Selective Functional Movement Assessment (SFMA)
Clinician-facing sibling of the FMS for patients WITH pain, reserved for licensed providers. Level 1 (~$799, diagnostic algorithm) and Level 2 (treatment model) with exam.
Inter-rater reliability among certified raters is fair-to-moderate (ICC 0.61-0.72); predictive validity of the parent FMS framework is contested-to-negative in multiple meta-analyses, and no RCT shows SFMA-guided care outperforms standard examination.
No RCT shows SFMA-guided treatment outperforms standard PT examination; supporting evidence is case reports, a pilot study, and one exploratory validity study with mixed findings.
Applies broadly across outpatient orthopedic and sports caseloads since it is built for patients with pain, though it adds little in acute care, neuro, pelvic health, or geriatrics.
Confers no billing privileges or payer advantage; movement assessment is bundled into standard PT evaluation codes.
The algorithmic top-tier-to-breakout structure systematizes whole-body examination, but the full breakout flowcharts are time-consuming to learn and apply initially.
Well recognized in sports medicine and performance-PT postings as preferred, essentially never required.
The whole-body, regional-interdependence narrative resonates with active patients, but no published data link SFMA use to satisfaction.
Fits the cash-based sports/performance niche; movement assessments package naturally into athlete intake evaluations, and the FMS brand has consumer recognition in fitness circles.
Supports modest premium positioning for athlete-focused evaluations, but the contested evidence base and ubiquity among sports clinicians limit defensible uplift.
Recognizable branding helps marketing, but SFMA certification is common enough among sports-focused clinicians that it differentiates only in generalist markets.
A standardized, trainable system that scales across staff and integrates with the broader FMS ecosystem for referral pipelines.
Steady demand in sports/performance segments; negligible pull in general orthopedic or Medicare-heavy markets.
Low cost (~$799 per level, online and self-paced with CEU approval) and fast to complete; low payback threshold.
Viewed as a proprietary commercial product rather than an academic credential; the negative FMS predictive-validity literature has dented its scholarly standing.
A genuine publishable literature exists (multiple IJSPT reliability studies) and open validity questions offer research opportunities, but the contested evidence cuts both ways.
The structured algorithm is a useful pedagogical scaffold for teaching systematic movement examination; novice-reliability studies show students learn it quickly.
Reliability fair-to-moderate at best, SFMA-specific validity barely explored, and the parent FMS injury-prediction claims are contradicted by multiple meta-analyses.
Essentially never appears in faculty position requirements.
Cheap and quick relative to academic credentials, so time cost is trivial even if academic payoff is small.
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- 01DOI ↗Intra- and inter-rater reliability of the selective functional movement assessment (SFMA)Glaws KR, Juneau CM, Becker LC, Di Stasi SL, Hewett TE · International Journal of Sports Physical Therapy · 2014First psychometric study: reliability varied from poor to good by movement pattern, with greater SFMA experience associated with better agreement.Cross-sectionalPMID 24790781
- 02DOI ↗Inter-rater reliability of the Selective Functional Movement Assessment (SFMA) by SFMA certified physical therapists with similar clinical and rating experienceDolbeer J, Mason J, Morris J, Crowell M, Goss D · International Journal of Sports Physical Therapy · 2017In 49 patients with pain, experienced certified PTs achieved moderate-or-better agreement on 10 of 15 movements; composite ICC 0.72 real-time.Cross-sectionalPMID 29181253
