THE EFFECT OF AN INTERVENTION PROGRAM ON
FUNCTIONAL MOVEMENT SCREEN TEST SCORES IN
MIXED MARTIAL ARTS ATHLETES
JAMIE G. BODDEN, ROBERT A. NEEDHAM, AND
Center for Sport, Health and Exercise Research, Faculty of Health Sciences, Sport & Exercise, Staffordshire University, Stoke on
Trent, United Kingdom
ABSTRACT
Bodden, JG, Needham, RA, and Chockalingam, N. The effect
of an intervention program on functional movement screen test
scores in mixed martial arts athletes. J Strength Cond Res
29(1): 219–225, 2015—This study assessed the basic funda-
mental movements of mixed martial arts (MMA) athletes using
the functional movement screen (FMS) assessment and deter-
mined if an intervention program was successful at improving
results. Participants were placed into 1 of the 2 groups: inter-
vention and control groups. The intervention group was
required to complete a corrective exercise program 4 times
per week, and all participants were asked to continue their
usual MMA training routine. A mid-intervention FMS test was
included to examine if successful results were noticed sooner
than the 8-week period. Results highlighted differences in FMS
test scores between the control group and intervention group
(p = 0.006). Post hoc testing revealed a significant increase in
the FMS score of the intervention group between weeks 0 and
8 (p = 0.00) and weeks 0 and 4 (p = 0.00) and no significant
increase between weeks 4 and 8 (p = 1.00). A x2 analysis
revealed that the intervention group participants were more
likely to have an FMS score .14 than participants in the con-
trol group at week 4 (x2 = 7.29, p , 0.01) and week 8 (x2 =
5.2, p # 0.05). Finally, a greater number of participants in the
intervention group were free from asymmetry at week 4 and
week 8 compared with the initial test period. The results of the
study suggested that a 4-week intervention program was suf-
ficient at improving FMS scores. Most if not all, the movements
covered on the FMS relate to many aspects of MMA training.
The knowledge that the FMS can identify movement dysfunc-
tions and, furthermore, the fact that the issues can be improved
through a standardized intervention program could be advan-
Address correspondence to Robert A. Needham, r.needham@staffs.ac.uk.
29(1)/219–225
Journal of Strength and Conditioning Research
Ó 2015 National Strength and Conditioning Association
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
NACHIAPPAN CHOCKALINGAM
tageous to MMA coaches, thus, providing the opportunity to
adapt and implement new additions to training programs.
KEY WORDS assessment, corrective, exercise, training,
prehabilitation
INTRODUCTION
S
trength and conditioning programs have become
a fundamental aspect of the modern day mixed
martial arts (MMA) athlete (2,3,31). The goal of
any strength and conditioning program is to
improve performance and help prevent the risk of injury by
enhancing the stability of a joint through improving strength
of the surrounding musculature (2,13). Amtmann and Berry
(2) and Amtmann (1) stated that boxers and MMA athletes
had a tendency to develop the anterior musculature greater
than the posterior musculature. This could be a consequence
of the myth that training the chest and arms using pushing
movements, such as the bench press, created greater punch-
ing power (12) or maybe strength and conditioning programs
have become too specific to meet the demands of the sporting
movement. Other common anterior dominant exercises used
in boxing and MMA training were abdominal exercises such
as sit-ups or crunches (2,12,29). Recently, there has been
a debate on the inclusion of such spinal flexion exercises into
training programs. McGill (24) recommended a complete
exclusion of these repeated spinal flexion exercises. Moreover,
in a recent pod cast, McGill (25) elaborated on this topic and
stated that repeated flexion would cause delamination of the
annulus between the intervertebral disk, thus allowing the
nucleus to pass though causing a herniation.
Amtmann and Berry (2) and Amtmann (1) documented
that the anterior dominance would create a muscle imbalance
that could be detrimental to the athlete, exposing them to
increased risk of injury. This statement coincided with the
work of Sahrmann (30) who stated that repeated movements
or prolonged postures may cause a change in movement pat-
terns through tissue adaptation, consequently altering motor
control. One area of prolonged posture observed in contact
sports is the chin down or tucked position causing a kyphotic
and rounded shoulder posture (21).
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 FMS Test Scores in MMA Athletes
Cook et al. (7) established that numerous strength and con-
ditioning programs often failed to take into consideration the
quality of the client’s basic fundamental movements; pre-activity
movement screening would be advantageous to establish com-
petency without compensation. Moreover, individuals who
continue to train using unsatisfactory movement patterns would
be more susceptible to injury, thus adding “fitness on movement
dysfunction” (6). The functional movement screen (FMS) is an
assessment tool developed to investigate the fundamental
movement patterns of individuals (5,20). The FMS consists of
7 fundamental movement pattern assessments and 3 clearing
tests requiring mobility, stability, and balance; each test is scored
on a scale of 0–3 with a maximum value of 21 for the 7 tests (6).
