Predicting sport and occupational lower extremity injury risk through movement quality screening: a systematic review

• Published in: British journal of sports medicine Vol. 51; no. 7; pp. 580 - 585
• Main Authors: Whittaker, Jackie L, Booysen, Nadine, de la Motte, Sarah, Dennett, Liz, Lewis, Cara L, Wilson, Dave, McKay, Carly, Warner, Martin, Padua, Darin, Emery, Carolyn A, Stokes, Maria
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.04.2017
• Subjects: Arthritis; Athletes; Athletic Injuries - diagnosis; Colleges & universities; Health sciences; Humans; Injury prevention; Leg Injuries - diagnosis; Medical Subject Headings-MeSH; Military Personnel; Movement; Quality; Risk Factors; Sports; Lower extremity; Functional movement screen; Injuries; Risk factor
• ISSN: 0306-3674; 1473-0480; 1473-0480
• DOI: 10.1136/bjsports-2016-096760

BackgroundIdentification of risk factors for lower extremity (LE) injury in sport and military/first-responder occupations is required to inform injury prevention strategies.ObjectiveTo determine if poor movement quality is associated with LE injury in sport and military/first-responder occupations.Materials and methods5 electronic databases were systematically searched. Studies selected included original data; analytic design; movement quality outcome (qualitative rating of functional compensation, asymmetry, impairment or efficiency of movement control); LE injury sustained with sport or military/first-responder occupation. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. 2 independent authors assessed the quality (Downs and Black (DB) criteria) and level of evidence (Oxford Centre of Evidence-Based Medicine model).ResultsOf 4361 potential studies, 17 were included. The majority were low-quality cohort studies (level 4 evidence). Median DB score was 11/33 (range 3–15). Heterogeneity in methodology and injury definition precluded meta-analyses. The Functional Movement Screen was the most common outcome investigated (15/17 studies). 4 studies considered inter-relationships between risk factors, 7 reported diagnostic accuracy and none tested an intervention programme targeting individuals identified as high risk. There is inconsistent evidence that poor movement quality is associated with increased risk of LE injury in sport and military/first-responder occupations.ConclusionsFuture research should focus on high-quality cohort studies to identify the most relevant movement quality outcomes for predicting injury risk followed by developing and evaluating preparticipation screening and LE injury prevention programmes through high-quality randomised controlled trials targeting individuals at greater risk of injury based on screening tests with validated test properties.