- 03DOI ↗Intra- and inter-rater reliability of the Selective Functional Movement Assessment (SFMA) in healthy participantsStanek JM, Smith J, Petrie J · International Journal of Sports Physical Therapy · 2019Certified clinicians with greater SFMA experience demonstrated adequate reliability with the categorical scoring method; cervical patterns weakest.Cross-sectionalPMID 30746297
- 04DOI ↗Novice Inter-Rater Reliability on the Selective Functional Movement Assessment (SFMA) After a 4-Hour Training SessionHarper B, Aron A · International Journal of Sports Physical Therapy · 2023DPT students achieved moderate inter-rater reliability after 4 hours of training but identified fewer dysfunctions than a certified clinician.Cross-sectionaldoi:10.26603/001c.82173
- 05DOI ↗Selective Functional Movement Assessment (SFMA) Reliability and Proposal of Its Use in SportsAghi A, Salvagnini D, Berton G, et al. · International Journal of Environmental Research and Public Health · 2023In 28 competitive athletes, inter-rater reliability between expert and briefly-trained student was good (Kappa 0.60-0.62); intra-rater only moderate.Cross-sectionaldoi:10.3390/ijerph20032032
- 06DOI ↗Correlation of self-reported outcome measures and the Selective Functional Movement Assessment (SFMA): an exploration of validityRiebel M, Crowell M, Dolbeer J, Szymanek E, Goss D · International Journal of Sports Physical Therapy · 2017In 85 patients re-tested after 6 weeks, improvements in self-reported function correlated with reductions in painful SFMA patterns but NOT consistently with movement-quality changes; mixed construct validity.Cohort studydoi:10.26603/ijspt20170931
- 07DOI ↗The Effect of Exercise Intervention Based Upon the Selective Functional Movement Assessment in an Athlete With Non-specific Low Back Pain: A Case Report and Pilot StudyHuang L, Liu H, Zhao L, Peng L · Frontiers in Psychology · 20208-week SFMA-guided program in one athlete with chronic low back pain reduced pain and disability; low-level (n=1) evidence of clinical utility.Pilot/feasibilitydoi:10.3389/fpsyg.2020.02010
- 08DOI ↗Using the Selective Functional Movement Assessment and regional interdependence theory to guide treatment of an athlete with back pain: a case reportGoshtigian GR, Swanson BT · International Journal of Sports Physical Therapy · 2016Case report demonstrating SFMA breakouts directing treatment to remote impairments with positive outcomes; illustrative, lowest-tier evidence.Case seriesPMID 27525182
- 09DOI ↗Functional movement screening: the use of fundamental movements as an assessment of function - part 1Cook G, Burton L, Hoogenboom BJ, Voight M · International Journal of Sports Physical Therapy · 2014Foundational paper by the system's creators describing the FMS/SFMA conceptual framework and rationale underlying the certification.Narrative reviewPMID 24944860
- 10DOI ↗Do Functional Movement Screen (FMS) composite scores predict subsequent injury? A systematic review with meta-analysisMoran RW, Schneiders AG, Mason J, Sullivan SJ · British Journal of Sports Medicine · 2017CRITICAL: only a small association between FMS composite scores and injury; methodological limitations mean FMS composites should not be relied on for injury prognosis.Meta-analysisdoi:10.1136/bjsports-2016-096938
- 11DOI ↗Reliability, Validity, and Injury Predictive Value of the Functional Movement Screen: A Systematic Review and Meta-analysisBonazza NA, Smuin D, Onks CA, Silvis ML, Dhawan A · American Journal of Sports Medicine · 2017Excellent inter-rater reliability and increased injury odds with scores ≤14, but heterogeneity limits use as a standalone injury-prediction tool.Meta-analysisdoi:10.1177/0363546516641937
- 12DOI ↗Evaluation of the Functional Movement Screen as an Injury Prediction Tool Among Active Adult Populations: A Systematic Review and Meta-analysisDorrel BS, Long T, Shaffer S, Myer GD · Sports Health · 2015CRITICAL: high specificity (85.7%) but very low sensitivity (24.7%); findings do not support the predictive validity of the FMS.Meta-analysisdoi:10.1177/1941738115607445
