INTEGRATION OF THE FUNCTIONAL MOVEMENT SCREEN
INTO THE NATIONAL HOCKEY LEAGUE COMBINE
CHIP P. ROWAN,1 CHRISTIANE KUROPKAT,2 ROBERT J. GUMIENIAK,1 NORMAN GLEDHILL,1
VERONICA K. JAMNIK1
AND
1
Human Performance Laboratory, School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada; and
SportClinic Zurich, Zurich, Switzerland
2
ABSTRACT
Rowan, CP, Kuropkat, C, Gumieniak, RJ, Gledhill, N, and
Jamnik, VK. Integration of the Functional Movement Screen into
the National Hockey League Combine. J Strength Cond Res 29
(5): 1163–1171, 2015—The sport of ice hockey requires coordination of complex skills involving musculoskeletal and physiological abilities while simultaneously exposing players to a high risk
for injury. The Functional Movement Screen (FMS) was developed
to assess fundamental movement patterns that underlie both sport
performance and injury risk. The top 111 elite junior hockey players from around the world took part in the 2013 National Hockey
League Entry Draft Combine (NHL Combine). The FMS was integrated into the comprehensive medical and physiological fitness
evaluations at the request of strength and conditioning coaches
with affiliations to NHL teams. The inclusion of the FMS aimed to
help develop strategies that could maximize its utility among elite
hockey players and to encourage or inform further research in this
field. This study evaluated the outcomes of integrating the FMS
into the NHL Combine and identified any links to other medical
plus physical and physiological fitness assessment outcomes.
These potential associations may provide valuable information to
identify elements of future training programs that are individualized
to athletes’ specific needs. The results of the FMS (total score and
number of asymmetries identified) were significantly correlated to
various body composition measures, aerobic and anaerobic fitness, leg power, timing of recent workouts, and the presence of
lingering injury at the time of the NHL Combine. Although statistically significant correlations were observed, the implications of
the FMS assessment outcomes remain difficult to quantify until
ongoing assessment of FMS patterns, tracking of injuries, and
hockey performance are available.
KEY WORDS FMS, hockey performance, injury prevention,
sports medicine, fitness assessment
Address correspondence to Chip P. Rowan, [email protected].
29(5)/1163–1171
Journal of Strength and Conditioning Research
Ó 2015 National Strength and Conditioning Association
INTRODUCTION
A
thletic performance in professional sport is widely
followed and highly researched. The majority of
research in this area has been focused on optimizing the physical and physiological performance
capacities of competitive athletes while minimizing adverse
events that may lead to missed training and performance/
playing time. The Functional Movement Screen (FMS) was
developed as a whole-body assessment of fundamental
movement patterns that encompass the basis for athletic
movements and sport performance (4,5). The FMS was
the result of a paradigm shift among movement specialists,
therapists, qualified exercise professionals, and strength and
conditioning professionals toward a more “functional”
approach to identifying deficiencies that could prevent injuries associated with improper exercise execution, physical
asymmetries, injury rehabilitation, and physical fitness training (4,5).
The FMS consists of 7 different movements that are each
scored on a scale of 0–3, and 2 of these movements also
include specific pain clearance tests. The FMS protocols
were developed to collectively provide a tool to assess
dynamic movement using the concepts of kinetic chain
systems and proprioception (4,5). The FMS is ideally suited
to be incorporated into a comprehensive medical and/or
physical fitness evaluation for both recreational and highperformance athletes. Functional Movement Screen outcomes can be used to identify deficiencies in fundamental
movement patterns and to detect left-right asymmetries
that occur during these movements (4,12,16). Although
the primary goal of the FMS is the assessment of movement patterns and identification of deficiencies that may
increase injury risk, the FMS has also been used as a tool
to evaluate the efficacy of exercise training programs,
although research is limited in this area (11,17).
Regardless of its intended application, the FMS has
been shown to demonstrate high levels of interrater and
intrarater reliability when conducted by individuals with
adequate training using both real-time scoring and videobased analysis (10,19). The majority of research pertaining
to the FMS and its applicability has been conducted on
healthy recreational athletes, professional football players,
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Integration of Functional Movement Screen
military recruits, and workers in physically demanding
occupations (firefighting) (6,8,9,11,16,18). To date, there
have been no published studies involving the use of the
FMS with elite hockey players. The most recent survey
conducted with NHL strength and conditioning coaches
was undertaken in 2004, and at that time, only 1 respondent was using a system analogous to the FMS (7), and it
is unclear how this FMS information was being used.
