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The Effects of a Novel Quadrupedal Movement Training Program on Functional Movement, Range of Motion, Muscular Strength, and Endurance

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Buxton, JD, Prins, PJ, Miller, MG, Moreno, A, Welton, GL, Atwell, AD, Talampas, TR, and Elsey, GE. The effects of a novel quadrupedal movement training program on functional movement, range of motion, muscular strength, and endurance. J Strength Cond Res XX(X): 000-000, 2020-Quadrupedal movement training (QMT) is a form of bodyweight training incorporating animal poses, transitions, and crawling patterns to reportedly improve fitness. This type of training may improve multiple facets of fitness, unfortunately, little evidence exists to support commercial claims and guide practitioners in the best use of QMT. Therefore, the purpose of this study was to assess the impact of a commercially available QMT program on functional movement, dynamic balance, range of motion, and upper body strength and endurance. Forty-two active college-age (19.76 ± 2.10 years) subjects (males = 19, females = 23) were randomly assigned to a QMT (n = 21) or control (CON) (n = 21) group for 8 weeks. Quadrupedal movement training consisted of 60-minute classes performed 2×·wk in addition to regular physical activity. Active range of motion, Functional Movement Screen (FMS), Y-Balance Test (YBT), handgrip strength, and push-up endurance were assessed before and after the intervention. The QMT group showed significantly greater improvements than the CON group in FMS composite score (1.62 ± 1.53 vs. 0.33 ± 1.15, p = 0.004) and FMS advanced movements (0.81 ± 0.87 vs. 0.01 ± 0.71, p = 0.002) and fundamental stability (0.57 ± 0.75 vs. 0.05 ± 0.50, p = 0.011), along with hip flexion, hip lateral rotation, and shoulder extension (p < 0.05). No significant differences between groups were observed for dynamic balance or upper body strength and endurance. Our results indicate that QMT can improve FMS scores and various active joint ranges of motion. Quadrupedal movement training is a viable alternative form of training to improve whole-body stabilization and flexibility.
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Original Research
The Effects of a Novel Quadrupedal Movement
Training Program on Functional Movement, Range
of Motion, Muscular Strength, and Endurance
Jeffrey D. Buxton,
1,2
Philp J. Prins,
1
Michael G. Miller,
3
Anthony Moreno,
4
Gary L. Welton,
5
Adam D. Atwell,
1
Tirzah R. Talampas,
1
and Gretchen E. Elsey
1
1
Department of Exercise Science, Grove City College, Grove City, Pennsylvania;
2
Rocky Mountain University of Health Professions,
Provo, Utah;
3
Department of Human Performance and Health Education, Western Michigan University, Kalamazoo, Michigan;
4
School
of Health Promotion and Human Performance, Eastern Michigan University, Ypsilanti, Michigan; and
5
Department of Psychology,
Grove City College, Grove City, Pennsylvania
Abstract
Buxton, JD, Prins, PJ, Miller, MG, Moreno, A, Welton, GL, Atwell, AD, Talampas, TR, and Elsey, GE. The effects of a novel
quadrupedal movement training program on functional movement, range of motion, muscular strength, and endurance. J Strength
Cond Res XX(X): 000–000, 2020—Quadrupedal movement training (QMT) is a form of bodyweight training incorporating animal
poses, transitions, and crawling patterns to reportedly improve fitness. This type of training may improve multiple facets of fitness,
unfortunately, little evidence exists to support commercial claims and guide practitioners in the best use of QMT. Therefore, the
purpose of this study was to assess the impact of a commercially available QMT program on functional movement, dynamic
balance, range of motion, and upper body strength and endurance. Forty-two active college-age (19.76 62.10 years) subjects
(males 519, females 523) were randomly assigned to a QMT (n521) or control (CON) (n521) group for 8 weeks. Quadrupedal
movement training consisted of 60-minute classes performed 23·wk
21
in addition to regular physical activity. Active range of
motion, Functional Movement Screen (FMS), Y-Balance Test (YBT), handgrip strength, and push-up endurance were assessed
before and after the intervention. The QMT group showed significantly greater improvements than the CON group in FMS com-
posite score (1.62 61.53 vs. 0.33 61.15, p50.004) and FMS advanced movements (0.81 60.87 vs. 0.01 60.71, p50.002) and
fundamental stability (0.57 60.75 vs. 0.05 60.50, p50.011), along with hip flexion, hip lateral rotation, and shoulder extension
(p,0.05). No significant differences between groups were observed for dynamic balance or upper body strength and endurance.
Our results indicate that QMT can improve FMS scores and various active joint ranges of motion. Quadrupedal movement training is
a viable alternative form of training to improve whole-body stabilization and flexibility.
Key Words: quadrupedal locomotion, flexibility, motor control, FMS, mobility
Introduction
Quadrupedal movement training (QMT) is an emerging style of
bodyweight training that is gaining popularity in the fitness in-
dustry. Quadrupedal movement training incorporates postures
and movements mimicking the neurodevelopmental sequence
(25) and animal postures and movements (e.g., crawling, rolling,
postural transitions, etc). Many elements of QMT (e.g., quadru-
pedal alternating limb lift and 4-point crawling) are used in
physical rehabilitation of injuries and neurological diseases
(9,21,28,46). Recently, quadrupedal movements have become
popular additions to fitness programs as part of a dynamic
warmup or as accessory exercises (18,44).
