The Hip and Lower Limb Movement Screen
: Is it a valid tool to assess movement control in Royal Marines

  • Stephen Barbary

Student thesis: Master's ThesisMaster of Science

Abstract

There are several movement screens used in military and sporting populations, utilised with the intention of providing information about potentially harmful movement patterns. There remains a lack of research into the validity of many of these, and in particular a lack of research into their validity with specific populations. The Hip and Lower Limb Movement Screen (HLLMS) is a relatively new tool, initially conceived to look at hip control in footballers and increasingly under review for use with the Ministry of Defence (MOD) for its ability to assess movement control with different military groups. To date there are no available studies that have looked at the suitability of the HLLMS for use with Royal Marine personnel.

This research paper aims to establish the suitability of the HLLMS for use by the MOD generally and with a Royal Marine Population in particular. Using 3D motion analysis as a means to measure the kinematics and kinetics at the hip, knee and pelvis this study evaluated the ability of the HLLMS to predict movement faults in several military-type complex movements. This study looked at how the HLLMS was able to predict movement faults with movements similar to military usage such as adopting a firing position, stepping down, landing from a height and these were tested under military standards of load carriage as well as before and after a standard Royal Marine 8mile load carriage test known as the combat fitness test (CFT).

An custom-built Motion Analysis laboratory was built at 45 Commando Royal Marines and 32 Royal Marines were recruited and took part in intensive data collection over a 2 week period. Each individual performed the HLLMS followed by the Military Functional Movements, each with and without a 55lb load carriage. Both of these were then repeated the following day after an 8mile speed march (Combat Fitness Test (CFT)) carrying standard Bergen (rucksack) and rifle. The primary analysis was to compare key component parts of the HLLMS against hip, knee and pelvis kinematics performing Military Functional Movements – each movement was performed and analysed with and without load as well as before and after a CFT. Analysis was also carried out comparing these kinematics to HLLMS total scores and sub scores. Finally, analysis was performed on changes to the HLLMS scores with and without load and after completing a CFT.

The findings in this paper revealed consistent trends with certain component parts of the HLLMS to predict deviations in knee and hip kinematics on single leg squat (p=0.09), loaded single leg squat (p=0.09) and loaded lunge (p=0.07). In addition the HLLMS, Small Knee Bend (SKB) showed an 86% correlation between hip adduction max excursion value on loaded lunge (p=0.006) and a 72% correlation for an increase in knee rotational ROM on unloaded lunge (p=0.017). The results of the analysis of the HLLMS scores with and without load did not reveal any significant difference but on comparison of the scores before and after a CFT revealed a significant difference (p=0.008).

The author concludes that the key HLLMS observational faults of Knee Dynamic Valgus and Pelvis Fail To Stay Level demonstrate sufficient merit to recommend further use and research but suggests that the method of evaluating these complex movements may need to be reconsidered. The author also concludes that the clinical use of the HLLMS Small Knee Bend sub-scale in assessing movement faults in Royal Marines has significant value in particular in is ability to predict movement faults that occur whilst carrying load. Finally whilst further analysis is necessary the HLLMS’ ability to measure changes in performance after a CFT may also prove beneficial in improving our understanding of the effect this arduous activity has on movement control and how intervention may be best placed to limit these changes and reduce injury risk.
Date of Award2021
Original languageEnglish
SupervisorTim Drew (Supervisor) & Graham Arnold (Supervisor)

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