Background

The Functional Movement Screen™ (FMS™) is an assessment of human movement that may signal potential deficits that could predispose an otherwise healthy person to injury risk. FMS™ scores are well reported in both athletic and adult samples. However, to date, there has been no comprehensive systematic review and meta-analysis of FMS™ data among school-aged children and adolescents.

Objective

We aimed to systematically review and analyse functional movement proficiency of children and adolescents, specifically when assessed using the FMS™, and to establish initial normative values for the FMS™ in this population group and to further estimate differences in functional movement proficiency between the sexes, by school level (i.e., between primary and secondary school-level children and adolescents), and based on differences in child and adolescent body mass index (BMI).

Methods

In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, prospective studies were identified from searches across eight databases (MEDLINE, SPORTDiscus, CINAHL, Web of Science, EMBASE, ERIC, PsychINFO and PubMed), without any date restrictions, up to December 2020. The primary meta-analysis estimated the overall FMS™ score for school-aged children and adolescents across published studies. An additional three subgroup meta-analyses estimated comparisons for FMS™ data with school level, sex, and BMI across published studies. FMS™ data were meta-analysed using a number of different meta packages (Schwarzer et al. in Meta-Analysis with R, 1st ed, Springer International Publishing, Berlin, 2015), available in R Studio.

Results

A total of 19 articles were included in the systematic review. Meta-analysis revealed a weighted FMS™ mean score of 14.06, with a standardised Tau value of 0.56, signalling a moderate-to-large degree of variability in FMS™ means between studies. The difference in FMS™ means between samples of males (weighted FMS™ mean 13.91) and females (weighted FMS™ mean 14.56) was compatible with a possible small effect size (standardised mean difference − 0.27). The variability in FMS™ means between studies was approximately five times greater in samples of secondary school children (factor difference in Tau values 5.16). The final meta-regression identified a negative association between BMI and FMS™ scores (r = − 0.42), which signalled a moderate-to-large difference in FMS™ scores between healthy weight and overweight children/adolescents.

Conclusion

This systematic review and meta-analysis represents a novel and important synthesis of published FMS™ data from groups of children and adolescents. The study signals possible sex- and age-related differences in FMS™ scores, as well as a clear negative relationship between BMI and functional movement proficiency. More longitudinal research is needed to better understand the developmental trajectory and the effects of maturation milestones on FMS™ proficiency. Additional research is also needed to identify the types of interventions that could improve functional movement proficiency among ‘at risk’ groups, who are susceptible to functional movement deficiency, and whether changes in body composition mediate the relationship between these interventions and the improvement of FMS™ scores.

中文翻译：

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儿童和青少年功能性运动的评估：系统评价和荟萃分析

背景

功能性运动筛查™ (FMS™) 是对人体运动的评估，它可能预示着潜在的缺陷，这些缺陷可能会使原本健康的人容易受到伤害风险。FMS™ 分数在运动和成人样本中都有很好的报道。然而，迄今为止，还没有对学龄儿童和青少年的 FMS™ 数据进行全面的系统评价和荟萃分析。

客观的

我们旨在系统地审查和分析儿童和青少年的功能性运动熟练程度，特别是使用 FMS™ 进行评估时，并为该人群建立 FMS™ 的初始规范值，并进一步估计两性之间功能性运动熟练程度的差异，按学校级别（即小学和中学儿童和青少年之间），并基于儿童和青少年体重指数（BMI）的差异。

方法

根据系统评价和元分析的首选报告项目 (PRISMA) 指南，前瞻性研究是从八个数据库（MEDLINE、SPORTDiscus、CINAHL、Web of Science、EMBASE、ERIC、PsychINFO 和 PubMed）的搜索中确定的，没有任何日期限制，截至 2020 年 12 月。主要荟萃分析估计了已发表研究中学龄儿童和青少年的 FMS™ 总体得分。另外三个亚组荟萃分析估计了 ​​FMS™ 数据与已发表研究的学校水平、性别和 BMI 的比较。使用 R Studio 中提供的许多不同的元数据包（Schwarzer 等人在 Meta-Analysis with R，第 1 版，Springer International Publishing，柏林，2015 年）对 FMS™ 数据进行了元分析。

结果

系统评价共纳入 19 篇文章。荟萃分析显示加权 FMS™ 平均得分为 14.06，标准化Tau值为 0.56，表明研究之间 FMS™ 均值存在中度至大程度的变异性。男性样本（加权 FMS™ 平均值 13.91）和女性样本（加权 FMS™ 平均值 14.56）之间的 FMS™ 平均值差异与可能的小效应量（标准化平均差 - 0.27）相符。在中学生样本中，研究之间 FMS™ 平均值的变异性大约是五倍（Tau值的因子差异为 5.16）。最终的元回归确定了 BMI 和 FMS™ 分数之间的负相关（r = − 0.42)，这表明健康体重和超重儿童/青少年之间的 FMS™ 评分存在中到大的差异。

结论

该系统回顾和荟萃分析代表了对来自儿童和青少年群体的已发表 FMS™ 数据的新颖而重要的综合。该研究表明 FMS™ 评分中可能存在与性别和年龄相关的差异，以及 BMI 与功能性运动能力之间的明显负相关关系。需要更多的纵向研究来更好地了解发育轨迹和成熟里程碑对 FMS™ 熟练度的影响。还需要进一步的研究来确定可以提高“高危”人群（易受功能性运动缺陷影响）的功能性运动熟练程度的干预类型，以及身体成分的变化是否调节这些干预与 FMS™ 改善之间的关系分数。