Further investigation is certainly warranted to evaluate
the utility of the FMS for future and present NHL players
with respect to injury risk prevention, strength and conditioning practices, and performance optimization.
The annual NHL Combine is a multiday event that
hosts the top 100 junior age prospects from around the
Figure 1. Scoring sheet for FMS administration during the Combine.
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the
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world. The players undergo comprehensive medical evaluations that include medical history, physical examination,
orthopedic examination, electrocardiogram, echocardiogram, and motor coordination together with a battery of
physical and physiological fitness tests that assess muscular
strength, muscular endurance, muscular power, anthropometry, body composition, agility, anaerobic, and aerobic
power. To date, the published research on this cohort has
focussed on the outcomes of the NHL Combine assessments as they relate to a player’s hockey potential and
draft status (1,2,21). Before 2013, there has been no assessment of basic functional movement patterns in the test
battery conducted at the NHL Combine, but a growing
interest among NHL strength and conditioning coaches
led to the inclusion of the FMS in the test battery at the
2013 NHL Combine.
From a practical standpoint, the content of this investigation is of great interest to strength and conditioning
specialists both at the professional and amateur level.
Detection of potential imbalances or deficiencies in functional movement patterns may help tailor individualized
training programs for ice hockey players with the goal of
injury risk reduction/prevention and enhanced hockey
performance. Within the scope of the NHL Combine
assessments, it was hypothesized that there would be
a number of interesting correlations that link the outcomes
of the FMS to other medical, physical, and physiological
measures that will provide valuable insight to scouts,
strength and conditioning specialists, and sports medicine
practitioners. The 2 primary objectives of this investigation
were to describe the outcomes from the NHL Combine
FMS assessments and to determine whether they correlate
with results from the associated medical, physical, and
physiological assessments. A third objective was to create
strategies, based on expert opinion, that may enhance the
efficacy of FMS testing at future NHL Combines and for
use among strength and conditioning professionals in
other sport settings.
Figure 2.
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METHODS
Experimental Approach to the Problem
This study evaluated the outcomes of integrating the FMS
into the NHL Combine and identified any links to other
medical and fitness assessment outcomes using a nonrandomized cross-sectional design. The top 111 elite junior hockey
players from around the world took part in the 2013 NHL
Combine. The medical, physical, and physiological status of
the players was evaluated through a series of comprehensive
assessments pertinent to hockey performance. Of particular
interest to strength and conditioning specialists is the recent
integration of the FMS into the NHL Combine test battery.
The comprehensive medical, physical, and physiological
assessment customarily performed at the NHL Combine
allows for comparison with the FMS outcomes, with the goal
of establishing relationships to injury risk and limitations to
performance that may assist various health and qualified
exercise practitioners when developing training programs.
Subjects
In 2013, the top-ranked 101 junior hockey prospects from
around the world with a mean age of 17.8 (SD 6 0.4;
17–19 years old) years took part in the NHL Combine.
The study population included players at each position: forward (n = 59), defense (n = 34), and goaltender (n = 8).
Players with current musculoskeletal injuries that precluded
them from performing the FMS in its entirety were excluded
from this data analysis. All players provided signed informed
consent before their involvement in the NHL Combine. If
the player was younger than 18 years, parental or guardian
consent was obtained. Permission to report these data in
aggregate form was received from the players involved and
from the NHL. The methods used in this investigation have
been approved by the York University Human Participants
Review Subcommittee.
Procedures
Functional Movement Screen. The FMS was performed 1–3
days before all other medical,
physical, and physiological fitness assessments. This range in
the timing of FMS testing was
due to scheduling limitations,
arrivals of international players,
and the fact that the remainder
of the medical/fitness testing
was held over a 2-day period.
Despite these scheduling constraints, the FMS assessments
were all performed during the
evening over the specified 2day period. It should also be
noted that the participants
were not instructed to adhere
Description of participant involvement in the Combine fitness, medical, and FMS testing.
to any particular nutritional
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Integration of Functional Movement Screen
mobility and active leg raise along with the active impingement pain clearance. Station 4 included both the trunk staTABLE 1. Participants’ demographic and
bility push-up and the rotary stability tasks along with the
anthropometric data (n = 81).
pain clearance for both lumbar extension and flexion. The
Category
Mean 6 SD
randomly assigned order and the use of 4 stations allowed
multiple players to be assessed simultaneously.
