Landing Error Scoring System ( LESS)

Original Editor - Aastha Chowhan Top Contributors - Aastha Chowhan

Objective

The landing Error scoring System (LESS) is an inexpensive clinical tool used to asses the jump-landing biomechanics. It is used to identify the risk of non-contact injuries during jumping and landing movements. It assesses 9 landing concepts and has 17 questions which are scored out of 19 points.

Intended Population

The LESS is used to identify the risk of non-contact injuries in athletes especially involved in sports with a lot of jumping and landing[1]. It is an useful screening tool to identify 'at-risk' athletes and then direct them towards the appropriate training programs. The LESS is also used to assist in deciding return to sport for patients that have undergone anterior cruciate ligament reconstruction (ACLR) surgery [2].

Jumping technique.jpg

Method of Use

  • Materials required -
    • 12 inch platform
    • Target line (At a distance of half the subjects height)
    • 2 cameras at 1 meter height (At 10 feet in front of the landing area and at 10 feet to the right of the landing area)
    • LESS scale
  • Precautions - Make sure that the surface is not affected by wet or slippery conditions
  • Procedure -
    • Athlete is provided a demonstration prior to their assessment
    • The athlete is instructed to jump forward from the box with both feet
    • Both feet should make contact beyond the target line
    • After contact, jump right back up to maximal height and land again on both feet
    • This is repeated for three trials
    • The video of the jumps is taken from both the cameras in front and at the side
  • Interpretation ( refer to links for the performance sheet)
    • The feet, ankle, knees, hip, trunk, shoulder, neck and head posture is assessed through the video
    • It is a 19-point continuous scale. According to the performance sheet, the questions 1-15 are Yes/No questions that are rated as 0 or 1. The questions 16 and 17 are rated as 0,1 and 2 depending on the joint displacement and overall performance respectively
    • A maximal score of 19 can be reached for exceptionally poor performances and a score of <5 is considered to be good i.e the athlete is considered to be at low risk
    • 5.  The videos are evaluated as follows:
      • A.  Knee flexion angle at initial contact >30 degrees; 0 = yes, 1 = no
      • B.  Knee valgus at initial contact, knees over mid-foot; 0 = yes, 1 = no
      • C.  Trunk flexion angle at contact;0 = trunk is flexed,1 =not flexed
      • D.  Lateral trunk flexion at contact; 0 = trunk is vertical, 1 = not vertical
      • E.  Ankle plantar flexion at contact; 0 = toe to heel, 1 = no
      • F.  Foot position at initial contact, toes > 30 degrees external rotation; 0 = no, 1 = yes
      • G.  Foot position at initial contact, toes > 30 degrees internal rotation; 0 = no, 1 = yes
      • H.  Stance width at initial contact < shoulder width; 0 = no, 1 = yes
      • I.  Stance width at initial contact > shoulder width; 0 = no, 1 = yes
      • J.  Initial foot contact symmetric; 0 = yes, 1 = no
      • K.  Knee flexion displacement (knee position before jumping),>45 degrees;0 = yes, 1 =no
      • L.  Knee valgus displacement (knee position before jumping), knee inside great toe; 0 = no, 1 = yes
      • M.  Trunk flexion at maximal knee angle, trunk flexed more than at initial contact; 0  = yes, 1 = no
      • N.  Hip flexion angle at initial contact, hips flexed; 0 = yes, 1 = no
      • O.  Hip flexion at maximal knee angle, hips flexed more than at initial contact; 0 = yes, 1  = no
      • P.  Joint displacement, sagittal plane; 0 = soft, 1 = average, 2 = stiff
      • Q.  Overall impression; 0 = excellent, 1 = average, 2 = poor

Evidence

The LESS scores demonstrate good-to-excellent intra-rater , inter-rater and intersession reliability . The validity of the overall LESS score against 3-dimensional jump-landing biomechanics was good. The validity of LESS items versus 3-dimensional motion capture (gold-standard) data was moderate-to-excellent for most of the items that address the key risk factors for anterior cruciate ligament (ACL) injury[3].

Links


References

  1. Padua DA, DiStefano LJ, Beutler AI, de la Motte SJ, DiStefano MJ, Marshall SW. The Landing Error Scoring System as a Screening Tool for an Anterior Cruciate Ligament Injury-Prevention Program in Elite-Youth Soccer Athletes. J Athl Train. 2015 Jun;50(6):589-95. PubMed PMID: 25811846. PMCID: PMC4527442. Epub 2015/03/26. eng.
  2. Bell DR, Smith MD, Pennuto AP, Stiffler MR, Olson ME. Jump-landing mechanics after anterior cruciate ligament reconstruction: a landing error scoring system study. J Athl Train. 2014 2014 Jul-Aug;49(4):435-41. PubMed PMID: 24905666. PMCID: PMC4151830. Epub 2014/06/06. eng.
  3. Hanzlíková I, Hébert-Losier K. Is the Landing Error Scoring System Reliable and Valid? A Systematic Review. Sports Health. 2020 2020 Mar/Apr;12(2):181-8. PubMed PMID: 31961778. Epub 2020/01/21. eng.