The Landing Error Scoring System Real-Time test as a predictive tool for knee injuries: A historical cohort study

Landing error scoring system: A scoping review about variants, reference values and differences according to sex and sport

OBJECTIVE

The Landing Error Scoring System (LESS) is a movement analysis tool proposed to identify the risk of anterior cruciate ligament injuries, very useful for injury prevention. The aim of this study is to review the variants of the LESS, their normative scores and the differences according to sex and sport practiced.

METHODS

PubMed, Scopus and ScienceDirect databases were searched from inception to October 19, 2023. Studies were eligible if the objective was finding normative or reference scores for the LESS, analyze the differences between sexes or sports, or used some variant of the test. Results were limited to available full-text articles published in English in peer-reviewed journals.

RESULTS

Of the 360 articles identified, 20 were included for a full analysis (18,093 participants, age = 8-30 years, males = 70.6%). The military population was the most frequently analyzed (7 studies, n = 16,603). Results showed six variants of the LESS and average values ranged from 2.56 to 7.1. Males and females showed different pattern landing with errors in different planes.

CONCLUSIONS

Our findings highlight the need for more field studies on LESS reference scores, particularly for females and basketball or hockey players. Further research is required before conducting a systematic review and meta-analysis.

A systematic model to identify and reduce work-related musculoskeletal disorders in firefighters, and improve their function

INTRODUCTION

Firefighting is a high-risk job with a high prevalence of work-related musculoskeletal disorders (WMSDs). The aim of his study was to determine the prevalence of WMSDs, estimate the likelihood of subsequent disorders, and investigate the effect of NASM-based training protocol on firefighters function.

METHOD

First, prevalence and region of WMSDs in all 524 male Isfahan firefighters were determined by Medical-history-questionnaire. Then, functional movement screen (FMS) separated firefighters to the 2-dimension FMS score (FMSCS≤14 or FMSCS>14) to show at risk firefighters. Finally, 40 Participants with both FMSCS≤14 and common WMSDs randomly assigned to either an intervention (IG) (n = 20) or control (CG) (n = 20) group. The IG received NASM-based training, while the CG engaged in daily activities. Outcomes included movement efficiency during landing error scoring system-real time, Y balance, single-leg squat, and deep squat, which were assessed in pretest and posttest.

RESULTS

The prevalence of disorders was 52.1%, which lower limb, back, upper limb, and neck were the highest prevalence respectively. Only lower limb and back disorders could identify individuals at disorder risk with a likelihood of 89% and 71%, sequentially. Also, movement performance significantly improved in all functional tests in IG relative to CG.

CONCLUSIONS

Considering high disorder rate in firefighters, the value of our study lies in alleging a systematic model periodically to reduce WMSDs and risk of subsequent disorders. Not only our model determined the prevalence of WMSDs, but it also identified those who are at risk. In addition, our model represents exercise therapy as a solution.

Curves and kinematics: Relationship between the force-time curve and landing ability

Anterior cruciate ligament (ACL) injuries have a significant impact on athletic performance and long-term quality of life. Force plates and qualitative screening tools are feasible and effective screening methods to identify abnormal movement quality associated with increased injury risk. Comparing qualitative assessments of landing ability with force-time curves, may detect unique differences between safe and high-risk athletic movement patterns. The aim of this study was to determine low- and high-risk landing ability from qualitive landing assessments and to examine the resulting force-time curves using functional principal component analysis (fPCA). Thirty-one healthy academy athletes (10 males and 21 females) completed double- and single-leg dominant and non-dominant jump-landing-rebound tasks. All movements were filmed in multiple-planes, and vertical ground reaction forces (vGRF) were simultaneously collected. The Landing Error Scoring System (LESS) and Single-Leg Landing Error Scoring System (SL-LESS) were used to score landing footage. From these scores, athletes were categorized into low-risk and high-risk groups for further analysis. fPCA was used to examine differences between landing quality groups force-time curves. Compared to high-risk landers, low-risk landers demonstrated significantly longer contact times across all movements. Scores from fPC1 revealed safe and high-risk landing techniques expose athletes to significantly different loading patterns during double- and single-leg dominant movements. A significant positive relationship was observed between fPC1 and LESS scores, however this relationship was not observed in both single-leg landing scores. Where possible incorporating curve analysis methods like fPCA into multi-faceted screening approaches may help practitioners uncover unique insights into athletic loading strategies.

Writing assistant scoring system for English second language learners based on machine learning

To reduce the workload of paper evaluation and improve the fairness and accuracy of the evaluation process, a writing assistant scoring system for English as a Foreign Language (EFL) learners is designed based on the principle of machine learning. According to the characteristics of the data processing process and the advantages and disadvantages of the Browser/Server (B/S) structure, the equipment structure design of the project online evaluation teaching auxiliary system is further optimized. The panda method is used to read the data, the clean method is used to realize the data preprocessing, the model test is carried out, the cross validation method is selected, the data is divided in advance, and the process of programming the problem scoring system is further optimized, the automatic scoring technology is constructed by English teaching recognition module, feature extraction module and scoring module, the table structure of programming problems is designed, the auxiliary evaluation program of English writing is designed, and the design of writing auxiliary scoring system is completed. The analysis of the experimental results shows that the accuracy of the system is close to 90%, and the total average difference is 0.56. The system can normally take out a variety of test papers. Considering the subjectivity of manual scoring and the impact of key code setting on scoring, the carefully set key code can effectively improve the scoring accuracy of the system. The scoring strategy of the automatic scoring system is effective and the scoring effect is good, and it can be used in practical application.

