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Recently there has been a lot of buzz in the fitness industry about a new study showing that 45 minutes on vigorous activity boosts post exercise calorie burning by 190 calories.  Frankly, I think the study was done VERY well, but I think people are taking it to mean more than it does.  I figured I’d do a quick review to share a few of my thoughts.

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In short, the researchers took 10 subjects had each one spend 24 hours in a metabolic chamber on two separate occaisions.

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For the uninitiated, a metabolic chamber is an 8 x 10 foot room with a 7 foot ceiling that is completely sealed for the period in which the subject is studied.  (In other words, if you don’t like enclosed spaces you’d probably freak right the hell out)

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On one occaision the subjects did no physical activity within the chamber other than what was necessary for daily living (washing, brushing teeth, etc).  The rest of the time was spent sitting and no additional activity was permitted.

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On another occaision, the same methods were followed except that subjects performed 45 minutes of exercise at a “vigorous” intensity (75% VO2 max – actually VO2 peak, but that’s just being picky). 

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On both occaisions subjects received meals that were designed to keep them in calorie balance so on the exercise day subjects were fed more food to account for the calories expended from activity.

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The results of this very strictly controlled study showed that when the subjects exercised they burned 514 calories from the exercise bout itself and an additional 190 calories in the post exercise period.

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So what does this study actually tell us?

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This study shows that you’ll burn 190 extra calories after doing vigorous exercise than you would if you did absolutely nothing!

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Mind-friggin’-blowing isn’t it?!?

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I think the researchers did a very good job at answering the question they asked, but I’m not sure the the research is of much relevance to non-researchers (i.e., people who want to lose fat).  I don’t think there is really anything new here.

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Previous research has demonstrated that intensity and duration can both contribute to the post exercise calorie expenditure so this research just reinforces this fact. 

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.And more importantly, does it really matter?

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To illustrate the effects of such a protocol in the real world a training study would have to be conducted to show that fat loss would result as a chronic effect of this protocol.

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But again…you’d be looking at doing nothing versus doing something so I’m pretty sure you wouldn’t be surprised to see that the exercise group might come out on top.

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In summary, exercise versus not exercising DOES result in increased calorie expenditure.  You might even hypothesize (probably correctly) that this would result in greater weight loss over time. 

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Would there be a difference between two exercise intensities if done for the same time with both groups already in a calorie deficit and free living conditions (i.e., not being told to sit down all day in a box)?

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I don’t know the answer to that.  But I’m not holding my breath since exercise really doesn’t tend to result in more weight loss in trials where diet changes are already in place.

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In the end, this study does show we burn more calories when we exercise which is good (not surprising).  But it doesn’t really tell us much more than that.

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Knab AM, Shanely RA, Corbin K, Jin F, Sha W, Nieman DC. A 45-Minute Vigorous Exercise Bout Increases Metabolic Rate for 14 Hours. Med Sci Sports Exerc. 2011 Feb 8. [Epub ahead of print]

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Side Note - I found it interesting that this study actually had two references from Eric Poehlman whose career has come crashing down after admitting to falsifying data in grant applications and several studies.

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If you’d like to review studies like this for yourself, check out my product How to Read Fitness Research.

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As most of my frequent readers know, I’m an avid reader of anything and everything to do with fitness and nutrition.  Today I’d like to share with you some of the stuff I think is worth reading this week.

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1.  Interview with me by Ben Bruno

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In case you missed this last week, my friend and up and coming strength coach Ben Bruno (his blog seriously kicks ass) interviewed me about training, fat loss, mullets, and everything in between.  I think this is possibly my best interview yet.  Check it out HERE.

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2.  High-Intensity Intermittent Exercise and Fat Loss

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You’ve probably heard me ranting (as in the interview above) about the relative usefulness of interval training for fat loss.  Well…just today I recieved the email update from The Journal of Obesity and it featured a great review on the research on Interval Training for fat loss by Dr. Stephen Boutcher.

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His conclusion (for those who don’t feel like reading the whole thing) is as follows:

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“The effects of HIIE on subcutaneous and abdominal fat loss are promising but more studies using overweight individuals need to be carried out. Given that the major reason given for not exercising is time, it is likely that the brevity of HIIE protocols should be appealing to most individuals interested in fat reduction. The optimal intensity and length of the sprint and rest periods together with examination of the benefits of other HIIE modalities need to be established.”

