Warren Meghan, Lininger Monica R, Chimera Nicole J, Smith Craig A
Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ, USA,
Department of Athletic Training, Daemen College, Amherst, NY, USA.
Open Access J Sports Med. 2018 Sep 7;9:171-182. doi: 10.2147/OAJSM.S149139. eCollection 2018.
The Functional Movement Screen (FMS) is a popular movement screen used by rehabilitation, as well as strength and conditioning, professionals. The FMS, like other movement screens, identifies movement dysfunction in those at risk of, but not currently experiencing, signs or symptoms of a musculoskeletal injury. Seven movement patterns comprise the FMS, which was designed to screen fundamental movement requiring a balance between stability and mobility. The 7 movement patterns are summed to a composite FMS score. For an instrument to have wide applicability and acceptability, there must be high levels of reliability, validity, and accuracy. The FMS is certainly a reliable tool, and can be consistently scored within and between raters. Although the FMS has high face and content validity, the criterion validity (discriminant and convergent) is low. Additionally, the FMS does not appear to be studying a single construct, challenging the use of the summed composite FMS score. The accuracy of the FMS in screening for injury is also suspect, with low sensitivity in almost all studies, although specificity is higher. Finally, within the FMS literature, the concepts of prediction and association are conflated, combined with flawed cohort studies, leading to questions about the efficacy of the FMS to screen for injury. Future research on the use of the FMS, either the composite score or the individual movement patterns, to screen for injury or injury risk in adequately powered, well-designed studies are required to determine if the FMS is appropriate for use as a movement screen.
功能动作筛查(FMS)是康复以及力量与体能训练专业人员常用的一种动作筛查方法。与其他动作筛查一样,FMS能够识别有肌肉骨骼损伤风险但目前尚未出现损伤迹象或症状的人群的动作功能障碍。FMS由七种动作模式组成,其设计目的是筛查需要在稳定性和灵活性之间取得平衡的基本动作。这七种动作模式的得分总和即为FMS综合得分。对于一种工具而言,要具有广泛的适用性和可接受性,必须具备高度的可靠性、有效性和准确性。FMS无疑是一种可靠的工具,评分者之间以及评分者内部都能给出一致的分数。尽管FMS具有较高的表面效度和内容效度,但其效标效度(区分效度和聚合效度)较低。此外,FMS似乎并非针对单一结构进行研究,这对FMS综合得分的使用提出了挑战。FMS在筛查损伤方面的准确性也受到质疑,几乎所有研究中的敏感性都较低,尽管特异性较高。最后,在FMS相关文献中,预测和关联的概念相互混淆,再加上队列研究存在缺陷,导致人们对FMS筛查损伤的有效性产生疑问。未来需要开展充分有力、设计良好的研究,探讨使用FMS综合得分或单个动作模式来筛查损伤或损伤风险,以确定FMS是否适合用作动作筛查工具。