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Dimitrios-Sokratis Komaris, Cheral Govind, Andrew Murphy, Alistair Ewen and Philip Riches

Patients with osteoarthritis of the knee commonly alter their movement to compensate for lower limb weakness and alleviate joint pain. Movement alterations may lead to weight-bearing asymmetries, and potentially to the progression of the disease. This study presents a novel numerical procedure for the identification of sit-to-walk strategies and differences in movement habits between control adults and persons with knee osteoarthritis. Ten control and 12 participants with osteoarthritis performed the sit-to-walk task in a motion capture laboratory. Participants sat on a stool with the height adjusted to 100% of their knee height, then stood and walked to pick up an object from a table in front of them. Different movement strategies were identified by means of hierarchical clustering. Trials were also classified as to whether the left and right extremities used a bilateral or an asymmetrical strategy. Participants with osteoarthritis used significantly more asymmetrical arm strategies (P = .03) while adopting the pushing through the chair strategy more often than the control subjects (P = .02). The results demonstrated that the 2 groups favor different sit-to-walk strategies. Asymmetrical arm behavior possibly indicates a compensation for the weakness of the affected leg. The proposed procedure may be useful to rapidly assess postoperative outcomes and developing rehabilitation strategies.

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Constantine P. Nicolozakes, Daniel K. Schneider, Benjamin D. Roewer, James R. Borchers and Timothy E. Hewett

accurately predict football-related injuries are an important step toward identifying factors that may reduce injury risk. The functional movement screen (FMS™) is a screening method that was developed to identify movement asymmetries and deficiencies using fundamental exercises to assess the whole

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Lindsay M. Minthorn, Shirleeah D. Fayson, Lisa M. Stobierski, Cailee E. Welch and Barton E. Anderson

Clinical Scenario:

Appropriate movement patterns during sports and physical activities are important for both athletic performance and injury prevention. The assessment of movement dysfunction can assist clinicians in implementing appropriate rehabilitation programs after injury, as well as developing injury-prevention plans. No gold standard test exists for the evaluation of movement capacity; however, the Functional Movement Screen (FMS) has been recommended as a tool to screen for movement-pattern limitations and side-to-side movement asymmetries. Limited research has suggested that movement limitations and asymmetries may be linked to increased risk for injury. While this line of research is continuing to evolve, the use of the FMS to measure movement capacity and the development of intervention programs to improve movement patterns has become popular. Recently, additional research examining changes in movement patterns after standardized intervention programs has emerged.

Clinical Question:

Does an individualized training program improve movement patterns in adults who participate in high-intensity activities?

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Kyle B. Kiesel, Robert J. Butler and Philip J. Plisky


Previous injury is the strongest risk factor for future injury in sports. It has been proposed that motor-control changes such as movement limitation and asymmetry associated with injury and pain may be perpetuated as part of an individual's movement strategy. Motor control of fundamental 1-×-body-weight tasks can reliably and efficiently be measured in the field.


To determine whether the motor control of fundamental movement patterns and pattern asymmetry have a relationship with time-loss injury over the course of the preseason in professional football.


Injury-risk study.


American professional football facilities.


238 American professional football players.


To measure the motor control of 1-×-body-weight fundamental movement patterns, Functional Movement Screen scores were obtained before the start of training camp. The previously established cutoff score of ≤14 and the presence of any asymmetries on the FMS were examined using relative risk to determine if a relationship exists with time-loss injury.

Main Outcome Measure:

Time-loss musculoskeletal injury defined as any time loss from practice or competition due to musculoskeletal injury.


Players who scored ≤14 exhibited a relative risk of 1.87 (CI95 1.20–2.96). Similarly, players with at least 1 asymmetry displayed a relative risk of 1.80 (CI95 1.11–2.74). The combination of scoring below the threshold and exhibiting a movement asymmetry was highly specific for injury, with a specificity of .87 (CI95 .84–.90).


The results of this study suggest that fundamental movement patterns and pattern asymmetry are identifiable risk factors for time-loss injury during the preseason in professional football players.