- 13DOI ↗Predicting sport and occupational lower extremity injury risk through movement quality screening: a systematic reviewWhittaker JL, Booysen N, de la Motte S, et al. · British Journal of Sports Medicine · 2017CRITICAL: evidence that poor movement quality is associated with increased injury risk was inconsistent across 17 mostly low-quality studies.Systematic reviewdoi:10.1136/bjsports-2016-096760
- 14DOI ↗Why screening tests to predict injury do not work—and probably never will…: a critical reviewBahr R · British Journal of Sports Medicine · 2016CRITICAL: influential conceptual critique demonstrating no screening test has met the validation steps required to predict and prevent sports injuries.Narrative reviewdoi:10.1136/bjsports-2016-096256
- 15DOI ↗Functional movement screening: the use of fundamental movements as an assessment of function-part 2G. Cook; L. Burton; B. J. Hoogenboom; M. Voight · Int J Sports Phys Ther · 2014PMID 25133083
- 16DOI ↗Factors Influencing the Relationship Between the Functional Movement Screen and Injury Risk in Sporting Populations: A Systematic Review and Meta-analysisE. Moore; S. Chalmers; S. Milanese; J. T. Fuller · Sports Med · 2019Meta-analysisdoi:10.1007/s40279-019-01126-5
- 17DOI ↗Pre-participation screening: the use of fundamental movements as an assessment of function - part 1G. Cook; L. Burton; B. Hoogenboom · N Am J Sports Phys Ther · 2006PMID 21522216
- 18DOI ↗The effectiveness of the functional movement screen in determining injury risk in tactical occupationsR. O. Kollock; M. Lyons; G. Sanders; D. Hale · Ind Health · 2019Meta-analysisdoi:10.2486/indhealth.2018-0086
- 19DOI ↗Efficacy of the functional movement screen: a reviewK. Kraus; E. Schütz; W. R. Taylor; R. Doyscher · J Strength Cond Res · 2014Narrative reviewdoi:10.1519/JSC.0000000000000556
- 20DOI ↗The Movement Competency Screen Shows Improved Injury Predictive Ability Compared With the Functional Movement Screen in Ballet and Contemporary Dance Populations: A Critically Appraised TopicE. Callahan; L. C. Mangum · J Sport Rehabil · 2025Systematic reviewdoi:10.1123/jsr.2024-0194
- 21DOI ↗Utility of FMS to understand injury incidence in sports: current perspectivesM. Warren; M. R. Lininger; N. J. Chimera; C. A. Smith · Open Access J Sports Med · 2018Narrative reviewdoi:10.2147/OAJSM.S149139
- 22DOI ↗Impact of Core Training on Functional Movement Screen Scores in Athletes: A Critically Appraised TopicC. Niebla; R. Carson; L. C. Mangum · J Sport Rehabil · 2025Systematic reviewdoi:10.1123/jsr.2024-0204
- 23DOI ↗Myofascial and Movement Tests after Anterior Cruciate Ligament ReconstructionM. Biały; K. Kublin; G. Brzuszkiewicz-Kuźmicka; R. Gnat · J Hum Kinet · 2022doi:10.2478/hukin-2022-0052
- 24DOI ↗Association between Functional Movement Screen Scores and Athletic Performance in Adolescents: A Systematic ReviewK. Fitton Davies; R. S. Sacko; M. A. Lyons; M. J. Duncan · Sports (Basel) · 2022Systematic reviewdoi:10.3390/sports10030028
- 25DOI ↗How reliable are Functional Movement Screening scores? A systematic review of rater reliabilityR. W. Moran; A. G. Schneiders; K. M. Major; S. J. Sullivan · Br J Sports Med · 2016Systematic reviewdoi:10.1136/bjsports-2015-094913
- 26DOI ↗Effective Interventions for Improving Functional Movement Screen Scores Among "High-Risk" Athletes: A Systematic ReviewS. C. Clark; N. D. Rowe; M. Adnan; S. M. Brown; M. K. Mulcahey · Int J Sports Phys Ther · 2022Systematic reviewdoi:10.26603/001c.31001
- 27DOI ↗Evaluation of the Functional Movement Screen (FMS) in Identifying Active Females Who are Prone to Injury. A Systematic ReviewM. Asgari; S. Alizadeh; A. Sendt; T. Jaitner · Sports Med Open · 2021Systematic reviewdoi:10.1186/s40798-021-00380-0
- 28DOI ↗Movement Control Impairment and Low Back Pain: State of the Art of Diagnostic FramingS. Salvioli; A. Pozzi; M. Testa · Medicina (Kaunas) · 2019Systematic reviewdoi:10.3390/medicina55090548