Fitness screening, also known as the Functional Movement Screen (FMS), are gaining wider usage and popularity among personal trainers. It is used to identify potential injury risks in clients and athletes and gives trainers some feedback to decide what exercise methods they should use. Proponents of movement screens claim that these methods can help reduce the risk of injury and movement dysfunction while critics question the validity and effectiveness of such claims. Does the screen really work? Or are they just a way for gyms and trainers to make an extra buck? Before people flock to their nearest gym or trainer to get assessed, there are a few things every client should know about the movement screen.
In a FMS test, clients go through a series of seven movement patterns that look at how well they move. These patterns include the deep squat, hurdle step, lunge, shoulder mobility, press-up, single-leg raise, and rotary stability. Based on a scoring system, trainers can determine how well their clients move and what interventions they can use as part of their exercise program.
Exercise physiologist Anoop Balachandran, M.Sc., criticized that the FMS labels people, which make clients who score below average on the screen “to move less or have fear of movement.” They may spend more time and fork over more money trying to fix the problem — which may or may not exist — with their trainer. Balachandran states that there is little evidence that the FMS can help reduce the risk of injuries or enhance movement among the general, non-athletic population. However, Lee Burton, Ph.D., one of the founders of FMS, agreed that the screening may not likely work for the layperson. Based on the current research available, however, the FMS does work for special populations who perform specific activities, such as military personnel and firefighters.
Fitness professional Bret Contreras, C.S.C.S., did a thorough review on the Functional Movement Screen, which is something every trainer, coach, and client should know. Based on dozens of science-based evidence and scientific research, the FMS does have its merits and flaws.
1. Is it reliable?
For any test, screen, or system to be reliable, it must be able to be repeated either by different people at the same time (inter-rater) or by the same person at a slightly different time (intra-rater), according to Contreras. He reviewed 14 studies that examined how well professionals interpret and rate subjects perform the movement screen. In one of these studies that was published in the April 2013 issue of Journal of Strength and Conditioning Research, it showed that professionals with more clinical experience had a more accurate interpretation than those with less experience. Among the 14 studies, 13 reported on inter-rater reliability and eight reported on the intra-rater ability. Out of those 13 studies, only one study had a less-than-average reliability. Thus, the FMS probably has some degree reliability in most populations, Contreras concluded.
2. Is it valid?
For a test to be valid, it must measure what it is designed and intended to do. For example, the SAT tests math and reading aptitude, not driving ability. Contreras reviewed five studies that reflected the FMS’s purpose of identifying compensation movement patterns in sports and specific activities. These five studies had inconsistent results when comparing the test results and the outcome of the subjects’ performance. For example, in a study among 877 male and 57 female Marine Officer Candidates, researchers found that the FMS components had a weak correlation with one another and the results did not support the validity of the FMS total scores. Contreras concluded that the FMS’s validity should be “call into question.”
3. Does it really predict the risk of injury and athletic performance?
In terms of predicting the risk on injury among fitness enthusiasts and athletes, maybe. Among 11 studies that compared subjects’ score on the FMS and injury risks, four studies failed to find evidence suggesting that the FMS can predict injuries. According to Contreras, in the remaining seven studies, the relative risk was between 1.65 – 11.67 times. However, in the performance realm, the FMS may be treading murky waters. Eight studies had assessed the correlations between athletic performance and the FMS scores, and only two (one is unpublished, the other is a conference abstract) showed any correlation between the two variables. Based on these evidence, it is somewhat likely that the FMS may be able to identify those with higher or lower risks of injury. However, anyone who claims that having high FMS scores can improve athletic performance or having low FMS scores have a higher risk of injury should be taken with a grain a salt.
Fitness trainers should know that the Functional Movement Screen is not the Holy Grail to solving every clients’ problems. Recognizing the screen’s intentions and limitations can help both the trainer and the client find the best tool or system to solve a problem. Registered massage therapist Paul Ingraham, who wrote a review of the FMS, wrote that FMS is not proven nor is it disproved, and “it is resting on a number of questionable and untested assumptions.”
By Nick Ng