Currently, several commercially available QMT systems exist
including, Ground Force Method, Ginastica Natural, Original
Strength, MovNat, and Animal Flow (AF). AF is a novel form of
QMT consisting of dynamic quadrupedal movements that are
practiced, sequenced with other movements, and eventually
choreographed into a flow (a series of AF movements linked to-
gether). Like other commercial QMT systems, the AF system
claims to improve flexibility, range of motion, strength, and en-
durance; however these claims have not been substantiated.
Recently, research showed that QMT, specifically the qua-
drupedal crawling exercises used in AF, improved cognitive skills
and joint reposition sense (33). Furthermore, greater EMG ac-
tivity of core muscles was noticed in quadrupedal movements
involving cross-crawling patterns similar to those practiced in
most QMT systems (40). The aforementioned studies suggest that
QMT may improve proprioception and core stability, which have
been linked to improvements in both functional movement and
fitness (20). Additional research investigating similar training
strategies such as yoga (10), Pilates (30), and Dynamic Neuro-
muscular Stabilization (26) have shown improvements in upper
body muscular endurance, flexibility, and grip strength.
This evidence suggests that QMT may improve performance of
basic movement patterns and other fitness components such as
upper body muscular endurance, strength, flexibility, and dy-
namic balance. We hypothesized that QMT would produce sig-
nificantly greater improvements in each of these outcomes than a
Address correspondence to Jeffrey Buxton, buxtonjd@gcc.edu.
Journal of Strength and Conditioning Research 00(00)/1–8
Copyright ª2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf
of the National Strength and Conditioning Association.. This is an open-access
article distributed under the terms of the Creative Commons Attribution-Non
Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to
download and share the work provided it is properly cited. The work cannot be
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1
comparable physically active control group not performing
QMT. Such findings would be appealing for fitness specialists
because it could show an alternative and novel training program
to be effective for enhancing these elements of fitness above and
beyond that of regular training. Currently, no empirical evidence
exists to support these conclusions, nor have any studies in-
vestigated the impact of AF, or any QMT program, on these
fitness elements. Thus, the purpose of this study is to assess the
effects of a novel eight-week progressive QMT program, using the
AF system, on functional movement, dynamic balance, range of
motion, and muscular strength and endurance.
Methods
Experimental Approach to the Problem
This study used a randomly assigned parallel groups design in-
volving an intervention (QMT) and a control group (CON). Both
groups maintained their normal physical fitness regimens for
8 weeks, whereas the intervention group participated in 2
additional 60-minute QMT sessions per week. All subjects
performed range of motion assessment, Functional Movement
Screen (FMS), Y-Balance Test (YBT), handgrip strength (HGS)
test, and push-up endurance test before and after the 8-week in-
tervention period. All familiarization, testing, and QMT training
sessions were conducted in the Exercise Science Laboratory and
Dance Studios located in the Physical Learning Center building at
Grove City College.
Subjects
A convenience sample of 44 (19 male and 25 female; No
subject was under age of 18) physically active (30 minutes of
moderate intensity structured activity, 3 d·wk
21
for at least 3
months) (41) college students without any physical limitations
or history of advanced training methods such as yoga, Pilates,
CrossFit, Olympic lifting, etc. volunteered for this study. Two
subjects withdrew because of scheduling conflicts midway
through the study leaving 19 men and 23 women (n542) for
final analysis. Our sample size of 3040 subjects was calcu-
lated using G*Power version 3.1.9.2 with a probability of
error set at 0.05, power at 0.80 and moderate-to-large effect
sizes. Subject demographics are provided in Table 1.
The experimental protocols were approved by the Institutional
Review Boards of Rocky Mountain University of Health Profes-
sions and Grove City College. All subjects were informed of the
risks and potential discomforts associated with testing and the
intervention before providing their written informed consent. A
familiarization session consisting of several practice trials of each
test was provided to minimize learning effects. Subjects were
instructed to refrain from caffeine and alcohol consumption for
48 hours, physical activity for 24 hours and any food and drink
for 3 hours before each testing session. After pretesting, subjects
were then assigned to either the QMT or control CON group
using a random number generator (www.randomizer.org). Both
groups were instructed to maintain their usual training frequency
and activities throughout the study without increasing or de-
creasing training load. Compliance to this instruction was
assessed using a physical activity log during the first and last week
of the intervention. In addition, subjects were instructed to refrain
from using any ergogenic aids and to maintain their regular di-
etary habits throughout the study.
Procedures
Training Intervention. Subjects in both the QMT and CON group
maintained their regular physical activity regimens, which con-
sisted of a combination of general aerobic, free weight/machine-
based resistance training, and static stretching, throughout the
eight-week intervention period. Subjects in the QMT group par-
ticipated in 2 additional 60-minute QMT sessions per week sep-
arated by a minimum of 48 hours between sessions (16 total
sessions). All QMT sessions were group formats based on the AF
system and led by the principle investigator (Animal Flow Level 1
Instructor certified).