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It should be mentioned that the protocol created by his team that uses 8 second intervals with 12 seconds of rest that I described in THIS ARTICLE appears to be the best researched backed interval method for fat loss that I’ve seen to date.  I still think the results are pretty modest and not worthy of the hype intervals get, but if I’m going to use intervals this is the method of choice…for now at least.

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*Note that this review did not include Dr. Lemon’s latest study which shows similar amounts of fat loss for intervals versus steady state running.  Again…faster, but not necessarily better.

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3.  Factors that may impede the weight loss response to exercise-based interventions

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I’ve said before that exercise is often unable to provide much benefit over and above diet alone for weight loss.  However, it is important to remember that individual differences do apply and it does work for some (men more than women), but not others.  This review talks about these differences and makes recommendations on the use of exercise for weight loss.

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And finally, I want to congratulate Chris Krattiger on winning Mike Boyle’s Functional Strength Coach 3.0 last week.  Chris, I’ll be in touch shortly to get your mailing info.  Everyone else, keep reading.  More stuff to come this week!

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PS: Please feel free to read the articles above and discuss in the comments below.

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A couple weeks back my good friend Tony Gentilcore wrote a post about an article that was published recently called the Workout Enigma.  It talked about a study that showed some people actually became weaker and less fit after a 21 week exercise program.  Needless to say, I had to check this out.

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Today you can check out my full on review on Tony’s blog HERE.

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Also, don’t forget that there is only one day left to pick up your copy of Accelerated Muscular Development at a 20% discount and comment on the post HERE to grab your free copy of Mike Boyles Functional Strength Coach 3.0.

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As many of my readers already know, I have previously reviewed a few of the studies on the Functional Movement Screen including:

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Interrater Reliability of the Functional Movement Screen

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Core strength: A New Model for Injury Prediction and Prevention

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Research Review: Can Serious Injury in Professional Football be Predicted by a Preseason Functional Movement Screen?

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Today I’ve decided to start wrapping up my series by reviewing one final study on the FMS.  Tomorrow I’ll share more comment on the FMS that I think is worth addressing and that will be it for my discussion of the research piece.   However, I’m going to withhold my final thoughts on the system as a whole until I’ve finished reading and absorbing Gray Cook’s new book Movement as I feel this will contribute a lot more to the bigger picture than just reviewing the studies themselves.

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Let’s get to it!

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Functional Movement Test Scores Improve Following a Standardized Off-Season Intervention Program in Professional Football Players

Kiesel K, et al.  Scand J Med Sci Sports, 2009. 

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Background

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Previous research has shown that players scoring lower than a 14 on the FMS were more likely to be injured than those scoring above 14.  However, no studies have assessed whether changes in an individual’s FMS score can be achieved with a training program.

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Purpose

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1)  To determine if an offseason intervention program is effective in improving FMS scores in professional American football players.

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2)  To examine if there was a greater percentage of players above the injury threshold of a score of 14 at the after training than before.

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3)  Because, right and left asymmetry in the FMS has also been related to injury subjects were examined to see if more players were free of asymmetry at the end of the study compared with the beginning of the study.

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4)  To determine if it was possible to predict who would not improve their score above the injury threshold score of 14 using data from the pre-screen.

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Methods

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FMS scores were obtained prior to the start of an off-season training program for 62 professional American football players and each subject was prescribed an individualized training program based on their FMS score.  “Movement preparation” and “corrective exercises” were selected to improve movement scores and decrease assymetries.  After the 7 week training program FMS scores were collected and compared with the scores from prior to training.

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Results

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Linemen and linebackers tended to have slightly lower FMS scores both at the start and end of the study when compared to the other “skill positions” (my words not theirs). 

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As a whole, linemen and other players from ”skill positions” were able to increase their FMS scores from 11.8 to 14.8 and 13.3 to 16.3 respectively. 

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At the start of the study only 7 subjects had a score above the injury threshold of 14 on the FMS.  At the end of the intervention 30 subjects had a score above 14 on the Functional Movement Screen.  Keep in mind that this means that 32 people still failed to improve their FMS score above 14 over the training period.