Age (y)
17.8 6 0.4
Scoring adhered to the FMS guidelines and all testers who
Height (m)
1.86 6 0.05
conducted the scoring underwent approximately 20 hours of
Weight (kg)
86.1 6 7.6
Wing span (cm)
190.2 6 5.7
specific training using FMS-endorsed teaching materials
Body fat (%)
9.6 6 1.6
(video and manual) before the testing. All participants were
provided with identical verbal instructions and photographs
of the start and end positions for each movement. In
addition, because of language limitations among this diverse
population, a demonstration of proper technique was proguidelines. The testing venue consisted of 4 stations, with the
vided for each task. The demonstration was provided by the
testing at each station conducted by the same qualified exsame testers for each of the 7 tasks. Three attempts for each
aminers for all athletes. The players performed each of the 7
test were provided to the players in the event that a score of
FMS movements in a randomly assigned order. Station 1
3 was not attained on the initial or second trial. A
was the deep squat. Station 2 included both the hurdle step
customized scoring sheet was developed to gather additional
and the in-line lunge. Station 3 included both the shoulder
information regarding why a score of 3 was not achieved and
to further document any asymmetries between the left and
right side of the body. These
documented infractions are
TABLE 2. Summary of participants’ results for each FMS component.
based on the descriptions of
FMS component
Mean 6 SD
Score
Frequency
Percent
the FMS protocols and scoring
system, and they include limTotal score
15.2 6 2.5
ited range of motion, loss of
Number of asymmetries
1 6 0.9
Total restrictions
12 6 4.6
balance, and several taskDeep squat score
2.0 6 0.48
0
0
0.0
specific items, which are all
1
11
12.5
outlined clearly in Figure 1.
2
68
77.3
The selection of a “slight” vs.
3
9
10.2
a “significant” infraction was
Hurdle step
2.1 6 0.4
0
0
0.0
1
1
1.1
subjectively determined by the
2
76
86.4
testers at each station. For the
3
11
12.5
purpose of the data analysis,
In-line lunge
2.5 6 0.5
0
0
0.0
slight and significant infrac1
0
0.0
tions
were
subsequently
2
45
51.1
3
43
48.9
merged into a single category
Shoulder mobility
2.0 6 1.0
0
9
10.2
of “infractions” because of the
1
12
13.6
potential limitations associated
2
35
39.8
with subjective scoring. Each
3
32
36.4
task was individually scored
Active leg raise
2.3 6 0.5
0
0
0.0
1
1
1.1
out of 3, and a total score out
2
59
67.0
of 21 was recorded for each
3
28
31.8
participant together with the
Push-up
2.5 6 0.9
0
8
9.1
total number of asymmetries
1
0
0.0
identified and the pain clear2
20
22.7
3
60
68.2
ance results. Asymmetries were
Rotary stability
2.0 6 0.3
0
2
2.3
noted when a participant at1
1
1.1
tained a different score on one
2
84
95.5
side of the body compared
3
1
1.1
with the other. Asymmetries
could not be added to the
score sheet for the deep squat
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and the trunk stability push-up because neither movement is
performed unilaterally.
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about the number of years playing hockey, days since last
game, days since last off-ice workout, plus the type and
intensity of exercise training routinely performed.
Medical Evaluation. All players underwent medical history,
and physical examination and orthopedic examination
were performed by the same 3 physicians before undergoing any further testing. These physician assessments were
followed by an electrocardiogram (Mortara ELI 100,
Milwaukee, WI, USA) and an echocardiogram (Philips
iE33 xMatrix, Andover, MA, USA), which were all
evaluated by the same cardiologist for the detection of
potential arrhythmias or cardiomyopathies. During the
medical evaluation, the following information was recorded:
level of body development, assessment of neuromuscular
function and joint range of motion, current and previous
injury (including treatments and/or surgeries), and current use
of medications/supplements. Information was also gathered
Physical and Physiological Fitness Evaluations. The physical
and physiological fitness evaluation encompassed 4 primary
components. The first component was anthropometry and
body composition: height, body mass, wing span, standing
reach height, and percent body fat from skinfold calipers
(West Sussex, United Kingdom) using the Yuhasz sum of 6
skinfolds formula (3). The second component was the
assessment of selected musculoskeletal components: a hand
grip dynamometer (Takei T.K.K. 5401, Niigata, Japan), the
Gledhill Force Meter for upper-body push and pull strength,
maximum number of push-ups performed to a metronome
(50 b$min21), maximum number of 150 lb bench press repetitions to a metronome (50 b$min21), upper-body power
using a 2-handed seated 4 kg
medical ball put, standing long
jump and lower-body power
TABLE 3. Summary of participants’ medical evaluation findings.