During the first 4 weeks, each QMT session began with general
dynamic stretches followed by specific wrist mobility exercises,
core and shoulder activation exercises, form specific stretches,
traveling forms, switches and transitions, and finally, choreo-
graphed flows (Table 2). Sessions during the last 4 weeks began
with general dynamic stretches, wrist mobility exercises, and
form-specific stretches. This was followed by one to 2 mini cir-
cuits consisting of an activation exercise, a form specific stretch
and a traveling form performed for 3060 seconds. The circuits
were followed by combinations of switches and transitions and,
finally, a choregraphed flow segment (Table 2). Progressive
overload was applied throughout the intervention period by
gradually increasing reps and sets of each movement, and by
gradually decreasing rest times between sets and exercises.
Data Collection. During the initial familiarization session, height
(cm) measurements were taken using a physicians scale (Pelstar;
LLC/Health O Meter Professional Scales, McCook, IL) followed
by body composition analysis (mass [kg], fat mass [% and kg] and
fat-free mass [kg]) using a Tanita bioelectrical impedance analyzer
(MC-980Plus; Tanita Corporation of America, Arlington Heights,
IL). Subjects then practiced several trials of the range of motion
assessments, FMS, YBT, handgrip dynamometer, and pushup test.
The schedule for pretesting and post-testing was identical: (a)
active joint ROM, (b) functional movement, (c) dynamic balance,
(d) muscular strength, and (e) upper body muscular endurance.
Active Joint Range of Motion. Active range of motion for ankle
dorsiflexion, hip flexion, hip extension, hip medial and lateral
rotation, shoulder flexion, shoulder extension and shoulder me-
dial, and lateral rotation were assessed using a standard goni-
ometer (True Angle; Quint Graphics, Columbus, NJ). Procedures
for evaluating each joint motion followed previously established
guidelines (19). Degrees of motion were assessed to the nearest
Table 1
Subject demographics, physical activity (PA) log data (means 6
SD) and p-value for independent samples t tests of baseline
characteristics.*
QMT (n521) CON (n521) p
Age 19.38 61.36 20.14 62.63 0.236
Height (cm) 174.64 613.05 173.32 610.53 0.915
Mass (kg) 68.87 611.80 66.55 611.64 0.715
Body fat % 20.29 67.04 19.99 66.56 0.691
Fat Mass (kg) 13.51 64.00 13.20 64.66 0.822
Fat free Mass (kg) 55.36 613.03 54.34 610.96 0.589
PA wk 1 (min·wk
21
) 385.71 6164.26 355.05 6223.27 0.615
PA wk 8 (min·wk
21
) 388.19 6167.59 381.52 6296.14 0.929
*QMT 5ground-based movement training group; CON 5control group.
The Effects of Quadrupedal Movement Training (2020) 00:00
2
0.5°. Three measurements were taken on both right and left sides
for each motion with the averages for each side used for analysis.
Before testing an intrarater reliability of r50.99 was established
for the principle investigator.
Functional Movement. Functional movement was assessed using
the FMS. The FMS is a screening tool used to assess performance
of a series of fundamental movement patterns. The FMS consists
of 7 individual movement patterns and 3 clearing tests. Each of
these 7 tasks can be categorized into 1 of 3 subcategories: ad-
vanced movements (Deep Squat, Hurdle Step & In-Line Lunge),
fundamental mobility (Shoulder Mobility and Active Straight Leg
Raise), and fundamental stability (Trunk Stability Push-up and
Rotary Stability Test) (9,27,43). Performance of the 7 movements
was scored on an ordinal scale of 03,where 3represents
completion of the movement without compensation, 2repre-
sents completion of the movement with compensation, 1
represents an inability to complete the movement, and 0rep-
resents pain during either the movement or associated clearing
test (3). Five of the 7 tests assess right and left side separately with
the lowest of the 2 scores being used to compute a final score for
each of these 5 tests. All final scores were summed to compute an
overall composite score (CS). In addition, CSs were computed for
each FMS sub-category (43). The FMS Test Kit (Functional
Movement Systems, Inc., Chatham, Virginia) was used to ad-
minister the test. Testing procedures followed the guidelines
established by Cook, et al. (68). The FMS shows good reliability
(r50.810.91) and face validity for assessing functional move-
ment, however, content and construct validity remain unclear (3).
Dynamic Balance. Dynamic balance was assessed using the YBT,
which measures the farthest single limb reach attained in 3
reaching directions while balancing on a platform with the op-
posite limb (3,39). Procedures for upper quarter (UQ) and lower
Table 2
Sample Animal Flow (AF) training programs.