Normative FMS values of general active males have been
reported to be 15.8 6 1.8 (32).
Kiesel et al. (20) and Kiesel et al. (19) stated that the FMS had
the ability to predict athletes at risk of injury and established
athletes who scored below #14 on the FMS were 11 times
more likely to become injured throughout the season. Further-
more, Kiesel et al. (19) reported that athletes who possessed an
asymmetry were 3 times more likely to become injured even
with scores above the injury risk factor of 14. Similar results
were seen in the military population; Raleigh et al. (28) reported
that recruits who scored #14 were twice more likely to sustain
a musculoskeletal injury and not graduate the training camp.
Corrective exercises have been developed to retrain dys-
functional movement patterns, establish symmetrical move-
ment, and balance posture (6). To establish if FMS scores
could be enhanced, Kiesel et al. (18) carried out a study to
determine if an intervention program of corrective exercises
improved the results of subjects to above the injury risk factor
of 14 and corrected any asymmetry. The study results con-
firmed that the intervention significantly increased the num-
ber of players who were above the injury risk factor of 14 and
also significantly increased the percentage of players who
were free of asymmetry. Yet, the study failed to include a con-
trol group; therefore, it is difficult to determine how effective
the intervention program was. Cowen (8) examined FMS
scores in fire fighters before and after an intervention program
consisting of yoga techniques. The results revealed that the
intervention significantly improved FMS scores to above the
injury factor of 14. However, no control group was included,
and it was noted from a pre-activity questionnaire that sub-
jects were very physically active outside of work, which could
have impacted on results. Conversely, Frost et al. (14)
reported no significant increase in FMS scores when compar-
isons were made against a control group during an interven-
tion program. However, the study appeared to portray
confounding factors that could have impacted the outcome.
Although the decision regarding FMS exercise selection was
made by coaches based on the initial screening results, the
programs were instructed by strength and conditioning profes-
sionals who were unaware of the results. Furthermore, the study
does not specify if the professionals assigned to implementing
the intervention had any prior experience or certification
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220 Journal of Strength and Conditioning Research
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regarding corrective exercises; skill to oversee corrective exer-
cise could vary significantly between individuals. Finally, there
was a high priority placed on strength, power, and aerobic
development for the intervention group 1. However, if the
program was generic for all participants, particular exercises
could have been contraindicated depending on limitations
and weakest links identified from the initial screening, there-
fore, could have negated the corrective exercise focus.
Although not all movement screens are identical and it does
not apply to all athletic populations, this study focuses on
MMA. Although there are reports on factors leading to injuries
within this group (1,2), there is a clear paucity of information
on functional screening, which would inform exercise and
strength conditioning prescription, which will have an effect
on reducing injuries. Furthermore, the reliability of FMS has
been scrutinized by previous research and has been reported to
have a strong inter- and intra-tester reliability (17,26,34).
The purpose of this study was to assess the basic
fundamental movements of semiprofessional MMA athletes
using the FMS assessment and to determine if an 8-week
intervention program was successful at improving FMS scores.
Importantly, a control group and an intervention group were
included. A mid-intervention FMS test was integrated at week
4 to examine if successful results were noticed sooner than the
8-week period as recommended by Kiesel et al. (18). In addi-
tion, the study determined if there were a greater number of
players above the injury risk factor of 14 poststudy compared
with prestudy. Also, because of the previously discussed liter-
ature linking asymmetries with risk of injury, the study exam-
ined whether a greater number of players were free from
asymmetry at the end compared with at the start.
METHODS
Experimental Approach to the Problem
Mixed martial arts fighters volunteered to participate and were
placed into 1 of the 2 groups: intervention and control groups.
Their FMS scores were measured before, during, and after an
8-week intervention program. Participants in the intervention
group were required to complete a corrective exercise program
4 times per week; this quantity has previously been successful
at improving FMS scores (18). All participants were asked to
continue their standard MMA training routines.
Subjects
The participants in this study included 25 male MMA
athletes competing at a semiprofessional level, with a mean
age of 24.31 6 4.46, height (cm) 178.42 6 7.32, and weight (kg)
78.38 6 10.67. All participants were clear of any musculoskeletal
disorder and had been in full unrestricted training. University
ethics review board approved the study, and all the participants
gave their informed consent before any data collection.