using both vertical jump (both
squat jump and countermoveComponent
Mean 6 SD
Frequency
Percent
ment jump (2)) on the Vertec
Days since last game
39 6 23.0
(JumpUSA, Sunnyvale, CA,
Days since last off-ice workout
11 6 19.7
USA), and a 4-jump protocol
Years playing hockey
11 6 2.3
using the Probotics “Just Jump”
Upper-body development
vertical jump mat (Probotics,
Below average
25
24.8
Inc., Huntsville, AL, USA). The
Average
49
48.5
Above average
27
26.7
third component was the assessLower-body development
ment of anaerobic power and %
Below average
17
16.8
fatigue index using a 30-second
Average
57
56.4
Wingate cycle ergometer (MonAbove average
27
26.8
ark 894E, Vansbro, Sweden) proPhysician comments
Healthy
57
62.6
tocol against a resistance equal to
Healthy with a condition
15
16.5
0.09% of the player’s body mass.
Other
19
20.9
The fourth and final component
Current treatment for injury
was the direct assessment of aerNo treatment
72
80.9
obic power on a cycle ergometer
Rehabilitation
13
14.6
Other treatment
4
4.5
(Monark 874E) for the determiCurrent medication use
nation of maximal oxygen conNone
58
64.4
_ O2max)
using
sumption
(V
Supplements
22
24.4
a
customized
loading
sequence
Other
10
11.1
and direct gas analysis with
Allergies (yes)
27
30.0
Unhealed injury (yes)
20
21.1
expired air collected by a Tissot
Current injury still causing
6
8.2
gasometer. The attainment of
problem (yes)
_ O2max was confirmed when
V
Training program
_ O2 value leveled off with
the
V
Participate in aerobic + resistance
89
89.9
increasing
work rates or when
Only resistance
4
4.0
Only aerobic
6
6.1
the athlete was no longer able
Training program intensity
to consistently maintain a pedalModerate
4
4.5
ing rate greater than 70 rpm.
Vigorous
31
35.2
The athletes were allowed
Moderate + vigorous
53
60.2
a minimum of 30-minute rest
between the Wingate and
_ O2max test protocols.
V
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Integration of Functional Movement Screen
Statistical Analyses
The players’ medical, physical, and physiological fitness data
were summarized using descriptive statistics (mean 6 SD) and
frequencies (n, %). Pearson’s correlations were performed to
test the hypothesis that FMS outcomes would be linked to
components of the other health, physical, and physiological
outcomes assessed during the NHL Combine. The analysis
was performed on FMS total scores and the number of leftright asymmetries and total number of documented FMS infractions compared with various quantifiable components of
the medical, physical, and physiological fitness evaluations. It
should be noted that the use of “documented FMS infractions”
in the analysis has not been performed previously in the literature. The accepted alpha level of significance was set a priori
at p # 0.05 for all correlations. All analyses were performed
using IBM SPSS Version 20 (IBM Corp., Armonk, NY, USA).
RESULTS
Of the 101 players who attended the NHL Combine, 88
completed the FMS testing. The 13 players who did not
participate in the FMS had acute musculoskeletal injuries
that precluded their involvement. Complete physical and
physiological fitness data were obtained for 81 of the NHL
Combine participants. Twenty of the players did not
TABLE 4. Summary of participants’ physical/physiological
Component
Combined hand grip (kg)
Push-ups (max no)
Bench press (repetitions of 150 lb)
Push strength (kg)
Pull strength (kg)
Standing long jump (cm)
Jump mat average 4-jump height (cm)
4 kg medicine ball throw (m)
Vertek vertical jump—squat jump
Jump height (cm)
Lewis average leg power (W)
Sayers peak leg power (W)
Vertek vertical jump—countermovement jump
Jump height (cm)
Lewis average leg power (W)
Sayers peak leg power (W)
Wingate test
Peak power (W)
Average power (W)
Average rpm
Peak heart rate (b$min21)
Heart rate after 1 min (b$min21)
Fatigue (%)
V_ O2max test
V_ O2max (ml$kg21$min21)
Peak heart rate (b$min21)
Test duration (s)
1168
the
perform select components of the physical and physiological
fitness assessment because of current musculoskeletal injuries identified during the medical evaluation. Figure 2 summarizes the involvement of the athletes. Player demographic
and anthropometric data are presented in Table 1.