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Prior to training 31 players were determined to have at least one assymetry on the FMS.  After training only 20 players had a remaining assymetry.

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The only significant predictor of whether a subject failed to improve their score above the injury threshold of 14 on the FMS was a low score on the deep squat.

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Funding

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None declared.

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My Thoughts

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I think there are a few things that need to be addressed when looking at this study, but the main thing that stands out to me is the complete lack of a control group.  Although the football players had some quite impressive improvements in their scores, it is hard to determine whether these were due to the FMS specific interventions, any off-season training program in general, or just becoming more proficient on the tests as a result of repeated practice.

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Moreover, there may have been other treatments (massage, chiropractic, etc) taking place during the same time from so it is possible that these contributed to the improvments in scores.  That is not to say that I don’t think the improvements are there, but I think a control group is one of the most important elements of the study design when evaluating the effectiveness of an intervention.  As a result, the results of this study (while promising) should be taken with a grain of salt until similar results are produced in the presence of a control group.

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The other thing that leaps out at me is that while the FMS score below 14 has been related to an increased risk of injury we must be cautious in interpreting the results of this study as they pertain only to the FMS and not to actual injury risk.  In other words, “It has yet to be determined if prospective improvements in the FMS actually reduce injury risk.”

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I should note that the authors of this study did acknowledge both of the limitations above so perhaps future research that addresses them will turn up eventually.

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Finally, I think it is interesting that the deep squat is such a powerful predictor of success or failure when it comes to reaching a score of 14 on the FMS.  I find this especially interesting because (as far as I know) this is not one of the patterns that is typically immediately addressed with an FMS specific intervention.

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Given the relatively large number of subjects who failed to reach the injury threshold of 14 on the FMS, perhaps this indicates a need for more intensive intervention for those who score low on the deep squat from the very beginning.  I’m also wondering if the lack of improvement in the total score (and assymetry) in some of the players is simply a result of a short intervention. 

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Summing Up

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I think what we can take away from this study as a definite is that FMS scores can be improved and assymetries can be eliminated.  While it is likely that this is due to a specific exercise protocol related to the FMS score, the results of this study should be taken as tentative or hypothesis generating until an intervention trial with a control group is performed.

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Again, I think it is important to reiterate that FMS scores are an injury prevention tool and there is no research yet to suggest that increasing these scores or eliminating assymetries will reduce injury.  I think it is pretty safe to say that this is possible…or even likely…but it certainly isn’t guaranteed. 

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Finally, I think it highlights the need to look at the deep squat when assessing our clients whether we use the FMS or not.  This movement is obviously related to global improvements in movement patterns and it should be carefully investigated if there are any limitations.

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What you you think?

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Speaking of injuries, don’t forget to grab your FREE copy of Mike Robertson’s Bulletproof Knees by dropping a comment on THIS POST before midnight tonight.

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And while you’re here, don’t forget to grab your FREE core audio interviews with Mike and other industry giants like McGill, Myers, Tumminello, and more HERE.

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Every so often I get the question “Mark, how is it that you are such a genius and are  also so incredibly good looking?  It is so damn unfair.”  Okay…I think the question goes more like “What are you reading these days that you think is worth sharing?”

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As you can see, these two questions are almost exactly the same.  In any case, below are a few things I think you should definitely check out.

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1.  Categories of Weight Training

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If you’ve not been following Lyle McDonald’s latest series on types of weight trainining (from depletion, to hypertrophy, to maximum strength) you are absolutely missing out.  Do your self a favor and start HERE to read part 1 and then click your way on through the entire series.  Included in this series is possibly one of the best summaries on training for hypertrophy I’ve seen in a long while and almost completely in line with my own thoughts.

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2.  Hypertrophy Specialist Interview

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Along the same lines, I think you should definitely check out this great article by Bret Contreras where he interviews Brad Schoenfeld about his recent review on hypertrophy in the Journal of Strength and Conditioning Research.  I still don’t agree with the assertion Brad made in his interview about the impact of acute hormone changes on muscle growth, but the rest of the interview is pretty solid.