Procedures
The data collection, intervention program design, and
implementation were carried out by an FMS level-2 certified
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Journal of Strength and Conditioning Research | www.nsca.com

coach. The reliability of the FMS has been reported by divided into the control and intervention groups. The main
Minick et al. (26), who established the FMS to have a high hypothesis was interpreted using a “mixed between-within
interrater reliability and proposed reliable scores could subjects analysis of variance (ANOVA)” as described by Pal-
be achieved by individuals who have completed the stan- lant (27) to compare between the groups and within the time
dard FMS program. The corrective exercise intervention frames in the intervention program. A post hoc Bonferroni
program followed the exercise selection guide as recom- test established whether there was a significant increase in
mended in the FMS advanced corrective exercise manual FMS scores and at what point in the intervention program
(15) and on the FMS certification training course instructed the significance occurred. A 1-way ANOVA was used to
by D’Agati and Jones (10). Because the current physical establish where the significance was between the control
activity of the participants might have an impact on the and intervention groups at each of the 3 test periods (27).
outcome of this study, the participants who already follow The analysis of the subsequent hypothesis was performed
a training regime were instructed not to change from their using a x2 test for independence to determine if the group
training routine. This study assessed the improvement from was related to improvement over the injury risk factor.
this baseline.
Before data collection, corrective exercise programs for RESULTS
each of the 7 FMS tests were filmed. After the filming, A significant main effect was found for the groups, highlight-
screenshots were taken to produce paper file exercise ing differences in FMS test scores between the control group
programs and, subsequently, Internet video files were created and intervention group (f = 9.26, p = 0.006) (Figure 1). There
within the video analysis software (Dartfish Pro Video was also a significant time by group interaction effect for FMS
Analysis Software v.4.5; Dartfish company, Fribourg, Swit- test scores during the intervention program (f = 11.33, p =
zerland) to produce video exercise programs. The partic- 0.00). A post hoc Bonferroni test revealed a significant
ipant’s gym location determined placement into the control increase in the intervention groups’ FMS score between
or intervention group. The rationale for this grouping was weeks 0 and 8 (p = 0.00). In addition, for the intervention
based on the competitive nature of the participants and the group, post hoc testing identified a significant increase in
sport in general. This experimental design enabled us to FMS scores between weeks 0 and 4 (p = 0.00) and no signif-
reduce the confounding variables by avoiding the partici- icant increase between weeks 4 and 8 (p = 1.00) (Figure 1).
pants modifying their training program with an influence This suggested that a 4-week intervention program was suffi-
from the other experimental group. cient at improving FMS test scores.
The administration of the FMS was carried out in A 1-way ANOVA was used to further identify where the
accordance with the previously published guidelines (6); other differences were between the groups and at what time
than the verbal instructions, no additional coaching points periods. It was established that there was no significant
were used during the screening process. The intervention pro- difference in FMS test scores between the control and
gram was 8 weeks in duration
and included an FMS test at
week 4 to monitor progress as
recommended by Kiesel et al.
(18). The individual programs
were based on the algorithm
recommended by Cook (6)
and focused on the weakest
and asymmetrical scores, with
primary focus on mobility pat-
terns and secondary moving
onto stability patterns if appro-
priate. The testing procedures
were scheduled in such a way
that it ensured no influence
from other confounding factors,
such as the time of the day, had
an impact on the movement ca-
pabilities of the participants.
Figure 1. Mean functional movement screen (FMS) test scores for the control group and intervention group at
Statistical Analyses each phase of the intervention program. *Significant difference in FMS scores between groups. **Significant
To carry out the statistical increase in FMS scores over time at 4 and 8 weeks compared with 0.
analysis, the subjects were

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 FMS Test Scores in MMA Athletes
Figure 2. The control and intervention groups’ functional movement
screen (FMS) scores #14 and .14 at week 0, week 4, and week 8 test
periods. *Significant improvements in FMS score to above the injury risk
factor between groups.
intervention groups at week 0 (f = 0.002, p = 0.962). There
were significant differences in FMS scores at week 4 (f =
15.51, p = 0.001) and week 8 (f = 14.40, p = 0.001) (Figure
1). This highlighted the improvements in FMS test scores for
the intervention group at week 4 and week 8 compared with
the control group (Figure 1).
At the initial test period, only 1 participant displayed
a score of above the injury factor of 14 (Figure 2). A x2
analysis revealed significant differences based on group and
FMS score #14 or .14. Figure 2 illustrates that participants
who followed an 8-week intervention program were more
likely to have an FMS score .14 than participants in the
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222 Journal of Strength and Conditioning Research
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Figure 3. The control and intervention groups’ asymmetry at week 0,
week 4, and week 8.
control group (x2 = 5.2, p # 0.05). Additionally, significant
improvements in FMS score to above the injury risk factor of
.14 were identified after week 4 testing (x2 = 7.29, p , 0.01)
(Figure 2).
