Influence of a Corrective Exercise Training Program on Measures of Functional Movement Among Active-Duty Firefighters

Study Overview
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Brief Summary
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The occupation of firefighting is considered to be one of the most dangerous occupations in the United States (U.S.). As such, a high prevalence of musculoskeletal injuries (MSKIs) have been observed among the firefighter population. This high rate of MSKI has created an extremely large financial impact on fire departments across the United States. Therefore, interest in developing methods of identifying those at risk for developing a future MSKI and interventions designed to prevent these MSKIs from happening has grown among both the firefighter population, as well as among researchers and practitioners. Previous research has demonstrated relationships between MSKI and altered movement patterns. In addition, researchers have started to demonstrate the ability of functional movement assessments to predict future MSKI in various populations, including firefighters. Two of these functional movement assessments include the Functional Movement Screen (FMS) and the Movement Efficiency (ME) Test, which is a component of the Fusionetics Human Performance System. These assessments both quantify the overall functional movement quality of an individual by creating a composite movement score (i.e., Total FMS & Average ME Test scores, respectively). In addition, various theoretical models of corrective exercise programming have been proposed. These programs are designed to restore optimal neuromuscular control and correct any identified neuromuscular imbalances observed during the movement assessment through the use of simple and easy-to-follow exercises. The Fusionetics Human Performance System utilizes one such model, with the goal of improving the functional movement quality of an individual by correcting the aforementioned neuromuscular deficiencies observed during the ME Test. Based on this framework, these corrective exercise programs theoretically lower the risk of MSKI of the individual as well. However, there is currently a lack of research in the literature examining the influence of corrective exercise programming on functional movement quality among the active-duty firefighter population. As such, it remains unknown if a corrective exercise intervention is capable of significantly improving functional movement quality among active-duty firefighters. In addition, recent research suggests that various health and fitness measures are associated with functional movement quality. These measures include total body power output, lower extremity muscular strength, and core muscular endurance. As such, an examination of the influence of a corrective exercise intervention on measures of health and fitness among active-duty firefighters is warranted.

Official Title
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Influence of a Corrective Exercise Training Program on Measures of Functional Movement Among Active-Duty Firefighters

Conditions
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Functional Movement Quality

Intervention / Treatment
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* Other: Corrective Exercise Programming


Participation Criteria
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Eligibility Criteria
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General Eligibility Criteria: Participants will be considered eligible for this study if they: are fluent in speaking and writing English; are at least 18 years of age; they are an active-duty firefighter; are cleared by their fire department for full active-duty work; and have been an active-duty firefighter for at least 12 months (i.e., one year). Inclusion Criteria: Participants will be included into this study if they: do not suffer from chest pain or dizziness; have not been diagnosed with a heart condition; are not currently pregnant; have not had any serious ankle, knee, hip, back, or shoulder trauma that required medical attention in the past 3 months; have not had surgery on their ankle, knee, hip, back, or shoulder within the past year (12 months); or do not have any current bone, joint, or muscle abnormalities that require medical attention; have not been instructed by a physician or their Health and Safety Officer (HSO) to not participate in this study. Exclusion Criteria: 1. Participants will be excluded from being placed into Phase 2 (i.e., the intervention portion) of this study if they are already engaged in a structured corrective exercise program. Furthermore, in order to ensure similar baseline functional movement quality between the CEP and CON groups, participants will be excluded from being placed into the intervention portion of this study if their Overall MET score is < 25 or > 75.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Corrective Exercise Program<br>Participants in the Corrective Exercise Program (CEP) group (n = 28) will be given a four-week corrective exercise programming intervention. | Other: Corrective Exercise Programming<br>* Participants will be given a four-week corrective exercise protocol, with four corrective exercise sessions prescribed each week. Participants in the CEP Group will be required to complete a minimum of three of these four training sessions per week throughout the four-week corrective exercise program intervention. All corrective exercise programming will be created through the Fusionetics Human Performance System. This system, along with weekly compliance questionnaires, will also assess the compliance-level among the participants.<br>|
| No Intervention: Control<br>The participants in the Control (CON) group (n = 28) will have their four-week corrective exercise programming intervention deferred for 4 weeks, and as such, will serve as the comparative group for the CEP group. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Total Functional Movement Screen (FMS) Score | The Functional Movement Screen (FMS) is a seven task movement screen test that will be scored on a 4-point scale (0-3, worst-best), for a total of 21 possible points. | Pre-Intervention (Week 0), Mid-Intervention (Week 3), Post-Intervention (Week 5) | 
| Change in Overall Movement Efficiency (ME) Test Score | The Movement Efficiency (ME) Test, which is part of the Fusionetics Human Performance System, uses a 0-100 scale to score the functional movement quality of an individual. | Pre-Intervention (Week 0), Mid-Intervention (Week 3), Post-Intervention (Week 5) | 
| Change in Dynamic Balance Ability | The dynamic balance ability of each participant will be assessed by utilizing the Y-Balance Test (YBT). | Pre-Intervention (Week 0), Mid-Intervention (Week 3), Post-Intervention (Week 5) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Range of Motion | Passive range of Motion (PROM) for the foot, ankle, knee, hip, shoulder, and trunk will be bilaterally measured with a standard plastic goniometer (a kind of ruler). | Pre-Intervention (Week 0), Mid-Intervention (Week 3), Post-Intervention (Week 5) | 
| Change in Total Body Power Output | Total body power output will be examined by performing a countermovement jump (CMJ), which is a field-test commonly utilized by practitioners to examine total body power output. | Pre-Intervention (Week 0), Mid-Intervention (Week 3), Post-Intervention (Week 5) | 
| Change in Lower Extremity Isometric Muscular Strength | The isometric lower extremity muscular strength of each participant will be examined utilizing the Jackson Strength Evaluation System. | Pre-Intervention (Week 0), Mid-Intervention (Week 3), Post-Intervention (Week 5) | 
| Change in Core Muscular Endurance | The overall core muscular endurance of each participant will be examined through the use of a prone plank. Participants will perform a prone plank until volitional fatigue. | Pre-Intervention (Week 0), Mid-Intervention (Week 3), Post-Intervention (Week 5) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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corrective exercise program, movement efficiency