Functional Movement Screen
Table 2 provides a summary of FMS results. The mean FMS
total score out of 21 from all players was 15.2 6 2.51, and the
mean number of left-right asymmetries identified was 0.9 6
0.91. The FMS movement for which the athletes most frequently received the highest score of 3 was the trunk stability
push-up (68.2%), whereas the movement that was performed most poorly was the rotary stability task, with 98%
of athletes receiving a “2” or lower.
Medical Evaluation
Results from the medical evaluation are summarized in
Table 3. Based on the physicians’ evaluation of the players’
overall health status, 62.6% of the players were identified as
being “healthy,” 16.5% were “healthy with a slight injury,”
and 20.9% were deemed “not healthy,” primarily due to an
acute injury. The latter percentage corresponds to the percentage of the athletes (21.1%) who self-reported having
some form of unhealed injury. Table 3 also shows the mean
elapsed time since the players’
last game and information
regarding their regular training
fitness data.
regimen. Furthermore, there
were no cardiomyopathies or
Mean 6 SD
arrhythmias identified during
111.3 6 14.3
the medical evaluation.
26
8
104.4
112.2
262
51.7
5.1
6
6
6
6
6
6
6
5.1
3.6
17.1
15.1
15.2
5.6
0.4
62.0 6 6.7
1,448 6 159.1
5,525 6 549.7
65.1 6 6.5
1,483 6 157.7
5,700 6 535.2
1,126
846
115
192
175
51.8
6
6
6
6
6
6
129.3
85.4
6.0
8.8
11.1
6.8
55.3 6 4.3
194 6 7.9
693 6 80.1
Physical and Physiological
Fitness Evaluations
The physical and physiological
data of the athletes are summarized in Tables 1 and 4.
Upper- and lower-body musculoskeletal fitness measures,
Wingate test, and V_ O2max results are presented in Table 4.
Correlation of the Functional
Movement Screen to Medical,
Physical, and Physiological Fitness
Data. The total FMS score and
the medical evaluation were
significantly correlated with several outcomes from the medical,
physical, and physiological fitness assessments. The statistically significant (p # 0.05)
correlations between the FMS
score, the number of asymmetries identified by the FMS,
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mean total score of 15.2 is lower
than that reported for a different
TABLE 5. Statistically significant correlations between the findings from the
professional athlete population
medical and fitness evaluations and outcomes from the FMS.
(football players) (12), but there
Total
have been no other published
number of
FMS total
Number of
studies involving the administraComponent
score
asymmetries infractions
tion of the FMS to recreational
or elite hockey players and
Sum of 6 skinfolds (mm)
therefore it is difficult to deterPCC
0.274
Sig
0.010*
mine if the sport of hockey may
Body fat (%)
be predisposing players to lower
PCC
0.265
scores on the FMS based on the
Sig
0.013*
sport-specific movement patCurrently receiving injury treatment
terns that have been used and
PCC
0.235
Sig
0.039*
developed during player develDays since last off-ice workout
opment. The number of asymPCC
20.245
metries identified (mean = 0.93)
Sig
0.032*
appears to be quite low, but
Wingate average power (W)
there is no relevant population
PCC
20.217
Sig
0.048*
described in the literature with
Wingate average rpm
which a comparison can be
PCC
20.261
made. The movements perSig
0.017*
formed with the highest (trunk
21
Wingate (W$kg )
stability push-up) and lowest
PCC
20.258
Sig
0.018*
(rotary stability task) success
V_ O2max (ml$kg21$min21)
rates are in line with those
PCC
20.304
observed in other studies
Sig
0.005*
(16,18), which may simply be
Vertek peak leg power (squat jump)
a reflection of the difficulty or
PCC
20.242
Sig
0.027*
complexity of the movements
Vertek peak leg power
themselves, as opposed to
(countermovement jump)
a result of sport-specific funcPCC
20.270
tional movement pattern alteraSig
0.013*
tions. The scoring system used
Standing long jump (cm)
PCC
20.320
in this study was unique in that
Sig
0.030*
a quantifiable system of FMS
Jump mat average jump height (cm)
performance infractions was imPCC
20.241
plemented with a mean of 24
Sig
0.027*
infractions noted. Although not
*Significance (sig) (p # 0.05).
previously used or reported in
the literature, this system of
tracking infractions may be useful to inform the design of funcand the number of infractions to the measures collected during
tional exercise training prescriptions by strength and
the NHL Combine are summarized in Table 5.
conditioning coaches and warrants further investigation.