AF categories AF movements Reps/Time Sets Rest
Sample AF training session for weeks 1–4
Wrist mobilizations Wrist rolls 30 s each 1 0
Wrist waves 30 s each 1 0
Prayer stretch 30 s 1 0
Wrist shakers 30 s 1 0
Wrist relief 30 s 1 0
Quadruped wrist 60 s 1 0
Activations Beast 1 10–15 s 2 30–60 s
Crab 1 10–15 s 2 30–60 s
Beast 2 10–15 s 2 30–60 s
Crab 2 10–15 s 2 30–60 s
Form stretches Loaded beast unload 3 to 5 1 30–60 s
Loaded beast wave 2 to 3 1 30–60 s
Ape reach 3 to 5 1 30–60 s
Traveling forms Forward/reverse beast 10 yds 1 to 3 30–60 s
Forward/reverse Ape 10 yds 1 to 3 30–60 s
Switches & transitions Underswitch 10 to 20 1 to 3 30–60 s
Side kick through 10 to 20 1 to 3 30–60 s
Flows/Games Use movements taught earlier in class and from previous
classes
60–90 s 1 to 5 60–120 s
Sample AF training session for weeks 5–8
Wrist mobilizations Wrist rolls 30 s 1 0
Wrist waves 30 s 1 0
Prayer stretch 30 s 1 0
Wrist shakers 30 s 1 0
Wrist relief 30 s 1 0
Quadruped wrist 30 s 1 0
Form stretches flow Perform as a circuit 23through
Loaded beast unload 1 2 0
Wave unload 1 2 0
Beast reach 1 2 0
Ape reach 2 2 0
AMM circuit 1 Perform as a circuit 33with 30–60 s rest b/w circuits
Activate Beast 3 10 3 15 s
Mobilize Crab reach 10 3 15 s
Move Lateral Ape 1 10 3 15 s
AMM circuit 2 Perform as a circuit 33with 30–60 s rest b/w circuits
Activate Crab 3 10 3 15 s
Mobilize Scorpion reach 6 3 15 s
Move Forward/reverse beast 20 (10 each) 3 15 s
Switches and transitions Perform all sets of combo 1 then perform all sets of combo 2
Combo 1 Side kick through to full scorpion 5–10 per side 2 to 3 60 s
Combo 2 Front step though to front kick through 5–10 per side 2 to 3 60 s
Flows Beast flow 1 2–4 rounds 60 s
The Effects of Quadrupedal Movement Training (2020) 00:00 |www.nsca.com
3
quarter (LQ) tests followed previously established guidelines
(15,39). The YBT kit (Functional Movement Systems Inc.) was
used to administer the test. The farthest reach in each of the 3
reaching directions to the nearest 0.50 cm was recorded and used
to determine a normalized (by subjects lower and upper ex-
tremity length) CS and normalized single reach scores for each
reach direction. The YBT has good intrarater reliability (r5
0.840.91) and good content and face validity (3).
Muscular Strength. Muscular strength was assessed via a HGS
test using a TKK Smedley III Analog Grip Tester (Takei Scientific
Instruments Co., Ltd., Niigata City, Japan). Handgrip strength
testing is one of the most valid and reliable field measures of
muscular strength and fitness (3). Subjects stood erect with their
shoulder adducted and neutrally rotated (along the side of the
body), elbow extended and forearm, wrist and hand in a neutral
position. Subjects were then instructed to squeeze the dyna-
mometer with one maximal effort (no more than 5 seconds) and
no extraneous movement (36). Three trials were administered for
each hand with 1-minute rest between trials. Each trial was
measured to the nearest 0.50 kg with the best score achieved for
each hand used for data analysis.
Upper Body Muscular Endurance. A push-up test following
guidelines established by the ACSM (38) and NSCA (16) was
used to assess upper body muscular endurance. Male subjects
used a standard push-up position and females used a modified
push-up position with knees on the ground. Subjects were
instructed to perform as many consecutive repetitions as possible
without rest. Tests were terminated when subjects could no longer
maintain proper technique within 2 repetitions or rested for more
than 2 seconds in the up position. The total number of push-ups
was recorded and used for analysis.
Statistical Analyses
Statistical analyses were performed using SPSS version 23.0 (IBM
SPSS Statistics Inc., Chicago, IL). Statistical significance was set a
priori at p,0.05. Descriptive statistics were calculated for all
variables. An independent samples t-test was used to assess
baseline differences between groups.
A 2 (pre vs post) 32 (QMT vs. CON) mixed analysis of var-
iance (ANOVA) with repeated measures for time was performed
to assess differences between groups over the 8-week intervention
period. Post-hoc analyses of significant main and interaction ef-
fects were conducted where appropriate using the Bonferroni
adjustment. The assumption of sphericity was confirmed using
Mauchlys test. Greenhouse-Geisser epsilon corrections were
used when the assumption of sphericity was violated. Effect sizes
using partial eta squared (h2
p) (small 50.01, medium 50.06, &
large 50.14) (29) and 95% confidence intervals (CIs) were
calculated.
Results
Baseline Differences, Session Attendance, and
Physical Activity
Independent samples t tests revealed no significant differences
between groups at baseline for any demographic or outcome
variables (p.0.05). Quadrupedal movement training session
attendance was 94% with subjects attending an average of 15.10
60.99 of 16 training sessions over the intervention period.
Finally, 2 32 mixed ANOVA showed no group 3time in-
teraction (p50.551), or main effects for time (p50.473) or
group (p50.774), indicating that both groupsamount of
physical activity were similar throughout the intervention.
