Movement Assessments as Predictors for Initial Anterior Cruciate Ligament Injury: A Critically Appraised Topic.

Clinical scenario: Anterior cruciate ligament (ACL) injury risk may increase when certain movements are noted during landings. Initial ACL injury produces poor long-term outcomes for patients. Movement assessments may help predict risk of initial ACL injuries.

Clinical question: Are movement assessments predictive of initial ACL injuries in college/high school athletes?

Summary of key findings: Six articles met the inclusion criteria. Some movement assessments did not predict ACL injury. However, the functional movement screen composite score of 14 or less and landing error scoring system scores of 5 or greater were found to be associated with an increased risk of an ACL injury. Knee valgus angles of ≥6.5 cm were associated with future knee injury but only had fair predictive validity.

Clinical bottom line: There are conflicting results on whether movement assessments can accurately predict primary ACL injuries. However, clinicians can consider the use of the functional movement screen composite score (14 or less) and the landing error scoring system score (5 or greater) as both may predict a future ACL injury. More research is needed to uncover movement assessments that better predict ACL injury.

Strength of recommendation: A grade B recommendation can be given that movement assessments may be used for screening for initial ACL injury.