Bruce Leicht Amelia S, Thompson Xavier D, Queen Robin M, Rodu Jordan, Higgins Michael J, Cross Kevin M, Werner Brian C, Resch Jacob E, Hart Joe M
Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY, USA.
Department of Kinesiology, University of Virginia, Charlottesville, VA, USA.
J Sport Rehabil. 2025 Jun 9:1-5. doi: 10.1123/jsr.2024-0249.
The landing error scoring system (LESS) was developed to screen healthy individuals for anterior cruciate ligament (ACL) injury risk factors using a jump landing task. The purpose of this study was to evaluate unique landing error components of a modified LESS scoring criteria to determine its clinical utility in patients following ACL reconstruction (ACLR).
An observational cross-sectional study design was implemented to determine if each individual error component of the modified LESS provided unique information in an ACLR patient population.
Post-ACLR patients (N = 194 [47.9% female]) completed the LESS 7.91 (1.80) months after surgery. To complete the LESS, patients stood on a 30-cm plyometric box and jumped down to a ground target, at 50% of their height in front of the box, then completed a maximal vertical jump. The LESS was repeated 3 times. Two video cameras positioned 3 m from the landing area at a height of 1 m above the floor (frontal and sagittal) recorded all trials. Video analysis of landing kinematics was performed to determine scores for each error item using the modified LESS. Itemized error scores for each patient were evaluated using an exploratory factor analysis, and factors were retained if eigenvalues were greater than 1.
Our exploratory factor analysis yielded 2 factor groupings. The first factor (λ = 1.61) was comprised of 4 biplanar error items (ie, errors that occur in both the frontal and sagittal plane) that evaluated body segment positioning (eg, hip and knee flexion during landing). The second factor (λ = 1.02) was comprised of 2 errors occurring in the frontal plane that evaluated knee valgus and the overall impression of their landing strategy.
Reducing the modified LESS errors to 6-items could improve the efficiency and clinical utilization of the LESS in ACLR patients. An abbreviated version of the modified LESS may guide clinicians' decision making in gauging patients' readiness to return to play after ACLR.
着陆误差评分系统（LESS）旨在通过跳跃着陆任务筛查健康个体的前交叉韧带（ACL）损伤风险因素。本研究的目的是评估改良后的LESS评分标准中独特的着陆误差成分，以确定其在ACL重建（ACLR）患者中的临床应用价值。
采用观察性横断面研究设计，以确定改良后的LESS的每个个体误差成分是否能为ACLR患者群体提供独特信息。
ACLR术后患者（N = 194，47.9%为女性）在术后7.91（1.80）个月完成LESS测试。为完成LESS测试，患者站在一个30厘米的弹力训练箱上，向下跳到箱子前方其身高50%处的地面目标上，然后完成一次最大垂直跳跃。LESS测试重复3次。两台摄像机分别位于着陆区域前方3米处、离地面1米高的位置（正面和矢状面），记录所有测试过程。通过视频分析着陆运动学，使用改良后的LESS确定每个误差项目的得分。使用探索性因素分析评估每位患者的分项误差得分，特征值大于1时保留各因素。
我们的探索性因素分析产生了2个因素分组。第一个因素（λ = 1.61）由4个双平面误差项目组成（即在正面和矢状面都出现的误差），这些项目评估身体节段的定位（例如着陆时的髋部和膝部屈曲）。第二个因素（λ = 1.02）由正面平面出现的2个误差组成，这些误差评估膝外翻及其着陆策略的整体印象。
将改良后的LESS误差减少到6项，可以提高LESS在ACLR患者中的效率和临床应用价值。改良后的LESS简版可能会指导临床医生在评估ACLR患者恢复运动的准备情况时做出决策。
