The Long-Term Effect of Auto-Generated Corrective Exercise Programming on Movement Literacy Among Firefighters

Introduction: Approximately 50% of firefighter injuries occur in the musculoskeletal system and poor movement quality increases injury risk. Previous research suggests that corrective exercise interventions with integrated movements improve movement literacy; however, the long-term benefit of corrective exercise programming has not been established among firefighters. Purpose: To investigate, as a continuation of a previously published short-term (mean—267 days) outcome pilot study, the long-term effectiveness of auto-generated corrective exercise programming on movement literacy scores among firefighters with lower baseline scores. Methods: Nine male firefighters (mean age +/− standard deviation 40 (12)) with baseline Functional Movement System (FMS™) scores less than 14/21 were initially recruited from October 2021 to September 2022. Baseline FMS™ assessments included detailed explanations of the seven movement screens as well as five clearing procedures and scoring criteria. A certified FMS™ professional performed each test first, prior to scoring, to demonstrate what was expected and firefighters were permitted to attempt each test for a total of three times with the highest score retained. Scores ranged from 0 to 3 for each of the seven movement screens with a maximum composite score of 21. Upon completing the screenings, test scores were reviewed and a detailed report was provided to each firefighter through the FMS™PRO APP. Additionally, each participant received an auto-generated corrective exercise program from the FMS™PRO APP with exercise figures, descriptions, and videos to be performed prior to routine conditioning programs. Participants were re-evaluated an average of 813 days after baseline for the long-term follow-up (F2). Pairwise comparisons from baseline to F2, as well as from a previously reported short-term follow-up (F1) to F2, were evaluated using the Friedman and Wilcoxon signed-rank tests. A Bonferroni correction resulted in an adjusted alpha of p = 0.025. Results: Composite FMS™ scores improved from a baseline mean of 11.3/21 to 14.7/21 at F2. When F2 was compared to the F1 scores from the previously published data set, scores declined by a mean of 1.4 points. Compared with baseline, scores at F2 were significantly improved (p = 0.013) with a large effect size (r = 0.83). In contrast, score declines (r = −0.73) from F1 to F2 were not statistically significant after Bonferroni correction (p = 0.028). Conclusions: An auto-generated corrective exercise program combined with a detailed explanation of baseline performance was effective in improving overall movement literacy in a standardized movement assessment tool in a long-term follow-up exceeding 2 years. The composite score change exceeded the threshold of error based on a previously established minimal detectable change (MDC) of 2.5/21, indicating true change occurred from baseline to F2. The decline from F1 to F2 did not exceed the threshold of error based on the MDC and may represent a regression to the mean and participant acknowledgement of marginal adherence after F1. Long-term adherence to programming is necessary to prevent the tapering of improvements seen in this study. The absence of a comparison or control group is a study limitation.