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3.  Cognitive-Behavioral Strategies to Increase the Adherence to Exercise in the Management of Obesity

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At first glance the title of this article probably makes it look like a snooze-fest, but it is actually one of the best review articles I’ve read on weight loss in a long time.  It comes from the Journal of Obesity (where the articles are free by the way) and it talks about many things relating to success with weight loss and maintenance.

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Trust me when I tell you that if you are trying to lose body fat or help others do so then this article will teach you something.  I personally grabbed a bunch of studies from the references too that I’ll be reading in the near future.

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The big picture though, is that this article reinforces my belief that long term fat loss has less to do with what type of exercise and nutrition plan you use and more to do with the psychosocial factors that help or hinder your consistency in executing whichever plan it is you choose to follow.  If you address these you’re more likely to be successful than if you buy the next fat loss product that comes up on Twitter (which should occur in the next 3.5 seconds).

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4.  Best NEW blog in my RSS Feed

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 Ben Bruno is really smart and his blog always contains some great vids of people training hard and getting it done.   Moreover, this is a great example for young guys just gettting started in this field on blogging of how it is done. 

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If you’re a young coach or trainer start blogging now and build your readership as you learn.  You don’t have to be perfect and you don’t have to pretend to know everything.  Just be humble and share your thoughts as you learn.  Acknowledge when you’re wrong and updating your ideas.

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I waited far too long to launch this blog and feel like I’m finally coming into my own over 10 years into my career.  Don’t do that.  Read Ben’s blog, enjoy the content, then get to work.

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5.  Interview with Tony Gentilcore

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This is a great interview with the funniest man in fitness where he talks at great length about many of the things that make a good trainer…and other things that make trainers like Jillian Michaels suck.  Perhaps more importantly (or at least MY favorite part of the article), Tony mentions me as one of the fitness professionals that people should take notice of.  You hear that Men’s Health?  Huh?  Huh?

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In all seriousness, when guys like Tony take time out to mention me I feel flattered and it is great to know that my work is starting to be appreciated by some of the bigger names in this industry as well.  I almost cried a little tear of excitement.  Almost.

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And that’s it for good reads.  Before you go make sure to drop a comment on yesterday’s post to score yourself some FREE protein.

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Oh…and since I’ll be giving away tons of free stuff over the next couple of months make sure you’re subscribed to my newsletter on the left, my RSS feed, Facebook, and Twitter so you don’t miss out.  You snooze, you lose.

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Recently I’ve undertaken the task of reviewing some of the research on the very popular Functional Movement Screen.  Previously I’ve reviewed the Interrater Reliability of the Functional Movement Screen and Core strength: A New Model for Injury Prediction and Prevention.

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Today I’ll be taking on the 3rd of 4 studies I hope to review.  After the final review I’ll talk a little bit more about my overall impression of the FMS and how I believe it should be used.

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Can Serious Injury in Professional Football be Predicted by a Preseason Functional Movement Screen?

Kiesel K, et al.  North American Journal of Sports Physical Therapy Aug 27, 2:3

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Background

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Risk factors for injuries in high school and collegiate football include previous injury, body mass index, body fat percentage, playing experience, femoral intercondylar notch width, cleat design, playing surface, muscle flexibility, ligamentous laxity, and foot biomechanics.  However, injury risk is likely a combination of many of the above.

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Further, evaluation of isolated risk factors does not take into consideration how the athlete performs functional movement patterns required for sport.  The goal of this study was to examine functional movement scores (assessed by the FMS) and to determine the relationship between professional football players’ score on the FMS and the likelihood of serious injury.

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Methods

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FMS scores were obtained prior to the start of the season for 46 professional football players.  A receiveroperator characteristic curve the FMS score was used to predict injury during one complete football season.  For the sake of this study, injury was defined as membership on the injured reserve for at least 3 weeks.

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A dependent t-test was used to determine if a difference existed between of the FMS scores of those who were injured versus those who were not.

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Sidebar – Definitions

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To have a clear understanding of the methods and the results of this study a brief discussion is needed to definte sensitivity, specificity, and how these are used to create a ROC curve (receiveroperator characteristic curve).

