University of Oulu

Toivo K, Kannus P, Kokko S, et al. Musculoskeletal examination in young athletes and non-athletes: the Finnish Health Promoting Sports Club (FHPSC) study. BMJ Open Sport & Exercise Medicine 2018;4:e000376. doi:10.1136/bmjsem-2018-000376

Musculoskeletal examination in young athletes and non-athletes : the Finnish Health Promoting Sports Club (FHPSC) study

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Author: Toivo, Kerttu1,2; Kannus, Pekka1,2; Kokko, Sami3;
Organizations: 1Tampere Research Center of Sports Medicine, Tampere, Finland
2UKK Institute for Health Promotion Research, Tampere, Finland
3Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
4Clinic for Sports and Exercise Medicine, Helsinki, Finland
5 Paavo Nurmi Centre & Unit of Health and Physical Activity, University of Turku, Turku, Finland
6Department of Sports and Exercise Clinic, Oulu Deaconess Institute, Oulu, Finland
7Center for Life Course Health Research, University of Oulu, Oulu, Finland
8Medical Research Center, University of Oulu and University Hospital of Oulu, Oulu, Finland
9Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
10Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
11 Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: BMJ, 2018
Publish Date: 2018-11-08


Objectives: To determine the inter-rater repeatability of a musculoskeletal examination and to compare findings between adolescent athletes and non-athletes in Finland.

Methods: In this cross-sectional study, a musculoskeletal examination assessing posture, mobility and movement control was carried out by a sports and exercise medicine physician on 399 athletes aged 14–17 years and 177 non-athletes. Within 2 weeks another sports and exercise medicine physician repeated the examination for 41 adolescents to test the inter-rater repeatability.

Results: In total, 10 of the 11 tests performed had at least moderate inter-rater reliability (κ ≥0.4 or percentage agreement >80%). Athletes more often than non-athletes had one shoulder protruded (8.0% vs 4.0%, OR 2.81, 95% CI 1.16 to 6.81). Forty-six per cent of athletes had good knee control in the two-legged vertical drop jump test compared with 32% of non-athletes (OR 1.99, 95% CI 1.29 to 3.06). Athletes had better core muscle control with 86.3% being able to remain in the correct plank position for 30 s compared with 68.6% of non-athletes (OR 2.70, 95% CI 1.67 to 4.36). In the deep squat test, good lumbar spine control was maintained only by 35.8% of athletes and 38.4% of non-athletes.

Conclusions: A basic musculoskeletal examination is sufficiently reliable to be performed by trained physicians as a part of a periodic health evaluation. Shortfalls in mobility, posture and movement control are common in both athletes and non-athletes. These deficits could have been caused by sedentary behaviour, monotonous training, or both.

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Series: BMJ open sport & exercise medicine
ISSN: 2055-7647
ISSN-E: 2055-7647
ISSN-L: 2055-7647
Volume: 4
Issue: 1
Article number: e000376
DOI: 10.1136/ bmjsem-2018-000376
OADOI: bmjsem-2018-000376
Type of Publication: A1 Journal article – refereed
Field of Science: 315 Sport and fitness sciences
Funding: This study was financially supported by the Finnish Ministry of Education and Culture (major, grant number: 6/091/2011) and Ministry of Social Affairs and Health (minor, grant number: 152/THL/TE/2012).
Copyright information: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: