Sadra Medical Journal

Association between Dynamic Neuromuscular Stabilization Functional Test and the Incidence of Musculoskeletal Injuries in Football Players

Document Type : Original Article

Authors

Mojtaba Kamkar 1
Ali Asghar Norasteh 2
Mostafa Zarei 3

1 Department of Corrective Exercises and Sport Injuries, School of Physical Education and Sport Sciences, University of Guilan, Rasht, Iran

2 Department of Physiotherapy, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran

3 Department of Sport Rehabilitation and Health, Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, Iran

https://doi.org/10.30476/smsj.2026.107326.1648
Abstract
Introduction: Non-contact injuries are a common issue in football, and identifying potential risk factors can aid in designing preventive interventions. This study aimed to investigate the association between the Dynamic Neuromuscular Stabilization Functional (FDNS) Test and the incidence of non-contact musculoskeletal injuries in football players.
Methods: This prospective correlational study involved 100 male football players aged 18-25 years who were active in the North Khorasan provincial league in 2023. All participants performed the FDNS test, which consisted of 11 subtests. Non-contact sports injuries were recorded weekly throughout the season by the researcher using a modified version of the Fuller et al., injury questionnaire. Data were analyzed using Spearman’s correlation coefficient at a significance level of P<0.05 with SPSS software, version 27.
Results: A total of 45 non-contact injuries were reported during the season (prevalence rate=45%; injury incidence=4.1 injuries per 1000 hours). The most common injury sites were the ankle, groin, and hamstring. There was a statistically significant but weak negative correlation between the overall FDNS test score and non-contact injuries (r=-0.304, P=0.002). Among the subtests, hip flexion (r=-0.230, P=0.043) and trunk extension (r=-0.244, P=0.014) showed weak but significant correlations with injury occurrence.
Conclusion: The observed association between the FDNS test scores and non-contact injuries in this study was weak. However, this test might have the potential to be used as a component of initial injury screening. Nevertheless, further studies are necessary to more comprehensively evaluate the predictive validity of this test

Keywords

Incidence
Cumulative Trauma Disorders
Athletic Injuries
Postural Balance
Core stability
Soccer
Exercise
  1. Dekkers LM, Janssen AJ, Donders ART, Nijhuis-van der Sanden MW, de Swart BJ. Construct validity of the observable movement quality scale in pediatrics: hypothesis testing of a formative measurement model. Phys Ther. 2020;100(2):346-58.
  2. Dekkers LM, de Swart BJ, Jonker M, van Erp P, Wisman A, van der Wees PJ, et al. Reliability and responsiveness of the observable movement quality scale for children with mild to moderate motor impairments. Phys Occup Ther Pediatr. 2020;40(6):681-96.
  3. Boden BP, Dean GS, Feagin JA, Garrett WE. Mechanisms of anterior cruciate ligament injury. J Athl Train. 2000;35(2):181-6.
  4. Cook G, Burton L, Kiesel K, Rose G, Brynt MF. Movement: functional movement systems: screening, assessment, corrective strategies. 1st ed. Aptos: On Target Publications; 2010. p. 73-106.
  5. Sahrmann S. Diagnosis and treatment of movement impairment syndromes. St Louis: Mosby; 2002.
  6. Frank C, Kobesova A, Kolar P. Dynamic neuromuscular stabilization & sports rehabilitation. Int J Sports Phys Ther. 2013;8(1):62-73.
  7. Alvani E, Zia M, Sahebzamani M, Sahbzamani M. The effect of dynamic neuromuscular stabilization (DNS) exercises on dynamic balance and functional disability in athletes with non-specific chronic low back pain. Res Sport Rehabil. 2020;8(15):127-38.
  8. Hernández-García R, Aparicio-Sarmiento A, Palao JM, de Baranda PS. Influence of previous injuries on fundamental movement patterns in professional female soccer players. Rev Int Cienc Deporte. 2020;16(60):214-35.
  9. Huxel Bliven KC, Anderson BE. Core stability training for injury prevention. Sports Health. 2013;5(6):514-22.
  10. McCunn R, Meyer T. Screening for risk factors: if you liked it then you should have put a number on it. Br J Sports Med. 2016;50(21):1354.
  11. Cha YJ, Lee JJ, Kim DH, You JH. The validity and reliability of a dynamic neuromuscular stabilization-heel sliding test for core stability. Technol Health Care. 2017;25(5):981-8.
  12. Kobesova A, Davidek P, Morris CE, Andel R, Maxwell M, Oplatkova L, et al. Functional postural-stabilization tests according to Dynamic Neuromuscular Stabilization approach: proposal of novel examination protocol. J Bodyw Mov Ther. 2020;24(3):84-95.
  13. Kivlan BR, Martin RL. Functional performance testing of the hip in athletes: a systematic review for reliability and validity. Int J Sports Phys Ther. 2012;7(4):402-12.
  14. Kritz M, Cronin J, Hume P. The bodyweight squat: a movement screen for the squat pattern. Strength Cond J. 2009;31(1):76-85.
  15. Cook G, Burton L, Hoogenboom BJ, Voight M. Functional movement screening: the use of fundamental movements as an assessment of function—part 1. Int J Sports Phys Ther. 2014;9(3):396-409.
  16. Cook G, Burton L, Hoogenboom B. Pre-participation screening: the use of fundamental movements as an assessment of function–part 1. N Am J Sports Phys Ther. 2006;1(2):62-72.
  17. Cook G, Burton L, Hoogenboom BJ, Voight M. Functional movement screening: the use of fundamental movements as an assessment of function—part 1. Int J Sports Phys Ther. 2014;9(3):396-409.
  18. Caraffa A, Cerulli G, Projetti M, Aisa G, Rizzo A. Prevention of anterior cruciate ligament injuries in soccer: a prospective controlled study of proprioceptive training. Knee Surg Sports Traumatol Arthrosc. 1996;4(1):19-21.
  19. Fousekis K, Tsepis E, Vagenas G. Intrinsic risk factors of noncontact ankle sprains in soccer: a prospective study on 100 professional players. Am J Sports Med. 2012;40(8):1842-50.
  20. Wilke C, Pfeiffer L, Froböse I. Return to sports after lower extremity injuries: assessment of movement quality. Health (Irvine Calif). 2017;9(10):e1416.
  21. Mok KM, Leow RS. Measurement of movement patterns to enhance ACL injury prevention—a dead end? Asia Pac J Sports Med Arthrosc Rehabil Technol. 2016;5:13-6.
  22. Anderson BE, Neumann ML, Bliven KCH. Functional movement screen differences between male and female secondary school athletes. J Strength Cond Res. 2015;29(4):1098-106.
  23. Monaco JT, Schoenfeld BJ. A review of the current literature on the utility of the functional movement screen as a screening tool to identify athletes’ risk for injury. Strength Cond J. 2019;41(5):17-23.
  24. Sheu Y, Chen LH, Hedegaard H. Sports- and recreation-related injury episodes in the United States, 2011–2014. Natl Health Stat Report. 2016;(99):1-12.
  25. Bennett H, Davison K, Arnold J, Slattery F, Martin M, Norton K. Multicomponent musculoskeletal movement assessment tools: a systematic review and critical appraisal of their development and applicability to professional practice. J Strength Cond Res. 2017;31(10):2903-19.