Range of Motion
Means and standard deviations for each ROM test are shown in
Table 3. Significant group 3time interactions were found for
right shoulder extension (p50.004, h2
p50.189), left shoulder
extension (p50.008, h2
p50.163), left hip extension (p50.033,
h2
p50.109), right hip flexion (p50.002, h2
p50.218), left hip
flexion (p50.004, h2
p50.192), right hip lateral rotation (p5
0.002, h2
p50.209), and left hip lateral rotation (p50.013, h2
p5
0.131) with the QMT group showing a significantly greater av-
erage increase in active ROM over time than the CON group. In
addition, QMT significantly improved right shoulder lateral ro-
tation (p50.029), right hip extension (p50.005), right and left
medial hip rotation (p,0.001 & p50.001), and right and left
ankle dorsiflexion (p50.018 & p50.002) pretest to post-test;
however these changes were not significantly different than
the CON.
Functional Movement
Table 4 presents the means and standard deviations for the FMS
results and the YBT, handgrip, and pushup tests. Functional
Movement Screen CSs (FMSCS) improved significantly more
across time in the QMT group than the CON group (p50.004,
h2
p50.191) (Figure 1A). The QMT group improved FMSCS an
average of 1.62 61.53 (p,0.001, 95% CI 0.932.31) points,
whereas there was no significant improvement in CON group
(p50.267).
Functional Movement Screen Subanalysis
There was a significant group 3time interaction for advanced
movement CSs (AM) (p50.002, h2
p50.214) showing that the
QMT group improved average scores more over time than the
CON (Figure 1B). The average change pretest to post-test for the
QMT group was 0.81 60.87 (p,0.001, 95% CI 0.411.21)
points. No significant change in AM was found for the CON
group (p51.00).
In addition, a significant group 3time interaction was found
for fundamental stability CSs (STAB) (p50.011, h2
p50.152),
with the QMT groups average scores improving more over time
than the CON (Figure 1D). The QMT group showed a significant
average improvement of 0.57 60.75 (p50.002, 95% CI
0.250.90) points. No significant change was found for the CON
group (p50.733). There was no significant group 3time in-
teraction for fundamental mobility CSs (MOB) (p50.843);
however, a significant main effect for time (p50.035, h2
p5
0.107) showed that both groups improved pretest to post-test. In
addition, a significant main effect for group (p50.008, hR
p
RP
2
50.161) revealed that QMT had higher MOB scores at both
pretest and post-test compared with CON.
Dynamic Balance
There were no significant differences in YBT UQ and LQ right
and left CSs between groups over the course of the intervention
(UQ: p50.154 & 0.063, LQ: p50.167 & 0.265 respectively).
The Effects of Quadrupedal Movement Training (2020) 00:00
4
The QMT group significantly increased YBT UQ right CS by
5.17 66.96% (p,0.001, 95% CI 2.617.73%), UQ left by
4.70 66.92% (p50.003, 95% CI 1.657.76%), LQ right
by 2.24 64.79% (p50.015, 95% CI 0.464.02%), and LQ left
by 2.11 62.20% (p,0.001, 95% CI 1.033.20%). The CON
group significantly increased UQ right by 2.57 64.37% (p5
0.049, 95% CI 0.015.13%) and LQ left by 1.26 62.69% (p5
0.024, 95% CI 0.172.34%).
There was a significant interaction between group and time for
YBT LQ right posterolateral reach scores (p50.02, h2
p50.127)
showing that the GBMT group improved significantly more over
time than the CON group. The QMT group significantly im-
proved YBT UQ right and left medial reach (p50.004 & 0.042
respectively), UQ left superolateral reach (p50.004), LQ right
and left posteromedial reach (p50.027 and 0.009 respectively),
and LQ right and left posterolateral reach (p50.005 and 0.019
respectively) scores pre-intervention to postintervention; how-
ever, these improvements were not significantly different than the
CON group. There were no significant improvements pre-to post-
intervention for any single direction reach score in the CON
group.
Upper Body Muscular Strength and Endurance
There were no significant interaction effects or main effects (p.
0.05) for either right or left HGS. Additionally, there were no
significant interaction effect (p50.427) or main effect for group
(p50.744) with regards to push-up endurance. However, a
significant main effect for time (p,0.001, h2
p50.506) showed
that the average number of push-ups increased over time
Table 4
Means and SD’s pretest and post-test for FMS, Y-Balance, Push-ups, and Handgrip.*†
QMTpretest QMTpost-test CONpretest CONpost-test
FMSCS 13.76 61.33 15.38 61.91‡ 13.29 61.95 13.61 62.13
AM 5.52 60.98 6.33 61.15‡ 5.95 61.02 5.95 61.02
MOB 5.05 60.92§ 5.29 60.78§4.14 61.35 4.43 61.25
STAB 3.19 60.40 3.76 60.94‡ 3.19 60.51 3.24 60.70
YBT UQRCS 96.01 68.62 101.18 610.5196.79 68.29 99.36 69.27
YBT UQLCS 96.16 69.05 100.86 610.05‡ 99.61 66.89 100.24 68.62
YBT LQRCS 91.89 66.83 94.14 66.2194.62 65.71 95.10 66.55
YBT LQLCS 91.54 68.50 93.65 67.8293.75 67.72 95.01 66.76
Push-ups 25.05 614.07 31.57 614.9924.48 611.79 29.52 611.86
Handgrip right (kg) 37.50 612.58 38.38 612.12 38.80 611.82 38.81 611.50
Handgrip left (kg) 34.29 612.05 35.21 612.13 34.98 610.14 36.05 611.08
*FMSCS 5functional movement screen composite score; AM 5functional movement subcategory composite score; MOB 5fundament al mobility subcategory composite score; STAB 5fundamental stability
subcategory composite score; YBT UQRCS/UQLCS 5Y-Balance Test upper quarter right/left composite score; YBT LQRCS/LQLCS 5Y-Balance Test lower quart er right/left composite score.