Tracking additional infractions will allow strength and condiDISCUSSION
tioning professionals to further detect individual differences in
The 2 primary objectives of this investigation were to describe
an apparently homogeneous population of athletes based on
the outcomes from the NHL Combine FMS assessments and
FMS total score alone. These individualized programs may be
to determine whether they correlate with the results from the
more successful in correcting or minimizing the deficiencies
associated medical, physical, and physiological assessments.
identified by the FMS by adopting training techniques that
The third objective was to create strategies, based on expert
focus on improving the specific infractions, which contributed
opinion, that may enhance the efficacy of FMS testing at
to lower overall FMS scores. The goal of such programs
future NHL Combines and for use among strength and
should be to ultimately reduce injury risk and potentially
conditioning professionals in other sport settings. The FMS
improve hockey performance.
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Integration of Functional Movement Screen
The investigation into correlating the FMS results with the
medical, physical, and physiological fitness evaluations results
only revealed a small number of relationships. The total FMS
score, number of asymmetries identified, and total number of
infractions identified on the FMS exhibited statistically
significant correlations that were seemingly slight, coincidental, or even counterintuitive in their directionality when linked
with the outcomes from the medical, physical, and physiological fitness test results. This may simply be a result of the
homogeneity of the participant population or due to a lack of
concordance between FMS scores and performance outcomes, which is consistent with the existing literature on the
subject (15,17). For example, the link between peak leg power
and FMS total score (Pearson Correlation Coefficient
[PCC] = 20.242) implies that with increases in FMS total
score, there is a corresponding low peak leg power. Of particular note was the correlation between the FMS total score
and days since last off-ice workout (PCC = 20.245). This
correlation, although it is not particularly strong, makes sense
from the perspective that those who were participating in
regular conditioning programs in the days immediately preceding the Combine would perform better on the FMS.
Unfortunately, what the authors did not determine, and
what would be very informative, is the number of athletes
who are currently under the regular supervision of a strength
and conditioning coach, the number of athletes who have
undergone the FMS before the Combine, and the number of
athletes who incorporate “functional movement corrective
training” into their regular conditioning regimes. Although
previous studies have demonstrated good test-retest reliability
(14,20) when using the FMS, there is potential for learning
effects associated with familiarization with the test itself. Furthermore, if there were athletes who had previously completed the FMS, the allowance of 3 attempts would mitigate
any potential advantages that those with experience may possess. Also, studies have shown that, with corrective exercises
and focused training, athletes can improve their FMS scores
(11). Information about previous FMS experience would be
valuable for scouts and strength and conditioning professionals with regard to the amount of weighting they place on the
FMS scores established during the NHL Combine. These
questions should be incorporated into future medical evaluations at the NHL Combine so that more detailed information
regarding training habits can be examined and if there are
correlations between previous experience performing the
FMS and the FMS score at the NHL Combine. The apparent
lack of concordance between the FMS and results from the
medical evaluation is of particular interest and warrants further investigation regarding any potential links between longterm injury outcomes and FMS performance.
Potential limitations of this investigation include the use of
tester demonstrations for each of the FMS movements. This
has not been performed in previous studies, and little is known
about how the inclusion of a demonstration may alter the FMS
scores. The rationale for this inclusion was (in addition to
1170
the
language barriers) an attempt to evaluate players based on their
ability to fully perform the movements as they were designed
rather than how they interpret instructions and choose to
execute the movement. However, the authors believe that the
inclusion of tester demonstrations is an improvement in the
FMS protocol. Another potential limitation was the randomized order used for the FMS movement evaluations. Although
it has been implied that the FMS movements should be
evaluated in the same specific order that they are outlined in
the original FMS publications (4,5), 1 recent study has demonstrated good reliability when randomly assigning the order
of the movements (20). The choice for randomized movement
order was made to optimize the use of time during the NHL
Combine and 4 stations were setup with the same testers scoring each task for all athletes, thus allowing 4 athletes to be
tested within the same scheduled time frame.
