Oslo Sports Trauma Research Center

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Information about project titled 'Functional movement screening of athletes - how stable is the Nine-plus battery test?'

Functional movement screening of athletes - how stable is the Nine-plus battery test?

Details about the project - category Details about the project - value
Project status: Published
Project manager: Arnhild Bakken
Supervisor(s): Roald Bahr, Karim Khan, Erik Witvrouw
Coworker(s): Stephen Targett, Tone Bere, Cristiano Eirale, Johannes Tol, Rodney Whitely, Abdulaziz Farooq


Introduction: Functional movement tests have become increasingly popular as screening tool to identify the athlete at risk, but also used for clinical assessments to determine treatment response and assist in return to play decision making. The 9+ is a functional movement test attempting to identify limitations in fundamental movement patterns assumed to predispose athletes for injury. However, the inter-season variability of the 9+ test is unknown. To be able to meaningfully interpret differences in a test result, the normal variation, in the absence of any intervention, is important to document.

The purpose of this study was therefore to examine the stability of the 9+ test between two consecutive seasons in professional male football players.

Method: In total 220 football players completed the 9+ at the beginning of 2013 and 2014 seasons. Time-loss injuries in training and matches were obtained from the Aspetar Injury and Illness Surveillance Program. No intervention was initiated between test occasions. Of the 220 players, 136 (61.8%) suffered a time-loss injury between the two tests, mainly to the lower extremity.

The results demonstrated a small but statistically significant increase in mean total score of the 9+ test from season 1 to season 2, which tended to be greater for the injured than the uninjured groups. However, the variability was large between season 1 and 2, irrespectively of injury and severity.

The 9+ test showed large measurement error (SEM, 3.0 to 3.4 points), and a minimal detectable change (MDC) of at least 8 points were necessary to represent a real change in the 9+ test. This was true irrespective of injury and severity.

The results suggest that the 9+ test will have limited clinical applicability to detect change over time due to injury or clinical intervention, mainly because of the sizeable measurement error.

However, the researchers behind this study emphasises that further studies are necessary to determine whether the 9+ test can be used to identify the player at increased risk of injury.

The study was performed at Aspetar Orthopaedic and Sports Medicine Hospital in Doha, Qatar, and is part of a larger PhD project led by a PhD student at the Oslo Sport Trauma Research Center, Arnhild Bakken.