Landing Error Scoring System

NewsBot · Jan 26, 2020

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Is the Landing Error Scoring System Reliable and Valid? A Systematic Review
Ivana Hanzlíková et al
Sports Health: A Multidisciplinary Approach

Context:
The Landing Error Scoring System (LESS) is a clinical tool often used in research and practice to identify athletes presenting high injury-risk biomechanical patterns during a jump-landing task.

Objective:
To systematically review the literature addressing the psychometric properties of the LESS.

Data Sources:
Three electronic databases (PubMed, Web of Science, and Scopus) were searched on March 28, 2018, using the term “Landing Error Scoring System.”

Study Selection:
All studies using the LESS as main outcome measure and addressing its reliability, validity against motion capture system, and predictive validity were included. Original English-language studies published in peer-reviewed journals were reviewed. Studies using modified versions of the LESS were excluded.

Study Design:
Systematic literature review.

Level of Evidence:
Level 4.

Data Extraction:
Study design, population, LESS testing procedures, LESS scores, statistical analysis, and main results were extracted from studies using a standardized template.

Results:
Ten studies met inclusion criteria and were appraised using Newcastle-Ottawa Quality Assessment Scale adapted for cross-sectional studies. The overall LESS score demonstrated good-to-excellent intrarater (intraclass correlation coefficient [ICC], 0.82-0.99), interrater (ICC, 0.83-0.92), and intersession reliability (ICC, 0.81). The validity of the overall LESS score against 3-dimensional jump-landing biomechanics was good when individuals were divided into 4 quartiles based on LESS scores. The validity of individual LESS items versus 3-dimensional motion capture data was moderate-to-excellent for most of the items addressing key risk factors for anterior cruciate ligament (ACL) injury. The predictive value of the LESS for ACL and other noncontact lower-extremity injuries remains uncertain based on the current scientific evidence.

Conclusion:
The LESS is a reliable screening tool. However, further work is needed to improve the LESS validity against motion capture system and confirm its predictive validity for ACL and other noncontact lower-extremity injuries
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NewsBot · May 9, 2020

Clinical implications of landing error scoring system calculation methods
I.Hanzlíková et al
Physical Therapy in Sport; 6 May 2020

Highlights
•Best jump method provided meaningfully different LESS scores than reference method.
•Comparing studies using different computation methods should be done with caution.
•Using consistent LESS protocol and final score computation method is recommended.
•Research needs to state computation methods clearly for valid inferences.
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Objectives
To explore whether final Landing Error Scoring System (LESS) scores differ between calculation methods used in literature.

Design
Cross-sectional.

Setting
Laboratory.

Participants
328 individuals.

Main outcome measures
LESS scores from 984 drop-jumps were extracted. Final LESS scores were calculated for every participant according to five methods: mean of 3 jumps, 1st jump score, 3rd jump score, best jump score, and sum of errors present in at least 2 jumps. The influence of the calculation method on group mean LESS score and group-level risk categorization using threshold of 5 errors was estimated using Generalized Estimating Equations, with the mean of 3 jumps score set as the reference method. The agreement in individual-level risk categorization was assessed using odds ratios and McNemar's tests.

Results
Compared to the reference, estimated group mean LESS score was 0.92 errors lower (p < 0.001) using the best jump method, as was group-level risk categorization (odds ratio: 0.50, p < 0.001). Individual-level risk categorization between calculation methods was inconsistent for 8–15% of participants compared to the reference method, significantly different from reference for the best jump score method (p < 0.001).

Conclusions
Calculation method meaningfully influences final LESS scores and risk categorization.
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NewsBot · Sep 10, 2020

Landing Error Scoring System scores change with knowledge of scoring criteria and prior performance
IvanaHanzlíkováKimHébert-Losier
Physical Therapy in Sport; 8 September 2020

Highlights
•Knowledge of scoring criteria and performance meaningfully improved LESS scores
•Knowledge of scoring criteria and performance altered LESS risk categorization
•Knowledge of scoring criteria and performance changed proportion of specific errors
•We caution against explaining the scoring criteria and errors to tested individuals
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Objective
To examine if the knowledge of scoring criteria and prior performance influence Landing Error Scoring System (LESS) outcomes.

Design
Cross-sectional.

Setting
Laboratory.

Participants
Thirty individuals.

Main outcome measures
The LESS was tested at Baseline and one week later under two conditions: Pre and Post information. For the Post condition, LESS items were explained to participants, as were their individual Baseline scores. Mean LESS scores and number of individuals categorized at high and low risk were compared between Pre and Post using paired t-tests and McNemar’s tests, respectively. McNemar’s tests were also used to compare proportions of specific LESS errors between Pre and Post conditions.

Results
Mean LESS Post scores (4.7 ± 1.2 errors) were significantly lower than Pre scores (6.6 ± 2.0 errors, p < 0.001) as was the number of individuals at high risk (25 vs 10 participants, p < 0.001). A significantly lower proportion of participants scored an error for the joint displacement item of LESS Post compared to Pre condition (p < 0.001).

Conclusion
When using the LESS, it is important that tested individuals have no knowledge of scoring criteria or previous errors for a valid assessment of innate jump-landing movement patterns and injury risk.
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