In the future, the NHL Combine should ideally include
video analysis for all athletes performing the FMS, which
would allow for the assessment of interrater and intrarater
reliability for FMS scores and the use of “documented infractions” as an auxiliary measurement within this sport-specific
population. The videos would also provide the baseline
assessment that may be used by the strength and conditioning
professionals with the team that the player is drafted by during subsequent pre-season, mid-season, or off-season training.
Furthermore, these videos with accompanying scores can be
integrated into an NHL database that will be bolstered with
new participants annually so that it will be possible to compare a larger pool of hockey players to potentially reveal
stronger or more meaningful relationships to the medical,
physical, and physiological fitness results. It should be noted
that the NHL has committed to using video analysis for all
athletes during the 2014 Combine, allowing for subsequent
investigation into the scoring system, the long-term monitoring of athletes, and its utility among strength and conditioning
professionals. Considering the apparent lack of correlation
between FMS scores and performance-related physical and
physiological outcomes at the NHL Combine, the main focus
for the utility of the FMS should be on injury risk and prevention through proper strength and conditioning programming. To improve the efficacy of the continued inclusion of
the FMS at future NHL Combines, the investigators highly
recommend the implementation of a year-round injury surveillance system that would allow follow-up assessment and
comparison with FMS scores measured during the NHL
Combine. This would enable an evaluation of the value of
FMS scores to assess injury risk among elite hockey players
through retrospective analyses of the FMS data collected during the NHL Combine along with data from our proposed
injury surveillance system. With regard to injury prediction,
previous literature has shown that FMS scores below 14 have
been significantly associated with increased injury risk both
among elite football players and military recruits (11,13,16).
The observation that injury risk was associated with FMS
outcomes in elite football players is interesting in that both
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football and hockey are high impact sports with a very high
risk for injury. Any information that may help identify those
players at risk so that corrections can be made to potentially
dysfunctional movement patterns, by strength and conditioning regimen, should be considered important. Among the
present group of athletes, 18.2% scored 13 or lower, which
may mean that given the evidence provided above, they are at
risk for future injury.
PRACTICAL APPLICATIONS
Despite the increasing use of the FMS by qualified exercise
professionals, coaches, and strength and conditioning specialists who work with both recreational and elite athletes for
evaluating deficiencies in functional movement patterns,
identifying injury risk and informing strength and conditioning regimens, very little is known about its effectiveness as it
relates to the sport of ice hockey. Although this study
observed some correlations between select components of
the medical, physical, and physiological fitness data and the
results of the FMS, further investigation into these relationships is necessary and is encouraged. Enhanced understanding
of practical implications for the FMS outcomes, as it pertains
to ice hockey, may translate into significant improvements in
athletes’ functional movement patterns, injury prevention, plus
strength and conditioning strategies focused on correcting the
individual infractions detected by the FMS that could lead to
consistent and enhanced sport performance. In addition to
examining the current strength and conditioning regimen
and use of the FMS among NHL prospects before the Combine, the adoption of more comprehensive evaluation protocols that include the use of video analysis for FMS
components and the implementation of a year-round injury
surveillance program for future and present NHL players are
highly recommended. This will permit further examination
into the relationship between FMS outcomes (total score
and documented infractions) and injury risk and for the development and evaluation of injury prevention programs that are
implemented as a result of the findings from the surveillance
system. Ultimately, any tool, such as the FMS, that could
potentially benefit the health, assessment, training, or performance of elite athletes should be thoroughly explored so that
its application can be maximized.
ACKNOWLEDGMENTS
The authors would like to acknowledge Mr. Dan Marr and
the National Hockey League Department of Central Scouting
for the use of the data from the Combine. The authors would
also like to acknowledge Dr. Scott Gledhill, Dr. Robert Brock,
Dr. Peter Rowan, Dr. Chi-Ming Chow, and Dr. Quan Chan
for their involvement in the medical evaluation process. The
authors have no conflicts of interest to disclose, and this work
was funded through internal York University research funding.
The results from this study do not constitute endorsement of
any products mentioned by the authors or the National
Strength and Conditioning Association.
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