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Sensitivity is basically the power to detect a true positive.  For example, if you were to go through a scanner at the airport to detect for metal it would be very sensitive to decrease the likelihood that someone were able to slip onto an airplane with a weapon.  On the other hand, the scanner doesn’t have very high specificity in that it will sound for almost any piece of metal not just weapons.  In this case, a high sensitivity is most important because it is important that weapons do not sneak aboard the aircraft.

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A dog trained to sniff for narcotics would have a high specificity since only those carrying drugs would need to be stopped.  If the dog didn’t have a high specificity for a specific substance, but was highly sensitive it would possibly alert people needlessly to any scent and make the purpose of having the dog useless (since every bag would have to be checked anyway).

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In a perfect world every test would have 100% sensitivity and 100% specificity (i.e., identifying every weapon at the airport without going off for every other piece of metal), but this is rarely the case.  There is usually a tradeoff between one and the other and the ROC curve plots sensitivity against specificity to determine the ideal cutoff number to use to maximize both.

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With the FMS the the cutoff was chosen using the ROC curve such that the test correctly identifies the greatest number of athletes at risk of injury (true positives) while minimizing incorrectly identifying athletes not at risk of injury (false positives).

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Results

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A score of 14 or less on the FMS was able to predict injury with specificity of 0.91 and sensitivity of 0.54. 

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The test had a very high specificity indicating that the majority of people with a score below 14 had a greater chance of injury.

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Those with a score under 14 that got an injury = 7

Those with a score under 14 that didn’t get an injury = 3

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Unfortunately, the test had a only a moderate sensitivity so it did not detect those with a score over 14 who did experience an injury.

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Those with a score over 14 that got an injury = 6

Those with a score over 14 that didn’t get an injury = 30

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In other words, the bulk of the people with an FMS score over 14 did not get an injury and the bulk of those with a score under 14 did.  Using something called an odds ratio the authors determined that the likelihood of injury was 11 times more likely if the player had a score below 14 on the FMS.

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However, 6 people that did have a score higher than 14 did end up getting injured.  These ones were missed by the screen.  In fact, it failed to identify almost as many people as it did identify as being at risk.

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Funding

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None declared, but I believe at least two of the authors have affiliation with the FMS.  (Not that there is anything wrong with that, but I would declare this as a possible conflict of interest.)

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My Thoughts

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All in all I think that the FMS did a great job of determining that those with a score less than 14 were at risk for injury.  In terms of practical application, these players could have been flagged for specific work with a fitness/rehab professional.  On the other hand, the test wasn’t sensitive enough to detect risk of injury such that 6 athletes slipped through the cracks and ended up being injured without this being detected by the screen.

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Unfortunately, there was no differentiation between the types of injuries that landed people on the reserve list so it is possible that some of the injured athletes suffered from contact injuries that could not have been predicted by any test or screen.  Perhaps if contact injuries were ruled out (since you can’t really test for these) the FMS would have proven to be more sensitive.  Then again, maybe some of those with a score below 14 suffered contact injuries as well.  It would have been interesting to see if the results were different if these types of injuries were excluded.

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It is also possible that one reason the FMS predicted injuries so well below the score cutoff of 14 with this group is because it is the same group whose results were used to create the cutoff in the first place.  Only future research will tell if this pass/fail cutoff is equally as effective for other groups.

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Summing Up

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The FMS indicated correctly that those with a score less than 14 were more prone to injury.  However, the results of the present study indicate that the FMS may also miss equally as many people as it detected (which may be the reason why the pass/fail score for the FMS when it is typically used is actually lower than this).

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It would also have been interesting to see which of the individual scores within the FMS were most related in injury.  Since the FMS typically suggests that side to side imbalances are most important to address, it would have been nice to see this data to see if this hypothesis holds true.

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In the end though, the FMS does appear to effectively predict injury in this below a value of 14 in the group studied.  It does not catch all injuries and as such is not a perfect screen, but effective at picking out some who are at risk.  And since the results are those of professional football players, we should be careful when generalizing them to other populations.

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What do you think?

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The common assertion in strength training literature (I use that term loosely) is that compound movements must be done (and short rest intervals used) to maximize the growth hormone output associated with training to accentuate muscle hypertrophy.

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Today my good friend Bret Contreras posted a guest blog by a really brilliant guy (guess who) investigating this very notion.  You can check it out HERE.