  26. Chimera NJ, Warren M. Use of clinical movement screening tests to predict injury in sport. World J Orthop. 2016;7(4):202-10.
  27. Leeder JE, Horsley IG, Herrington LC. The inter-rater reliability of the functional movement screen within an athletic population using untrained raters. J Strength Cond Res. 2016;30(9):2591-9.
  28. Kobesova A, Safarova M, Kolar P. Dynamic neuromuscular stabilization: exercise in developmental positions to achieve spinal stability and functional joint centration. In: Textbook of musculoskeletal medicine. Oxford: Oxford University Press; 2016. p. 1-15.
  29. Jacisko J, Stribrny M, Novak J, Busch A, Cerny P, Kolar P, et al. Correlation between palpatory assessment and pressure sensors in response to postural trunk tests. Isokinet Exerc Sci. 2021;29(3):299-308.
  30. Kobesova A, Davidek P, Morris CE, Andel R, Maxwell M, Oplatkova L, et al. Functional postural-stabilization tests according to Dynamic Neuromuscular Stabilization approach: proposal of novel examination protocol. J Bodyw Mov Ther. 2020;24(3):84-95.
  31. Jebavy R, Baláš J, Vomackova H, Szarzec J, Stastny P. The effect of traditional and stabilization-oriented exercises on deep stabilization system function in elite futsal players. Sports (Basel). 2020;8(12):153.
  32. Fuller CW, Ekstrand J, Junge A, Andersen TE, Bahr R, Dvorak J, et al. Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Scand J Med Sci Sports. 2006;16(2):83-92.
  33. Batavani MR, Dehghani F, Zolaktaf V. The comparison and association of incidence and severity of exercise-induced injuries among various genotypes of ACTN3 in Iranian male elite weightlifters. J Biol Sport Med. 2022;5(2):1-10. Persian.
  34. Mohammadi MR, Daghigh Rezaii S. Prevalence, type, and mechanism of musculoskeletal injuries among elite male futsal student athletes in Iran. Res Biol Sci Phys Act. 2015;3(2):29-36.
  35. Nazari MH, Norasteh A, Zarei M. Can the Functional Movement Screen (FMS) predict musculoskeletal injuries in club-level track and field athletes? J Rehabil Med. 2023;12(6):1-8.
  36. De Blaiser C, De Ridder R, Willems T, Vanden Bossche L, Danneels L, Roosen P. Impaired core stability as a risk factor for the development of lower extremity overuse injuries: a prospective cohort study. Am J Sports Med. 2019;47(7):1713-21.
  37. Verrelst R, De Clercq D, Vanrenterghem J, Willems T, Palmans T, Witvrouw E. The role of proximal dynamic joint stability in the development of exertional medial tibial pain: a prospective study. Br J Sports Med. 2014;48(5):388-93.
  38. Sharma K, Yadav A. Dynamic neuromuscular stabilization—a narrative. Int J Health Sci Res. 2020;10(9):221-31.
  39. Kolář P, Kobesová A, Valouchová P, Bitnar P. Dynamic neuromuscular stabilization: development kinesiology: breathing stereotypes and postural-locomotion function. In: Recognizing and treating breathing disorders: a multidisciplinary approach. Edinburgh: Churchill Livingstone Elsevier; 2014. p. 11-22.
  40. Kolar P, Sulc J, Kyncl M, Sanda J, Neuwirth J, Bokarius A, et al. Stabilizing function of the diaphragm: dynamic MRI and synchronized spirometric assessment. J Appl Physiol (1985). 2010;109(4):1064-71.
  41. Zhao F. The application of sports biomechanics in sports injury prevention and rehabilitation. Front Sport Res. 2024;6(3):142-7.
  42. Pasanen K. Neuromuscular training and sport injury prevention in different types of sports—what we know and what we do not know? In: Sports Medicine. Hoboken: Wiley Online Library; 2021. p. 551-2.
  43. Milanović Z, Pantelić S, Sporiš G, Mohr M, Krustrup P. Health-related physical fitness in healthy untrained men: effects on VO2max, jump performance and flexibility of soccer and moderate-intensity continuous running. PLoS One. 2015;10(8):e0135319.
  44. Shimozawa Y, Kurihara T, Kusagawa Y, Hori M, Numasawa S, Sugiyama T, et al. Point prevalence of the biomechanical dimension of dysfunctional breathing patterns among competitive athletes. J Strength Cond Res. 2023;37(2):270-6.
  45. McDonald AA, Wilkerson GB, McDermott BP, Bonacci JA. Risk factors for initial and subsequent core or lower extremity sprain or strain among collegiate football players. J Athl Train. 2019;54(5):489-96.
  46. Nuhmani S. Correlation between core stability and upper-extremity performance in male collegiate athletes. Medicina (Kaunas). 2022;58(8):982.
  47. Myers TW. Anatomy trains: myofascial meridians for manual and movement therapists. Edinburgh: Elsevier Health Sciences; 2009.
  48. Sciascia A, Cromwell R. Kinetic chain rehabilitation: a theoretical framework. Rehabil Res Pract. 2012;2012:853037.
Sadra Medical Journal
Volume 14, Issue 2
Spring 2026
Pages 434-448

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