Padua Darin A, DiStefano Lindsay J, Beutler Anthony I, de la Motte Sarah J, DiStefano Michael J, Marshall Steven W
Department of Exercise and Sport Science, University of North Carolina at Chapel Hill;
University of Connecticut, Storrs;
J Athl Train. 2015 Jun;50(6):589-95. doi: 10.4085/1062-6050-50.1.10. Epub 2015 Mar 26.
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.
To investigate the ability of the LESS to identify individuals at risk for ACL injury in an elite-youth soccer population.
Cohort study.
Field-based functional movement screening performed at soccer practice facilities.
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.
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%.
Despite sample-size limitations, the LESS showed potential as a screening tool to determine ACL injury risk in elite-youth soccer athletes.
确定前交叉韧带（ACL）损伤的神经肌肉筛查因素是大规模开展有效的ACL损伤预防计划的关键一步。落地误差评分系统（LESS）是一种有效且可靠的跳跃落地生物力学临床评估方法。
研究LESS在识别精英青年足球人群中ACL损伤风险个体方面的能力。
队列研究。
在足球训练设施进行基于场地的功能性运动筛查。
共有829名精英青年足球运动员（348名男孩，481名女孩；年龄=13.9±1.8岁，年龄范围=11至18岁），其中25%（n=207）年龄小于13岁。
所有参与者的季前基线测试包括一项跳跃落地任务（3次试验）。在整个足球赛季对参与者进行前瞻性随访，以诊断ACL损伤（1217个运动员赛季的随访）。
使用LESS对落地技术的“误差”进行评分。我们使用受试者工作特征曲线来确定LESS上的切点。评估LESS在预测ACL损伤方面的敏感性和特异性。
7名参与者在随访期间发生了ACL损伤；所有损伤的机制均为非接触性或间接接触性。未受伤参与者的LESS评分（4.43±1.71）低于受伤参与者（6.24±1.75；t1215=-2.784，P=0.005）。受试者工作特征曲线分析表明，5是LESS的最佳切点，敏感性为86%，特异性为64%。
尽管样本量有限，但LESS显示出作为一种筛查工具来确定精英青年足球运动员ACL损伤风险的潜力。
