The Relationship between Landing Error Scoring System Performance and Injury in Female Collegiate Athletes

Influence of a football match on landing biomechanics and jump performance in female football players

This study aimed to assess the acute effect of a competitive football match on jump performance and kinematic parameters during jump landing in semiprofessional female football players. Twenty-two semiprofessional players (20 ± 3 years) underwent a drop jump task for a posterior video analysis of the landing phase. These measurements were obtained at (1) baseline, (2) after, and (3) 48 h after a competitive football match. A one-way ANOVA with repeated measures was employed to detect differences over the time. There was a main effect of time for maximal knee flexion angle during drop landing (p = 0.001). In comparison with baseline, maximal knee flexion angle was reduced immediately post-match and was still reduced 48 h after the match (63.4 ± 8.6 vs 57.0 ± 11.7 vs 48.9 ± 19.1, p ≤ 0.038). There was also a main effect of time for drop jump height (p < 0.001). Drop jump height was reduced immediately post-match and remained low 48 h after the match in comparison with baseline (27.3 ± 3.6 vs 24.5 ± 2.8 ~ 25.5 ± 3.0 cm, p ≤ 0.002). There was a main effect of time on hip flexion angle during landing (p = 0.001), but the pairwise comparison revealed that this variable was not affected immediately post-match but was lower 48 h after the match than at baseline (50.1 ± 10.1 ~ 50.8 ± 13.2 vs 38.1 ± 17.8 °, p ≤ 0.005). A competitive football match worsened jump performance and several landing biomechanical parameters in female football players, which were still decreased in comparison with baseline even 48 h after the match.

Evaluation of the Anterior Cruciate Ligament Injury Risk During a Jump-Landing Task Using 3-Dimensional Kinematic Analysis Versus the Landing Error Scoring System

Background

The Landing Error Scoring System (LESS) has been utilized on the field or in the clinic to identify patients with an increased risk for anterior cruciate ligament (ACL) injuries; however, its validity and efficacy have not been fully confirmed.

Purpose

To assess the efficacy of the LESS in identifying the ACL injury risk by examining the correlation between the LESS score and motion patterns on 3-dimensional kinematic analysis.

Study Design

Controlled laboratory study.

Methods

The jump-landing motion was analyzed for 16 female basketball or badminton players who volunteered to participate in the study. All study participants were aged 19 or 20 years. The sequence of motion was evaluated with the LESS, while kinematic data were simultaneously acquired with a 3-dimensional motion analysis system utilizing the point cluster method. The correlation between the LESS score and knee kinematics was statistically analyzed.

Results

When a LESS score ≥6 was defined to be a risk factor for ACL injuries, 7 of the 16 participants (43.8%) were found to exhibit risky motion patterns. Significant correlations were noted between the LESS score and knee valgus (r = 0.87; P < .0001) and internal tibial rotation (r = 0.57; P = .02) at landing. By contrast, a substantial variability was present in knee flexion, showing no correlation with the LESS score.

Conclusion

Significant correlations were found between the LESS score and knee valgus and internal tibial rotation during a jump-landing task.

Clinical Relevance

The LESS can be regarded as an effective measure to identify risky motion patterns that may increase the likelihood of ACL injuries.

Age-Related Changes in Landing Mechanics in Elite Male Youth Soccer Players: A Longitudinal Study

The aim of this longitudinal observational study was to examine the age differences in jump landing kinematics in 13–17-year-old male soccer players. Landing technique was evaluated in three consecutive seasons in U14 (n = 15) and the U16 (n = 10) competition age groups using the Landing Error Scoring System (LESS). For the LESS, ANOVA revealed no significant interaction effect (p = 0.81, η2 = 0.009) or main effect for groups (p = 0.15, η2 = 0.086), but a significant year effect was observed (p < 0.001, η2 = 0.265). The LESS score in the U14 group decreased significantly in the second year (5.7 ± 1.9, p = 0.006, d = 0.84) and in the third year (5.9 ± 2.0, p = 0.020, d = 0.70) compared to the first year (7.1 ± 1.7). The LESS score in the U16 group decreased significantly in the second year (5.1 ± 0.9 points, p = 0.034, d = 0.77) and in the third year (4.9 ± 1.4, p = 0.013, d = 0.92) compared to the first year (6.4 ± 1.2). This trend was supported by the results of the separate assessment of the sagittal plane joint displacement. These findings support previous limited findings from cross-sectional studies, which point to improved landing mechanics during maturation. However, the LESS scores in both groups indicate that players who were around and/or post-peak height velocity during the observed periods may be considered “at-risk”, and suggest that preventive training programs should be introduced at earlier stages of players’ development.