Functional movement screening: the use of fundamental movements as an assessment of function-part 2

Abstract

Part 1 of this two-part series (presented in the June issue of IJSPT) provided an introduction to functional movement screening, as well as the history, background, and a summary of the evidence regarding the reliability of the Functional Movement Screen (FMS™). Part 1 presented three of the seven fundamental movement patterns that comprise the FMS™, and the specific ordinal grading system from 0-3, used in the their scoring. Specifics for scoring each test are presented. Part 2 of this series provides a review of the concepts associated with the analysis of fundamental movement as a screening system for functional movement competency. In addition, the four remaining movements of the FMS™, which complement those described in Part 1, will be presented (to complete the total of seven fundamental movements): Shoulder Mobility, the Active Straight Leg Raise, the Trunk Stability Push-up, and Rotary Stability. The final four patterns are described in detail, and the specifics for scoring each test are presented, as well as the proposed clinical implications for receiving a grade less than a perfect "3". The intent of this two part series is to present the concepts associated with screening of fundamental movements, whether it is the FMS™ system or a different system devised by another clinician. Such a fundamental screen of the movement system should be incorporated into pre-participation screening and return to sport testing in order to determine whether an athlete has the essential movements needed to participate in sports activities at a level of minimum competency. Part 2 concludes with a discussion of the evidence related to functional movement screening, myths related to the FMS™, the future of functional movement screening, and the concept of movement as a system.

Level of evidence: 5.

Keywords: Function; movement screening; movement system.

Figures

Figure 1.

Performance of the shoulder mobility test, scored as a “3”. Note: Fists are within one hand length.

Figure 2.

Performance of the shoulder mobility test, scored as a “2”. Note: Fists are within one and one half hand lengths.

Figure 3.

Performance of the shoulder mobility test, scored as a “1”. Note: Fists are not within one and one half hand lengths.

Figure 4.

Shoulder Clearing test. Perform this clearing test bilaterally. If there is pain associated with this movement, give a score of zero and perform a more detailed examination of the shoulder complex.

Figure 5.

Performance of the active straight leg raise test, scored as a “3”. Note the vertical line of the malleolus of the tested leg resides between the mid‐thigh and the ASIS. The non‐moving limb must remain in neutral position.

Figure 6.

Performance of the active straight leg raise test, scored as a “2”. Note the vertical line of the malleolus of the tested leg resides between the mid‐thigh and the knee joint line. The non‐moving limb must remain in the neutral position.

Figure 7.

Performance of the active straight leg rais test, scored as a “1”. Note the vertical line of the malleolus of the tested leg resides below the knee joint line. The non‐moving leg must remain in the neutral position.

Figure 8.

Performance of the trunk stability pushup test. A. The body lifts as a unit with no lag in the spine. Men perform a repetition with thumbs aligned with the top of the head; women perform a repetition with thumbs aligned with the chin to score a “3”. To score a “2”, the body lifts as a unit with no lag in the spine. B. Men perform a repetition with thumbs aligned with the chin. C. Women perform a repetition with thumbs aligned with the clavicle. D. A score of “1” is given if the subject is unable to perform a repetition (with the body lifting as a unit) in the hand positions in B, men thumbs aligned with the chin; women with the clavicle.

Figure 9.

Spinal extension clearing test. The subject performs a press‐up in from the pushup position. If there is pain associated with this motion, give a score of “0” and conduct a more thorough examination.

Figure 10.

Performance of the rotary stability test, scored as a “3”. The subject performs a correct unilateral repetition. A. Extended position (does not have to be > 6‐8” off the ground). B. Flexed position, elbow and knee must meet. Note: must maintain narrow upper and lower extremity weight bearing over the 2 × 6 board without major weight shift away from the board.

Figure 11.

Performance of the rotary stability test, scored as a “2”. The subject performs a correct diagonal repetition. A. Extended position (does not have to be > 6‐8” off the ground). B. Flexed position, elbow and knee must meet. Note: must maintain narrow upper and lower extremity weight bearing over the 2 × 6 board without major weight shift away from the board.

Figure 12.

Performance of the rotary stability test, scored as a “1”. The subject is unable to perform a diagonal repetition. A. Extended position. B. Flexed position.

Figure 13.

Spinal flexion clearing test. The subject assumes a quadruped position, and then rocks backward, touching the buttocks to the heels and chest to the thighs, reaching the arms out as far as possible. A score of “0” is give if there is any pain associated with this movement, and a more thorough examination should be performed.

Figure 14.

Functional Movement Systems. This diamond‐shaped representation of related functional movement tools demonstrates where the FMS™ fits into the bigger picture of functional assessment. Note that it resides above the horizontal line indicating pain, and below specific performance tests and skill testing, indicating it's role as a screen for movement competency. Of note, below the line indicating pain is the SFMA and impairment‐based examination and assessment.

Figure 15.

The Performance Pyramid. Of note, the lowest level is movement competency, or functional movement, where screening is appropriate. The upper two levels relate to movement capacity.