The effects of virtual reality immersion on drop landing mechanics

Virtual reality (VR) can be used to alter the environment and challenge sensory calibration which rehabilitation and return-to-sport testing lack. The purpose was to establish how VR manipulation of the environment changes knee landing biomechanics. Twenty-nine healthy active adults (22 males; 20.52 ± 1.21 years; 1.75 ± 0.09 m; 78.34 ± 14.33 kg) were recruited. Three drop landing trials (31 cm height box) were performed for three conditions: eyes-open (EO), eyes-closed (EC), and VR, consisting of a head-mounted display of a 360° photo of a steep man-made edge or drop. Knee kinematics and kinetics were evaluated using 3D motion capture. The VR condition significantly increased Landing Error Score System errors relative to EO (1.28 ± 0.20, p < 0.001) and EC (0.98 ± 0.22, p < 0.001) and increased vertical ground reaction force relative to EO (0.41 ± 0.09 N·bw-1, p < 0.001) and EC (0.34 ± 0.07 N·bw-1, p < 0.001). The VR condition had less knee flexion at initial contact compared to EO (4.39 ± 0.75°, p = 0.001) and EC (1.83 ± 0.63°, p = 0.021). The VR condition had more knee abduction at initial contact compared to EO (0.71 ± 0.24°, p = 0.002) and EC (0.69 ± 0.22°, p = 0.002) and increased knee abduction at maximum flexion compared to EO (2.01 ± 0.58°, p = 0.026). Landing in VR increased injury risk landing biomechanics, indicating that VR may option to incorporate into return-to-play or injury risk assessment.

A Machine-Learning Approach to Measure the Anterior Cruciate Ligament Injury Risk in Female Basketball Players

Anterior cruciate ligament (ACL) injury represents one of the main disorders affecting players, especially in contact sports. Even though several approaches based on artificial intelligence have been developed to allow the quantification of ACL injury risk, their applicability in training sessions compared with the clinical scale is still an open question. We proposed a machine-learning approach to accomplish this purpose. Thirty-nine female basketball players were enrolled in the study. Leg stability, leg mobility and capability to absorb the load after jump were evaluated through inertial sensors and optoelectronic bars. The risk level of athletes was computed by the Landing Error Score System (LESS). A comparative analysis among nine classifiers was performed by assessing the accuracy, F1-score and goodness. Five out nine examined classifiers reached optimum performance, with the linear support vector machine achieving an accuracy and F1-score of 96 and 95%, respectively. The feature importance was computed, allowing us to promote the ellipse area, parameters related to the load absorption and the leg mobility as the most useful features for the prediction of anterior cruciate ligament injury risk. In addition, the ellipse area showed a strong correlation with the LESS score. The results open the possibility to use such a methodology for predicting ACL injury.

Kiss goodbye to the 'kissing knees': no association between frontal plane inward knee motion and risk of future non-contact ACL injury in elite female athletes

The aim of this study was to investigate if frontal plane knee and hip control in single-leg squats or vertical drop jumps with an overhead target were associated with future non-contact anterior cruciate ligament (ACL) injury in elite female athletes. Of the 429 handball and 451 football athletes (age 21.5 ± 4.0 years, height 169.6 ± 6.4 cm, body weight 67.1 ± 8.0 kg), 722 non-injured and 56 non-contact ACL injured participants were eligible for analysis. We calculated lateral pelvic tilt, frontal plane knee projection angle, medial knee position, and side-to-side asymmetry in these from 2D videos recorded at baseline, and recorded any new ACL injuries prospectively. None of the aforementioned variables in either screening task were different or could discriminate between injured and non-injured athletes (all p values >.05 and Cohen's d values < .27). Two-dimensional video assessment of frontal plane knee and hip control during both a single-leg squat and vertical drop jump was unable to identify individuals at increased risk of non-contact ACL injury, thus should not be used for screening.

Factors influencing the Landing Error Scoring System: Systematic review with meta-analysis

OBJECTIVES

Systematically review the literature addressing age, sex, previous injury, and intervention program as influencing factors of the Landing Error Scoring System.

DESIGN

Systematic review with meta-analysis.

METHODS

Three databases (PubMed, Web of Science®, and Scopus®) were searched on 1 April 2020. Original studies using the Landing Error Scoring System as primary outcome and exploring age, sex, previous injury, and intervention program were included, assessed for risk of bias, and critically appraised. Three meta-analyses were performed using one random and two mixed effect models with dependent variables: sex, previous injury and intervention program, respectively. Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the strength of the evidence. PROSPERO registration number CRD42018107210.

RESULTS

Fifty-two studies were included. Pooled data indicated that females have higher Landing Error Scoring System scores than males (p<0.001, mean difference=0.6 error). Participants with previous anterior cruciate ligament injury have higher LESS scores than healthy controls (p=0.004, mean difference 1.2 error). Neuromuscular training programs lasting a minimum of six weeks and other intervention programs decrease Landing Error Scoring System scores (p<0.001, mean difference 1.2 error and p=0.042, mean difference 0.5 error, respectively). There is limited evidence suggesting that age may influence Landing Error Scoring System scores in clinically meaningful manner. Overall, Grading of Recommendations Assessment, Development and Evaluation ratings suggest very low strength of evidence.

CONCLUSIONS

History of anterior cruciate ligament injury and undertaking neuromuscular training for a minimum of six weeks meaningfully altered Landing Error Scoring System scores. These findings, however, should be interpreted cautiously considering the very low Grading of Recommendations Assessment, Development and Evaluation rating of the evidence.