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On a side note, ever since I sent Bret the initial article he keeps sending me emails saying something about how Jamie Eason affects his “Growth Hormone”.  Not really sure what he’s getting at, but I wish he’d keep it to himself. 

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A little while back I posted a review of a study looking at the interrater reliability of the Functional Movement Screen.  Today I’ll be looking at another study on the FMS to further elucidate the research that has been done on this popular system.

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Again, I’m not trying to rip anyone apart here.  I’m primarily looking the the research for my own benefit and in doing so have decided to share it with you.  If you care to read this study for yourself you can get the full text for free at the top right hand of the page HERE.

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Core strength: A New Model for Injury Prediction and Prevention

Peate WF, et al.   Journal of Occupational Medicine and Toxicology 2007, 2:3.

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Background

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Injuries to firefighters are among the highest of all occupations.  Research suggests that decreased core strength may contribute to injuries of the back and extremities, that training may decrease musculoskeletal damage, and that core stability can be tested using functional movement methods.  The purpose of this study was to use the Functional Movement Screen to better assess the risk of firefighter injury due to functional movement performance, and to decrease injuries by using that information.

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Methods Part 1: Screening

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Functional Movement Screen conducted on 433 active firefighters.  Analyzed correlation between FMS scores and data from fire department database including injury history, age, gender, tenure, and rank.

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Methods Part 2: Intervention

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Firefighters underwent 3 hour seminars (actual number attended by each firefighter hard to determine based on the way the study was written) covering causation and prevention of injuries.  During seminars each firefighter demonstrated proper body mechanics in sample work settings and taught how to minimize spinal load during work situations.

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“For example, firefighters were instructed to use an outstretched arm held against a firm surface as a prop to decrease mechanical load on the back when the firefighter’s spine is in lumbar flexion.”

Subjects were taught how to activate their transversus abdominis as well.

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“Participants were shown that muscle’s location in the anterior abdominal wall. Photos of various methods of recruiting and strengthening the TA with written explanations were provided, along with verbal reinforcement of the material.  Once the firefighter demonstrated competency in basic TA muscle tightening, physiotherapy balls and dowels were employed to challenge the firefighter in different positions that mimicked firefighting tasks.”

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Core exercises included three basic models which are similar to hamstring pushups, hamstring pushups with the upper back on a ball (hip thrusts?), and hamstring pushups with the feet on a ball.  Arm movement was added using weights of various amounts.  A detailed explanation of exercise variations, progressions, and how loading was used is lacking in this paper.  There are a few photos, but you’d be hard pressed to repeat this protocol by just reading the article.

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Injuries after one year were compared to injuries in the year previous to the addition of the intervention.

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Results Part 1: Screening

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Increasing age, rank, and tenure was associated with a lower functional movement score using linear regression.  After adjusting for age and using multiple regression, those with a previous injury tended to score an average of 0.24 points lower on the FMS, but this relationship was not significant (p = 0.25).  When the scoring on the FMS was observed as a pass or fail score (for some reason they said a fail was below 16) the odds of failing the FMS after having a previous injury was 1.68 times greater based on multiple logical regression (p= 0.033).
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Results Part 2: Intervention

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Compared to the previous year, lost time due to injuries was reduced by 62%!  The total number of injuries was reduced by 44%.  Injuries to the back and upper extremities were reduced, but injuries to the lower extremities were not reduced by the intervention.
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Funding
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Administration of the Tucson Fire Department
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My Thoughts

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I’ve noticed that this article is frequently used to support the Functional Movement Screen as a tool for screening for injury risk prior to physical activity.  However, when you look at the outcomes, the FMS was only able to determine that the risk of injury increases with age, tenure, and rank (the latter two are also typically related to age).  I don’t think I’m going out on a limb to suggest that most people could have told you this before even running the FMS.