†QMT n521, CON n521.
‡Significant group by time interaction (p,0.05), QMT .improvement over time than CON.
§Significant main effect for group (p,0.05), QMT .than CON at pretest and post-test.
Significant main effect for time (p,0.05), post-test .than pre-test for both QMT and CON.
Table 3
Means and SDs for Range of Motion (in degrees).*†
QMTpretest QMTpost-test CONpretest CONpost-test
R hip ext 21.27 65.96 25.67 68.44† 22.94 66.91 24.21 67.61†
L hip ext 21.98 65.80 26.47 67.82§ 23.63 67.76 23.02 69.06
R shoulder ext 33.13 612.64 37.29 610.99§ 37.83 612.57 33.60 610.62
L shoulder ext 30.90 612.11 37.98 610.93§ 34.31 613.47 32.19 611.32
R hip flexion 118.42 65.73 127.45 66.43§ 118.34 610.13 121.23 610.92
L hip flexion 120.35 67.93 127.41 68.41§ 119.95 69.92 121.06 610.92
R shoulder flex 179.12 62.84179.51 61.66174.56 66.61 174.29 67.95
L shoulder flex 178.52 63.82178.95 62.94175.40 67.47 174.31 68.60
R shoulder MR 63.88 616.25 64.18 615.91 56.91 615.31 55.24 613.20
L shoulder MR 71.56 616.8971.95 615.5463.28 613.72 61.87 615.08
R shoulder LR 96.36 68.88 101.93 610.18† 94.50 615.73 99.47 613.90†
L shoulder LR 91.48 69.63 95.13 68.28† 88.17 611.85 92.21 614.09†
R hip MR 36.51 67.10 42.25 68.31† 36.97 65.23 40.29 67.45†
L hip MR 34.77 66.56 39.45 68.74† 37.67 65.13 39.60 67.13†
R hip LR 30.02 66.66 36.29 69.79§ 32.65 66.89 32.55 67.50
L hip LR 33.33 65.93 38.42 66.94§ 33.21 66.68 32.90 67.09
R ankle DF 19.63 65.56 22.17 65.44‡ 17.83 65.35 19.69 65.09‡
L ankle DF 19.86 65.62 22.79 66.08‡ 18.55 65.80 19.57 64.75‡
*Ext/Flex 5extension/flexion, MR/LR 5medial rotation/lateral rotation, DF 5dorsiflexion.
†QMT n521, CON n521.
‡Significant main effect for time (p,0.05), post-test .than pre-test for both QMT and CON.
§Significant group by time interaction (p,0.05), QMT .improvement over time than CON.
Significant main effect for group (p,0.05), QMT .than CON at pretest and post-test.
The Effects of Quadrupedal Movement Training (2020) 00:00 |www.nsca.com
5
regardless of group. The QMT group increased number of push-
ups on average by 6.52 65.52 (p,0.001, 95% CI 3.899.15),
whereas those in the CON group improved by 5.05 66.38 (p,
0.001, 95% CI 2.427.68).
Discussion
To our knowledge this was the first study to investigate the effects
of a QMT program on flexibility, functional movement, dynamic
balance, and muscular strength and endurance. Significant group
3time interactions with medium to large effect sizes were found
for 7 of the 18 range of motion measures, FMS CS and FMS sub-
category CSs for the advanced movement patterns and the fun-
damental stability patterns. These findings support our initial
hypothesis that the quadrupedal training program would result in
significantly greater improvements over time in FMS scores and
flexibility. Significant main effects for time, indicating improve-
ments from pretest to post-test were observed for all YBT CSs,
YBT UQ right and left medial reaches and left superolateral reach,
YBT LQ right and left posteromedial and posterolateral reaches,
right hip extension, left and right hip medial rotation, left and
right ankle dorsiflexion, right shoulder lateral rotation, and push-
up endurance regardless of group. These findings also support
our hypothesis that significant improvements would be noted
pretest to post-test, but fail to support the hypothesis that these
improvements would be significantly greater than those of the
control group.
Our primary finding is that while both groups improved upper
body muscular endurance and dynamic balance, the QMT group
showed significantly greater improvements to FMS scores and
active joint range of motion compared with the CON group.
Although the full utility of the FMS remains unknown, it is a
simple means to identify potential erroneous habitual movement
behaviors associated with certain movement patterns, which may
lead to future injury (5,6). The relationship between composite
FMS scores and injury risk remains questionable (3), with some
research supporting no association (11,12,45) and others sup-
porting some predictive power of a cut-offCS alone or in
combination with additional factors (e.g., previous injury history,
aerobic fitness, etc.) (14,22,24,31,37) Although questionable, a
cut-offscore of less than or equal to 14 seems to be the gold-
standardused in clinical and research applications. Consistent
with previous studies, in the present study, both groupsaverage
CSs at baseline were below 14 (1,2,10,13,23,43). After the in-
tervention, the GBMT group improved to 15.38 61.91 (6%
increase). The average change in the GBMT group from pretest to
post-test was 1.62 points, which exceeds the minimally clinically
important difference of 1.25 points previously established (4). In
addition, before the intervention, 16 subjects in the GBMT group
had CSs of 14 or less. Following the GBMT intervention only 6
subjects displayed CSs of 14 or less, an overall 62.5% reduction.
