A New Functional Screening Tool For Lower Limb Injury Risk: A Retrospective Cohort Study

Liping Jiang, Shimeng Shi, Xiaojian Shi, Zonghan Yang, Gordon Waddington, Jeremy Witchalls, Roger Adams, Doa El-Ansary, Jia Han

Research output: Contribution to journalMeeting Abstractpeer-review


Purpose: The aim of the current study was to develop a new screening instrument for lower limb functional assessment. Methods: Fifty-three athletes (33M,20F; mean age: 19.4 ± 2.5years old) volunteered for the study. Athlete injury history and sport performance level (international, national, regional, recreational) were recorded. A lower limb functional screening tool was developed (the LoLiFST), based on 5 lower limb movements in different modes, planes, directions and at varying intensities. Both legs were assessed in a random order and each athlete was given a technique and a symptom score. Reliability was evaluated. Spearman's correlation was employed to examine the relationship between the measures and the incidence of injury. Receiver operating characteristic (ROC) analysis was employed to assess the instrument's capacity to classify injury status. Results: (1) The test-retest reliability was 0.74. The inter-rater reliability was 0.95. (2) Twenty-five of the athletes had a history of low back or lower limb injures in the past 12 months. (3) Both the technique and symptom scores from the LoLiFST were significantly correlated with the injuries(ρ=-0.290, P=0.035; ρ=-0.390, P=0.004), and the two scores were significantly inter-correlated (ρ=0.354, P=0.009).(4) When technique or symptom scores alone were included to differentiate between athletes with or without injury, the area under the ROC curve (AUC) scores were 0.668 (P=0.036, 95%CI: 0.520-0.815) and 0.722 (P=0.006, 95%CI: 0.582-0.862), respectively. With technique and symptom scores combined, the AUC discrimination score was 0.762 (P=0.001, 95%CI: 0.634-0.890). When sport performance level was added into the variable set, the AUC discrimination score was 0.834 (P=0.00, 95%CI: 0.728-0.939), meaning that 83.4% of cases can be correctly classified as low back or lower limb injured/non-injured using the decision point obtained from applying Youden's index to the ROC curve. Conclusion: The findings support the use of a functional movement screening tool that includes both technique and reported symptoms, that can be used in combination with sporting performance level to enhance capacity for identifying injuries. Future longitudinal studies are warranted to explore the validity of the LoLiFST in determining low back and lower limb injury risk.
Original languageEnglish
Pages (from-to)936-936
Number of pages1
JournalMedicine Science in Sports Exercise
Issue number6S
Publication statusPublished - Jun 2019


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