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Although the authors do mention that there was a relationship between FMS score and previous injury based on linear regression, this relationship totally disappeared when corrected for age which appears to the major determinant of injury in this study.  The authors make a point of mentioning that they were indeed related but shy of statistical significance using multiple regression.  However, the p value (a measure of statistical probability) was 0.25 which is a LONG way from statistical significance at 0.05.  I would think it is fair to say that there is pretty much no relationship between FMS and previous injury in this study once you control for age.  Changing the FMS to a pass or fail criterion did make it better for determining risk after an injury.  As was mentioned earlier though, you don’t really need to do this if you just look at age as the primary predictor.
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I have also seen this study referenced to support the idea that the interventions based on the FMS are effective for injury prevention.  Taking a look at the study though, there are a few errors with this assumption.
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- The FMS was conducted at the beginning of the study and there was no follow up testing at the end to determine if there was an improvement in FMS score related to the 62% reduction in lost time due to injury.

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- The intervention had nothing at all to do with the FMS.  Everyone virtually received the same intervention regardless of score on the testing.  I’m no expert, but I’m pretty sure this isn’t how the FMS is supposed to be used.

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- There were other factors within the intervention besides the physical training.  Subjects were taught about injury mechanisms, bracing, and how to move in the work environment.  Personally I agree that this is a great way to intervene to make a larger difference in the safety of the firefighters.  However, from a scientific perspective, it introduces a whole bunch of other variables that could have lead to decreases in injuries that had nothing to do with the FMS.

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- There was no control group.  Injuries were compared to previous years which makes sense from a operations perspective, but when doing a scientific experiment a group not recieving treatment is usually run alongside the group that does.  In this case, it wasn’t done making comparisons in injury rates pretty difficult.  Again, a 62% decrease in lost time is excellent, but it could be due to factors beyond the intervention itself (i.e., less fires this year).
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Summing Up

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At the risk of pissing off a lot of people, I’m going to suggest that the FMS did not play an integral role (actually any role at all) in the improvements seen in this study.  Moreover, age was seen to be the biggest predictor of future injury which could technically be used alone instead of having to run the FMS on such a large group each year.

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As far as the Functional Movement Screen is concerned, the intervention doesn’t really matter because they weren’t really linked in any way.  That said, if you’re a firefighter, you might want to find out what these people are doing because it just may prevent you from experiencing an injury.  If you’re a firefighter and you’re a little older, you might want to consider a good accident benefits plan.

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What do you think?

I have to be honest and say that I was once swept up onto the interval training bandwagon.  But when it comes to fat loss, the research isn’t actually as strong in favor of intervals as you might think.  Check out my review on TMuscle HERE and let me know what you think.

Special thanks to Nate Green for editing my piece and making it look like I know how to write.

No thanks to the haters in the discussion after the article for the unsubstantiated personal attacks.  Damn interwebz.

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Anyone who reads this blog regularly knows that I’m a big fan of assessments prior to training and repeat assessments along the way to ensure results are coming as desired.  Recently though, it seems that the Functional Movement Screen which was created by Lee Burton and Gray Cook has become extremely popular among my colleagues in the fitness industry.

If you’re not familiar with the Functional Movement Screen, here’s a little excerpt from their website describing the system:

“Put simply, the FMS is a ranking and grading system that documents movement patterns that are key to normal function. By screening these patterns, the FMS readily identifies functional limitations and asymmetries. These are issues that can reduce the effects of functional training and physical conditioning and distort body awareness.

The FMS generates the Functional Movement Screen Score, which is used to target problems and track progress. This scoring system is directly linked to the most beneficial corrective exercises to restore mechanically sound movement patterns.

Exercise professionals monitor the FMS score to track progress and to identify those exercises that will be most effective to restore proper movement and build strength in each individual.”

In short, you do 7 movements, get scored, and based on the outcome your potiential issues are identified and your training program can be designed.

 
Being the skeptic I am, I had to consult the research to determine what has and hasn’t been studied about the FMS.  And while I do believe that not everything worth doing is necessarily validated by science (yet), I’m also cautious when I see a pendulum swinging in one direction and when a great number of people are on board. It seems to me that the FMS has been accepted with little discussion as to whether it is valid or not. The more people that jump on board, the less people are apt to question it (especially when those people are big names).

So I’m not saying the FMS isn’t valid or useful or trying to discredit Lee, Gray, or anyone else who uses the system.  The next few posts are simply meant to be an examination of the existing body of scientific study on the FMS.  More to the point, I’ll be reviewing only the peer reviewed studies that have appeared in journals and not the unpublished stuff that is available on the internet (including at least one doctoral dissertation and a couple conference poster presentations).