The improvements in FMS CSs seen in our study are consistent
with existing literature showing average improvements ranging
from 1.57 to 3.00 (2,3,24,40). These prior studies used corrective
exercise interventions that used strategies from the FMS system to
specifically improve mobility and stability requirements for each
the FMS tasks. The exact mechanism for improvements observed
in our study is unclear. The AF movements used in our study
challenged similar joint ranges of motion and stability require-
ments seen in the FMS tasks. As an example, the Loaded Beast
movement places subjects in a prone version of a deep squat.
Keeping the knees elevated off the ground in this position requires
significant whole-body stabilization and mobility. The QMT
group showed a 17.5% improvement in the CSs for the funda-
mental stability subcategory indicating an improvement in whole-
body stabilization strategies. These results provide an additional
possible explanation for the overall improvements in FMS CSs
and the advanced movement patterns subcategory CSs (16).
A second main finding from this study was that the QMT
group experienced significantly greater improvements than the
CON group in hip flexion, hip lateral rotation, and shoulder
extension. These results are not all that surprising as many of the
QMT intervention exercises were performed with the hips and
shoulders at or near end ROM. These movements provided a
combined passive and active stretching stimulus, both of which
have been shown to improve active joint ROM (17,34,35,42).
Each of the joint ROMs measured in our study were specifically
Figure 1. A) Functional movement screen, (B) advanced movement (AM), (C) fun-
damental mobility (MOB), and (D) fundamental stability (STAB) composite scores
pre-intervention and postintervention. *QMT significantly greater pre-intervention to
postintervention and significantly greater change across time than CON. QMT 5
ground-based movement training group; CON 5control group.
The Effects of Quadrupedal Movement Training (2020) 00:00
6
challenged either actively or passively by at least one or several of
the QMT movements practiced throughout the eight-week in-
tervention period. In addition, hip flexion, hip lateral rotation,
and shoulder extension were the joint ROMs challenged both
actively and passively in nearly every AF level 1 movement, while
most other joint ROMs were only challenged passively. For ex-
ample, in the Loaded Beast position, the hips are passively taken
into flexion (stretching posterior hips), whereas the hip lateral
rotators are actively strengthened. In the Beast Reach exercise, the
posterior hip is actively stretched by actively moving the upper leg
into hip flexion.
As noted earlier, main effects for time were observed for several
variables indicating improvements from pretest to post-test.
These included all YBT outcomes (with the exception of YBT LQ
right posterolateral reach score), right hip extension, right and left
hip rotation, right and left ankle dorsiflexion, right should lateral
rotation, and pushup test scores. Although pre-intervention to
postintervention improvements were not significantly different
between groups, these findings support our hypothesis that QMT
can improve multiple fitness characteristics; however, there is not
enough evidence to suggest that QMT is superior to general
training for dynamic balance and upper body endurance. Hand-
grip strength remained unchanged pretest to post-test for both
groups. Overall, these findings were surprising for several rea-
sons. First, the QMT program imposed primarily closed kinetic
chain demands on the upper extremities and core, which we hy-
pothesized would lead to significantly greater improvements in
YBT (especially UQ) and push-up scores for the QMT group.
However, most of the movements practiced in the QMT program
required the supporting upper extremities to remain close to the
body. This contrasts with the demands of the YBT UQ which
requires the reaching arm to extend as far as possible from the
body and support arm. It is possible that more advanced QMT
(i.e., Animal Flow Level 2) movements using extremity reaches
further from the base of support would result in significant group
differences. Second, the upper extremity focus of the QMT was
thought to improve overall upper body muscular endurance.
However, being a common exercise for recreationally active in-
dividuals, it is possible that push-ups were performed regularly
during the invention period by both groups and contributed to the
nonsignificant between group findings. In addition, most of the
QMT was performed with a straight elbow position. Again, more
advanced movements involve greater elbow flexion and may have
resulted in significant differences between groups. Finally, HGS
has been shown to improve following similar training styles
(26,32); however, in these studies longer durations and different
coaching for the hands were used then in the present study.
Several limitations to the study design must be considered
when interpreting our findings. There were no significant differ-
ences between groups at baseline for any of the tests; however, we
did not assess baseline cardiorespiratory fitness levels of subjects
using standardized methods such as V
̇
O
2
max testing and maximal
strength testing. In addition, although there were no statistically
significant differences between groups with respect to the amount
of physical activity performed, the QMT group was clearly ex-
posed to a greater amount of physical training with the addition
of the 2 60 minute QMT sessions per week. It must also be noted
that the exact amount of aerobic, resistance, and flexibility
training was not taken into consideration for analysis. Some
subjects may have performed more or less of a certain type of
training (aerobic, resistance, or flexibility) as part of their normal
routine than others. Given these limitations and our findings,
future research addressing differences between just QMT and
other types of training (yoga, Pilates, free weight training, etc.) is
recommended. In addition, future research investigating acute
and chronic effects of QMT on cardiorespiratory fitness would be
useful for strength and condition professionals.