Finally, the results highlighted that a greater number of
participants in the intervention group were free from asym-
metry at week 4 and week 8 compared with the initial test
period (Figure 3).
DISCUSSION
To the authors’ knowledge, this was the first study to include
both a control group and an intervention group with a mid-
intervention test and to compare differentials between groups
and changes in FMS test scores based on an intervention

program. The results uphold that there was a significant dif-
ference in FMS test scores between control and intervention
groups at both 4- and 8-week periods. Additionally, the results
of this study suggested that a 4-week intervention program of
corrective exercise was successful at significantly improving
FMS scores. Although post hoc testing revealed no significant
improvements in the intervention groups’’ test scores between
weeks 4 and 8, care should be taken when interpreting this
outcome. It was noticed that a number of subjects at week
4 testing achieved considerable improvements in FMS scores,
which in theory would have changed the subjects’ weakest
movement patterns and, furthermore, their corrective exercise
program. However, to standardize the study, subjects persisted
with the program from the initial screening for the entire
8-week period. A built-in exercise progression would have
been valuable at week 4 to target the change in the weakest
links of the improved subjects, which consequently could have
produced further improvements during this period.
Because of the limited research including both a control
group and an intervention group while implementing an
intervention program to improve FMS scores, it was difficult
to compare the differences established in the current study
with previous literature. However, significant improvements in
FMS scores after a standardized intervention program com-
pared with previous research were established in American
footballers (7) and fire fighters (8). Additionally, this study
established similar findings to Frost et al. (14) regarding a large
number of participants with the score of 2 on particular tests.
Furthermore, a score of 2 encompassed a broad range of
movement quality and differences between subjects, i.e., good
2’s and bad 2’s. However, based on the scoring criteria, the
same score had to be given. Frost et al. (14) tried to overcome
this problem by using a modified 100-point scoring system
based on possible compensations. However, the criteria could
be complex to implement without video analysis, which could
taint the FMS ability to be a simplistic and time-effective
screening tool. That been said, it should not deter coaches
making notes during the screening process, with regard to
the compensations identified, until a superior live scoring sys-
tem is available.
The results also indicated that the intervention program
significantly increased the number of participants whose
scores exceeded the previously established injury factor of
14. When exclusively focusing on the intervention group, pre-
intervention testing (week 0) identified that no participant
scored above the injury factor of 14, whereas, at 4- and 8-week
test periods, 66% of participants increased scores to .14.
These findings are comparable with the results of Kiesel
et al. (18), who reported that 11% of participants pre-interven-
tion scored .14 compared with 63% postintervention. Finally,
the results highlighted that a greater number of participants in
the intervention group were free from asymmetry at week 4
and week 8 testing compared to the start of the study.
The mean pre-intervention FMS test scores for both
the control and intervention groups were 13.23 6 0.80 and
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13.25 6 0.87, respectively. These results were compared with
the scores of professional nonlinemen American football
players who displayed a mean score of 13.3 6 1.9 (18) and
fire fighters 13.25 6 2.25 (8). The mean postintervention test
scores were 15.17 6 1.21 (week 4) and 15.33 6 1.43 (week 8),
which were comparable to values of general active males 15.8 6
1.9 (32). In addition, the results from the pre-intervention
screening revealed a number of trends regarding dysfunctional
movement patterns in both control and intervention groups,
including 13 shoulder mobility scores of 1 or asymmetries
and 10 active straight leg raise (ASLR) scores of 1 or asymme-
tries. Although the sample size was small, the participants came
from 5 unconnected gyms and were under the instruction of
different coaches resulting in a variety of training methods and,
therefore, represented a varied population, suggesting the move-
ment dysfunctions could be a common trait apparent in other
MMA fighters at this level.
Further investigation of the initial screening identified that
all asymmetrical ASLR scores were superior on the dominant
kicking leg. This could be a consequence of the continued use
of the limb during training and competition. As Turner (35)
suggested, limb dominance was 1 of 3 demands placed on the
body that could influence functional asymmetries.
Insufficient lumbopelvic stability may have affected ASLR
scores when assessed under the FMS procedure. Hip flexion
with decreased lumbopelvic stability may have caused an
anterior rotation of the pelvis, consequently, lengthening the
hamstrings because of the biarticular nature (4), therefore,
giving a false representation of a tight or short hamstring.