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Marlene Schoeman, Ceri E. Diss and Siobhan C. Strike

A unilateral transtibial amputation causes a disruption to the musculoskeletal system, which results in asymmetrical biomechanics. The current study aimed to assess the movement asymmetry and compensations that occur as a consequence of an amputation when performing a countermovement vertical jump. Six unilateral transtibial amputees and 10 able-bodied (AB) participants completed 10 maximal vertical jumps, and the highest jump was analyzed further. Three-dimensional lower limb kinematics and normalized (body mass) kinetic variables were quantified for the intact and prosthetic sides. Symmetry was assessed through the symmetry index (SI) for each individual and statistically using the Mann-Whitney U test between the intact and prosthetic sides for the amputee group. A descriptive analysis between the amputee and AB participants was conducted to explore the mechanisms of amputee jumping. The amputee jump height ranged from 0.09 to 0.24 m. In the countermovement, all ankle variables were asymmetrical (SI > 10%) and statistically different (p < .05) for the amputees. At the knee and hip, there was no statistical difference between the intact and prosthetic sides range of motion, although there was evidence of individual asymmetry. The knees remained more extended compared with the AB participants to prevent collapse. In propulsion, the prosthesis did not contribute to the work done and the ankle variables were asymmetrical (p < .05). The knee and hip variables were not statistically different between the intact and prosthetic sides, although there was evidence of functional asymmetry and the contribution tended to be greater on the intact compared with the prosthetic side. The lack of kinetic involvement of the prosthetic ankle and both knees due to the limitation of the prosthesis and the altered musculoskeletal mechanics of the joints were the reason for the reduced height jumped.

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Robert F. Chapman, Abigail S. Laymon and Todd Arnold

Subjects with scores on the Functional Movement Screen (FMS) assessment of ≤14 or with at least 1 bilateral asymmetry have been shown to have greater future injury incidence than subjects with FMS scores >14 or no movement asymmetries.


To determine if FMS injury risk factors extend to longitudinal competitive performance outcomes in elite track and field athletes.


Elite track and field athletes were examined (N = 121), each completing an FMS before the 2011 competitive season. Best competition marks for the year were obtained from athletes’ actual performances for 2010 and 2011. Performance change between 2010 and 2011 was examined in cohorts of FMS scores ≤14 (LoFMS) vs >14 (HiFMS), athletes with bilateral asymmetry in at least 1 of the 5 FMS movements vs athletes with no asymmetry, and athletes who scored 1 on the deep-squat movement vs athletes who scored 2 or 3.


HiFMS had a significantly different change in performance from 2010 to 2011 (0.41% ± 2.50%, n = 80) compared with LoFMS (−0.51% ± 2.30%, P = .03, n = 41). Athletes with no asymmetries had a longitudinal improvement in performance (+0.60% ± 2.86%, n = 50) compared with athletes with at least 1 asymmetry (−0.26% ± 2.10%, P = .03, n = 71). Athletes who scored 1 on the deep-squat movement had a significantly different change in performance (−1.07 ± 2.08%, n = 22) vs athletes who scored 2 (0.13% ± 2.28%, P = .03, n = 87) or 3 (1.98% ± 3.31%, P = .001, n = 12).


Functional movement ability, known to be associated with the likelihood of future injury, is also related to the ability to improve longitudinal competitive performance outcomes.

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Cherice N. Hughes-Oliver, Kathryn A. Harrison, D.S. Blaise Williams III and Robin M. Queen

up to 29% of all patients with ACLR suffering a second tear. Moreover, there is a 15 times greater likelihood of sustaining an ACL tear in a patient with ACLR when compared with a noninjured group. 40 Previous work in patients with ACLR has also demonstrated that both loading and movement asymmetry

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Alex T. Strauss, Austin J. Parr, Daniel J. Desmond, Ashmel T. Vargas and Russell T. Baker

screens in physically active populations. 9 – 12 The Functional Movement Screen (FMS ™ ) is a screening system designed to assess stability and mobility within full-body movements while identifying movement asymmetries and evaluating overall movement quality. 8 , 13 The FMS ™ may be used as a general

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Tsuyoshi Saida, Masayuki Kawada, Daijiro Kuroki, Yuki Nakai, Takasuke Miyazaki, Ryoji Kiyama and Yasuhiro Tsuneyoshi

severity, toe out angle and pain . Journal of Orthopaedic Research, 20 ( 1 ), 101 – 107 . PubMed ID: 11853076 doi: 10.1016/S0736-0266(01)00081-X Iijima , H. , Eguchi , R. , Aoyama , T. , & Takahashi , M. ( 2019 ). Trunk movement asymmetry associated with pain, disability, and quadriceps

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Zakariya Nawasreh, David Logerstedt, Adam Marmon and Lynn Snyder-Mackler

Rupturing the anterior cruciate ligament (ACL) is a common knee injury in sport activities. 1 Repeated episodes of knee instability, joint effusion, quadriceps strength deficits, limb-to-limb movement asymmetry, neuromuscular dysfunction, and abnormal gait pattern are commonplace after ACL rupture