Practical Applications
Quadrupedal movement training is a form of bodyweight
training gaining popularity in fitness, strength and condi-
tioning, and physical rehabilitation settings. The present study
used the Animal Flow level 1 programming for the QMT in-
tervention; however, QMT encompasses a broad spectrum of
programming. Our results indicate QMT can improve FMS
scores and range of motion at the hips and shoulders. The
results of this study provide consumers and health and fitness
professionals with a better understanding of the benefits of
QMT. As a form of bodyweight training, QMT is very ac-
cessible and can be used with a broad range of individuals and
abilities. Based on our findings, QMT would be a plausible
alternative training strategy used in warm-ups, embedded
within a training program as accessory exercises or as a stand-
alone training session for the purpose of improving joint range
of motion and whole body stabilization concurrently.
Acknowledgments
This project was funded by the Jewell, McKenzie and Moore
fund.
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The Effects of Quadrupedal Movement Training (2020) 00:00
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... Unfortunately, there is a paucity of research available on AF or similar QMT systems. A recent study showed that 8 weeks of QMT using the AF system resulted in significantly greater improvements in functional movement screen scores, fundamental stability, and various active joint ranges of motion (16). Additionally, research has shown greater EMG activity of core muscles, proprioception and cognitive flexibility (the ability to effectively switch focus between 2 or more tasks) (17) following training using quadrupedal crawling exercises found in AF system (18,19). ...
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... In total, 20 studies were selected in this study, including 15 RCTs [8,[31][32][33][34][35][36][37][38][39][40][41][42][43][44] and 5 non-RCTs [45][46][47][48][49]. All were published between 2016 and 2022 as peer-reviewed articles or dissertations. ...
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During bipedal locomotor activities, humans use elements of quadrupedal neuronal limb control. Evolutionary constraints can help inform the historical ancestry for preservation of these core control elements support transfer of the huge body of quadrupedal non-human animal literature to human rehabilitation. In particular, this has translational applications for neurological rehabilitation after neurotrauma where interlimb coordination is lost or compromised. The present state of the field supports including arm activity in addition to leg activity as a component of gait retraining after neurotrauma.
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Context: The Functional Movement Screen (FMS) is a tool designed to identify limitations between sections of the body during fundamental movements. However, there is limited evidence on the effectiveness of corrective exercises to improve FMS scores. Objetcive: To examine the effects of individualized corrective exercises on improving FMS scores in Reserve Officers' Training Corps (ROTC) cadets and correlate these changes with physical fitness performance as established with the standard Army Physical Fitness Test (APFT). Design: Cluster-randomized, cohort study. Setting: Controlled laboratory setting (FMS) and a field based setting (APFT). Participants: Forty-four healthy, physically active cadets met all inclusion and exclusion criteria. Intervention: Participants were randomly assigned to the experimental (n=24) or control (n=20) group by cluster. Personalized intervention programs were developed through the FMS Pro360 system, a subscription based software that generates corrective exercises based on individual FMS test scores. The experimental group performed the individualized programs 3 times per week for 4-weeks prior to morning Physical Training (P.T) regime. The control group continued to participate in the standard warm-up drills as part of morning P.T. Main outcome measures: The dependent variables included the individual and composite FMS and APFT scores. Scores were reported and analyzed in several ways to determine the efficacy of corrective exercises. Results: Group FMS and APFT scores were similar at pre-test. The experimental group had a significantly greater improvement in FMS composite score at 4-weeks post (U=87, z=-3.83, p=0.001, effect size=1.33, 95% CI: 0.69-1.98). No significant changes in APFT scores were found (U=237.5, z=-0.33, p=0.74). A non-significant, weak correlation between the FMS and APFT scores (r=0.25, p=0.10) was found. Conclusion: Individualized corrective exercises improved FMS scores, but did not change physical fitness performance. FMS composite scores and APFT performance are not related.
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Clinical movement screening tests are gaining popularity as a means to determine injury risk and to implement training programs to prevent sport injury. While these screens are being used readily in the clinical field, it is only recently that some of these have started to gain attention from a research perspective. This limits applicability and poses questions to the validity, and in some cases the reliability, of the clinical movement tests as they relate to injury prediction, intervention, and prevention. This editorial will review the following clinical movement screening tests: Functional Movement Screen™, Star Excursion Balance Test, Y Balance Test, Drop Jump Screening Test, Landing Error Scoring System, and the Tuck Jump Analysis in regards to test administration, reliability, validity, factors that affect test performance, intervention programs, and usefulness for injury prediction. It is important to review the aforementioned factors for each of these clinical screening tests as this may help clinicians interpret the current body of literature. While each of these screening tests were developed by clinicians based on what appears to be clinical practice, this paper brings to light that this is a need for collaboration between clinicians and researchers to ensure validity of clinically meaningful tests so that they are used appropriately in future clinical practice. Further, this editorial may help to identify where the research is lacking and, thus, drive future research questions in regards to applicability and appropriateness of clinical movement screening tools.