Without further ado, let’s get to the first study.

Interrater Reliability of the Functional Movement Screen

Minik KI, et al.  J Strength Cond Res. 2010. 24(2): 479-486

While this isn’t actually the first published study on the movement screen, I thought it was important to present this first as it is indicative of the reliability of the scoring.  In a setting where different individuals would be scoring the FMS, you would need for them to be scoring the same way or the tool would be a lot less useful.

Background

To reduce injury risk, sports medicine professionals have begun to focus on improving movement patterns as opposed to focusing on rehabilitation of a specific joint.  The Functional Movement Screen has been put forth as a potential screening tool for these movement patterns.  The goal of this study is to establish interrater reliability of the FMS by comparing expert raters (who took part in the development of the FMS) with novice raters (who have completed the standardized FMS training program).

Methods

Forty students were filmed performing each of the 7 movements in the Functional Movement Screen.  Each of the subjects’ videos were then viewed by two expert and two novice raters and each of the 7 movements was independently scored as a 0, 1, 2, or 3 using the FMS criteria.  The scores were then compared using the weighted Kappa statistic.

Results

The pair of novice raters demonstrated excellent agreement on 6 of the 17 test components, including the deep squat and shoulder mobility tests, and portions of the trunk stability push-up and ASLR tests. Substantial agreement was evident on 8 of the 17 test components. The right and left components of the lunge and the final component of the rotary stability test each demonstrated moderate agreement.

The pair of expert raters varied more in scoring, with excellent agreement on 4 of the 17 test components, including the shoulder mobility test and the final component of the ASLR. Substantial agreement was seen in 9 of the 17 test components. Two components of the lunge and 2 components of the rotary stability tests demonstrated moderate agreement.

When comparing the average scores of the paired novice and expert raters, 14 of the 17 tests demonstrated excellent agreement. Substantial agreement was evident in 1 component of the rotary stability test and 2 components of the in-line lunge.

Funding

University of Evansville Honor’s Program grant and the University of Evansville’s College of Education and Health Science.

My Thoughts

The kappa statistic is actually a good choice in this case because it is fairly conservative and takes into account possible agreement of the raters due to chance.  They also used a weighted kappa which allowed them to rate larger disagreements between the raters less favorably.   However, it should be noted that the categories listed as excellent, substantial, and moderate are pretty aribitrary and are based pretty much on the personal opinions of some other researchers.  Other arbitrary guidelines exist that rate kappa values differently.   I’m not sure how much this really matters in this case, but it is important to note that these ratings aren’t universally accepted.

The most surprising thing to me was that the novice raters tended to have more agreement with each other than the expert raters.  You’d expect that over time your ratings would become more similar than different.  But why did the novice and expert rater’s results tend to agree with each other when they compared them?  My guess is that some of the differences disappeared when they averaged the two novice and two advanced raters before comparing them to each other which could possibly have masked some of the variability.

The authors did suggest that since the tests were only filmed from two angles there was a third dimension missing and this could have influenced the degree of agreement between raters.  Having evaluated people in person, I can definitely see how this could have an impact.  In person you can move around and get a better view of each movement.  Perhaps one reason the expert raters had more disagreement is because they’re more used to looking at movements in three dimensions that novice raters who are less likely to be able to make as much use of this additional information.

All in all, I think the study was fairly well conducted and the results indicate that the scoring of the FMS is relatively reliable.  It did highlight that perhaps work needs to be done to ensure expert raters are scoring similarly.  Another important point to take home is that both sets of raters tended to struggle with agreement on the lunge and rotary stability tests so if you’re using the FMS you might want to pay extra attention when scoring these movements.

I personally would have liked to have seen the same raters score the same subject numerous times to see if the same rater would come up with the same scores each time.  In personal training settings I believe this scenario would be more likely.  Perhaps this could be a route for future investigation.

One final thing I want to mention is that two of the people conducting the study have a personal stake in the outcome since they are involved with the FMS.  This is not to suggest that they would deliberately alter the outcome, but the possibility is always something to be congizant of.  Testing by independent researchers always carries more weight (at least in my mind).

What are your thoughts?