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J Athl Train. 2015 Jun;50(6):589-95. doi: 10.4085/1062-6050-50.1.10. Epub 2015 Mar 26.

The Landing Error Scoring System as a Screening Tool for an Anterior Cruciate Ligament Injury-Prevention Program in Elite-Youth Soccer Athletes.

Author information

1
Department of Exercise and Sport Science, University of North Carolina at Chapel Hill;
2
University of Connecticut, Storrs;
3
Uniformed Services University of the Health Sciences, Bethesda, MD.

Abstract

CONTEXT:

Identifying neuromuscular screening factors for anterior cruciate ligament (ACL) injury is a critical step toward large-scale deployment of effective ACL injury-prevention programs. The Landing Error Scoring System (LESS) is a valid and reliable clinical assessment of jump-landing biomechanics.

OBJECTIVE:

To investigate the ability of the LESS to identify individuals at risk for ACL injury in an elite-youth soccer population.

DESIGN:

Cohort study.

SETTING:

Field-based functional movement screening performed at soccer practice facilities.

PATIENTS OR OTHER PARTICIPANTS:

A total of 829 elite-youth soccer athletes (348 boys, 481 girls; age = 13.9 ± 1.8 years, age range = 11 to 18 years), of whom 25% (n = 207) were less than 13 years of age.

INTERVENTION(S):

Baseline preseason testing for all participants consisted of a jump-landing task (3 trials). Participants were followed prospectively throughout their soccer seasons for diagnosis of ACL injuries (1217 athlete-seasons of follow-up).

MAIN OUTCOME MEASURE(S):

Landings were scored for "errors" in technique using the LESS. We used receiver operator characteristic curves to determine a cutpoint on the LESS. Sensitivity and specificity of the LESS in predicting ACL injury were assessed.

RESULTS:

Seven participants sustained ACL injuries during the follow-up period; the mechanism of injury was noncontact or indirect contact for all injuries. Uninjured participants had lower LESS scores (4.43 ± 1.71) than injured participants (6.24 ± 1.75; t1215 = -2.784, P = .005). The receiver operator characteristic curve analyses suggested that 5 was the optimal cutpoint for the LESS, generating a sensitivity of 86% and a specificity of 64%.

CONCLUSIONS:

Despite sample-size limitations, the LESS showed potential as a screening tool to determine ACL injury risk in elite-youth soccer athletes.

KEYWORDS:

biomechanics; children; knee; movement patterns

PMID:
25811846
PMCID:
PMC4527442
DOI:
10.4085/1062-6050-50.1.10
[Indexed for MEDLINE]
Free PMC Article
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