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Paige Guild, Monica R. Lininger, and Meghan Warren

Clinical Scenario: Female college student-athletes (SA) often experience time loss from musculoskeletal injuries to the lower extremities. This can lead to lengthy rehabilitation, expensive medical bills, and declines in health-related quality of life. Identifying at-risk athletes prior to the start of an athletic season may allow coaches or athletic trainers to prescribe an injury prevention program. Clinical Question: In female college SA, are preseason single leg hop (SLH) scores associated with identifying those at risk for lower-extremity musculoskeletal injuries? Summary of Key Findings: Five prospective cohort studies in female SA scored athletes on the SLH prior to the start of the athletic sport season. One of 5 studies found an association of SLH with injury risk. An additional 2 studies found that the SLH as part of a battery of functional performance tests was associated with injury risk in some anatomic locations (eg, thigh/knee), but not overall injury risk. Clinical Bottom Line: Methodological limitations of the reviewed studies limits a final conclusion, and there is insufficient evidence to determine if the SLH should be used as a sole functional performance test to identify at-risk female SA; it may be useful as part of a battery of functional performance tests for female college SA. Strength of Recommendation: All studies were prospective cohort studies (level 3).

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Meghan Warren, Craig A. Smith, and Nicole J. Chimera


The Functional Movement Screen (FMS) evaluates performance in 7 fundamental movement patterns using a 4-point scale. Previous studies have reported increased injury risk with a composite score (CS) of 14/21 or less; these studies were limited to specific sports and injury definition.


To examine the association between FMS CS and movement pattern scores and acute noncontact and overuse musculoskeletal injuries in division I college athletes. An exploratory objective was to assess the association between injury and FMS movement pattern asymmetry.


Prospective cohort.


College athletic facilities.


167 injury-free, college basketball, football, volleyball, cross country, track and field, swimming/diving, soccer, golf, and tennis athletes (males = 89).


The FMS was administered during preparticipation examination.

Main Outcome Measure:

Noncontact or overuse injuries that required intervention from the athletic trainer during the sport season.


FMS CS was not different between those injured (n = 74; 14.3 ± 2.5) and those not (14.1 ± 2.4; P = .57). No point on the ROC curve maximized sensitivity and specificity; therefore previously published cut-point was used for analysis with injury (≤14 [n = 92]). After adjustment, no statistically significant association between FMS CS and injury (odds ratio [OR] = 1.01, 95% CI 0.53–1.91) existed. Lunge was the only movement pattern that was associated with injury; those scoring 2 were less likely to have an injury vs those who scored 3 (OR = 0.21, 95% CI 0.08–0.59). There was also no association between FMS movement pattern asymmetry and injury.


FMS CS, movement patterns, and asymmetry were poor predictors of noncontact and overuse injury in this cohort of division I athletes.

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Nicole J. Chimera, Monica R. Lininger, and Meghan Warren

Clinical Question: Can text message be used for epidemiologic data collection and accurate injury reporting in recreational and club sport participation? Clinical Bottom Line: Text message may be advantageous for injury surveillance in recreational exercise and club sport participation. This novel method may provide a more complete understanding of injury rates as this tool allows for more immediate recall of injury exposures and incidences. Further, data suggest that injuries are reported more often via text message compared to those reported to health care personnel.

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Margaret Delaney, Meghan Warren, Brian Kinslow, Hendrik de Heer, and Kathleen Ganley

Disability is a tremendous public health challenge. No study has assessed whether meeting U.S. Physical Activity guidelines is associated with disability in mobility tasks, activities of daily living, and social participation among U.S. older adults. Using 2011–2016 National Health and Nutrition Examination Survey data, this study examined this relationship among 8,309 individuals aged ≥50 years. Most participants (n = 4,272) did not achieve guidelines, and 2,912 participants were completely inactive. People who did not meet guidelines had higher odds of disability compared with those who did (adjusted odds ratio [AOR] = 1.80) in addition to difficulty with mobility tasks (AOR = 1.85), activities of daily living (AOR = 1.66), and social participation (AOR = 2.09). There was a dose–response effect for each level of activity (inactive, insufficient, and meeting and exceeding recommendations). Among adults aged ≥50 years, meeting the U.S. guidelines was associated with better social and physical functioning.

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Michael D. McAdie, Monica R. Lininger, and Meghan Warren

Focused Clinical Question: In an individual who is physically active in recreation or sport, can the tuck jump assessment be reliably scored? Clinical Bottom Line: Current evidence regarding the reliability of the original tuck jump assessment and modified tuck jump assessment are conflicting.

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Ricky Camplain, Julie A. Baldwin, Meghan Warren, Carolyn Camplain, Monica R. Lininger, and Robert T. Trotter

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Nicole J. Chimera, Monica R. Lininger, Bethany Hudson, Christopher Kendall, Lindsay Plucknette, Timothy Szalkowski, and Meghan Warren

A novel technique of short message service (SMS), or text message, has examined injuries in elite handball and female football and community Australian football with a response rate of over 75%. The purpose of this study was to determine if text message is a feasible method of prospectively collecting injury density data in club sports teams in the United States. Participants received a weekly text message with four questions asking about pain and participation in the past week. If the participant indicated pain in the past week, a follow-up phone interview was conducted to determine the nature of the pain/injury. The overall text message response rate was 89.8%; there were 281 responses out of 313 participant contacts over the 12-week study period. Semi-structured follow-up phone interviews were completed for 37 of the 55 reports of pain that were indicated through text message response, resulting in further injury information for 65.5% of injuries. Incidence density of reporting pain over the 12-week study was 0.88 (95% CI: 0.68–1.15) per 1,000 min of activity. In this sample, text message response rates were similar to previous studies; however, we did lose nine (25.7%) participants to follow-up.