Liebenson et al. (23) documented that core engagement
through abdominal bracing before the ASLR significantly
increased muscle activity around the lumbopelvic region,
which, in turn, increased lumbar spine stability. Liebenson
et al. (23) hypothesized that the increased muscle activity
may have also facilitated pelvic stability. When taking into
account the above research, leg lowering with core engage-
ment, as outlined in the FMS advance corrective manual
(15), was used in the corrective strategies to help target this
issue. The exercise initiated core activation with a cook resis-
tance band before disassociating the legs, consequently help-
ing stabilize and resequence the muscle activation, altering
motor control of the leg raising pattern (4).
The low scores on the ASLR could also be attributed to
poor flexibility of the hamstring muscle group, and this would
relate back to the research of Schick et al. (33) who estab-
lished sit and reach test results in MMA athletes to be 30.3 cm
6 10.6, compared with kung-fu athletes’ (45.6 cm 6 6.1).
Schick et al. (33) suggested that this was a result of MMA
training focusing on flexibility to a lesser extent than more
traditional martial arts, which integrated flexibility as an inte-
gral aspect of training.
Finally, a common movement was observed during the
preliminary testing, which influenced some of the low scores
and/or asymmetries on the ASLR. A number of participants
failed to sustain the neutral position of the nonmoving
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 FMS Test Scores in MMA Athletes
(downward) limb and had a tendency to externally rotate to
facilitate the movement of the raised leg. This movement
pattern is noted as compensation in Cook (6) and, therefore,
had to be taken into account when scoring. External rotation
of downward leg is a common and critical feature of the
various kicks in MMA to allow rotation of the hip and knee.
Because kicking in MMA requires tri-planar movement, it
cannot be a direct comparison to the ASLR, which is assess-
ing movement strictly in the sagittal plane. However, it is an
active leg raise requiring hip flexion/knee extension of the
moving leg and hip extension of the downward leg, disasso-
ciating 1 leg from the other; all of which are major compo-
nents of the ASLR assessment. Therefore, subjects could have
displayed a sports-specific adaptation from kicking; moreover,
would correcting this movement pattern compensation on
the FMS affect the participants’ sporting performance?
Shoulder mobility was another limitation apparent in both
control and intervention groups. A possible mechanism
behind the insufficient scores in shoulder mobility could be
related back to the observations of Amtmann and Berry (2)
and Amtmann (1), who recognized that MMA athletes had
a propensity to develop the anterior muscles greater than the
posterior muscles. The anterior imbalance could accelerate
the kyphotic posture adaptations previously identified by
Kritz and Cronin (21) in combat athletes, through muscle
architecture alterations. Consequently, adaptations in posture
such as kyphosis and rounded shoulders have been reported
to reduce glenohumeral mobility (9,22). However, in some
instances especially whilst the fight is taking place on the feet,
this suboptimal posture is actually advantageous for MMA
athletes, acting as a defense mechanism from punches and
kicks. Although advantageous, these adaptations would need
managing through corrective exercise for other aspects of the
sport and training.
Another possible reason for insufficient scores and asym-
metries may compile from specificity of training becoming too
specific, with exercises imitating the biomechanical demands
of the sport (16). Most sports-specific exercises are unilateral;
Graham-Smith et al. (16) examined a common reverse punch
adapted exercise from boxing, using both a dumbbell and
a cable column; the exercise required repetitive use of a limb
under load. Repetitive use of a unilateral movement in base-
ball pitchers has been reported to reduce shoulder mobility
internal rotation compared with the contralateral side (11).
This could compare with the repetitive use of a limb during
MMA competition, sparing, and the aforementioned sports-
specific exercise training. Graham-Smith et al. (16) suggested
that the inclusion of such sports-specific exercises would jus-
tify the addition of nonspecific exercises to correct imbalance
and asymmetry adaptations.
PRACTICAL APPLICATIONS
The FMS would be an advantageous addition to pre-exercise
screening assessments, as the consideration of movement
quality should be assessed before that of quantity. Most if
the TM
224 Journal of Strength and Conditioning Research
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
not all, the movements covered on the FMS relate to many
aspects of strength and conditioning and MMA. The knowl-
edge that the FMS can identify movement dysfunctions and,
furthermore, the fact that the issues can be improved through
a standardized intervention program of corrective exercise
could be advantageous to MMA coaches and strength and
conditioning specialists, thus providing the opportunity to
adapt or implement new additions to training programs, based
on the dysfunctions and limiting factors identified using the
FMS. Without the FMS, coaches and fitness professionals
could be implementing exercises onto an insufficient move-
ment foundation and causing further problems.
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