percent body fat showed a positive correlation with maximum HR (r = 0.36, p < 0.05). VO2max was the only independent attribute that significantly influenced both the maximum HR and core temperature attained during HTT. Logistic regression analyses indicated that VO2max was the only independent parameter (OR = 0.89, p = 0.026) that significantly contributed to overall HTT performance. Low cardiorespiratory fitness was associated with heat intolerance, as defined by HTT performance, and can be addressed as a preventative measure for exertional heat illness. This study provides further evidence that the HTT can be an effective tool for assessment of thermoregulatory patterns.
We performed a systematic review and evaluation of the existing scientific literature on the association between flexibility, power, speed, balance, and agility, and musculoskeletal injury (MSK-I) risk in military and civilian populations. MEDLINE, EBSCO, EMBASE, and the Defense Technical Information Center were searched for original studies published from 1970 through 2015 that examined associations between these physical fitness measures (flexibility, power, speed, balance, and agility) and MSK-I. Methodological quality and strength of the evidence were determined following criteria adapted from previously published systematic reviews. Twenty-seven of 4,229 citations met our inclusion criteria. Primary findings indicate there is (a) moderate evidence that hamstring flexibility, as measured by performance on a sit-and-reach test or active straight-leg raise test assessed with goniometry, and ankle flexibility, assessed with goniometry, are associated with MSK-I risk; (b) moderate evidence that lower body power, as measured by performance on a standing broad jump or vertical jump with no countermovement, is associated with MSK-I risk; (c) moderate evidence that slow sprint speed is associated with MSK-I risk; (d) moderate evidence that poor performance on a single-leg balance test is associated with increased risk for ankle sprain; and (e) insufficient evidence that agility is associated with MSK-I risk. Several measures of flexibility, power, speed, and balance are risk factors for training-related MSK-I in military and civilian athletic populations. Importantly, these findings can be useful for military, first responder, and athletic communities who are seeking evidence-based metrics for assessing or stratifying populations for risk of MSK-I.
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