It’s not ‘who’ but ‘how badly’: The association of Functional Movement Screen with injury outcome in community rugby union

Abstract

Background: The use of the Functional Movement Screen (FMS) is widespread, but evidence supporting its use as an injury-screening tool in team sports such as Rugby Union is equivocal.

Objective: To determine the association between FMS score and match-injury incidence and match-injury burden in adult community rugby union players.

Design: Prospective cohort study.

Setting: English community rugby union clubs (2013-2014 season) with a formally qualified medical professional to diagnose and report match-injuries. FMS testing was completed during the pre-season period by the research team.

Participants: 436 players from 23 clubs completed the FMS. Match-injuries and individuals’ match exposure data was returned for 293 players.

Risk Factors: Lower FMS composite score (21 point maximum), the presence of pain and/or asymmetry.

Main Outcome Measurements: Association of FMS composite score, pain and asymmetry with match injury incidence (≥8days time-loss/1000hours) severe injury incidence (>28 days time-loss/1000hours) and injury burden (total time-loss days/1000hours).

Results: Poisson regression was offset for exposure (log transformed) and adjusted for random effects of club (cluster) and player. The associations between both match-injury incidence (≥8days time-loss)(rate ratio (RR), 90% confidence interval (CI) = 1.0, 0.9-1.0) and severe injury incidence (>28 days time-loss) (RR, 90%CI = 0.9, 0.8-1.0) with composite FMS score were trivial. A one-point increase in FMS score was associated with a 10% reduction in injury burden (RR, 90%CI = 0.9, 0.8-1.0), while the presence of both pain and asymmetry was associated with a three times increase in injury burden (RR, 90%CI = 2.9, 1.1 – 7.8).

Conclusions: FMS score was not associated with injury incidence, but was associated with injury burden. As the strongest association with injury burden was found for pain and asymmetry, clubs using the FMS may be advised to prioritise rehabilitation of players with asymmetrical, painful movement patterns.