A Prospective Evaluation of the Landing Error Scoring System (LESS) as a Screening Tool for Anterior Cruciate Ligament Injury Risk

Smith, Helen C.; Johnson, Robert J.; Shultz, Sandra J.; Tourville, Timothy W.; Holterman, Leigh Ann; Slauterbeck, James R.; Vacek, Pamela M.; Beynnon, Bruce D.

doi:10.1177/0363546511429776

Cited by 174 publications

(243 citation statements)

References 25 publications

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“…patellofemoral pain syndrome) [4,8], gender differences [7,9], perfecting screening tools [3,6,7], effect of maturation or joint laxity effects [5,7]. Hence, only one level 1 evidence study [28] was quality assessed.…”

Section: Search Resultsmentioning

confidence: 99%

Mapping current research trends on anterior cruciate ligament injury risk against the existing evidence: In vivo biomechanical risk factors

Sharir

Rafeeuddin

Staes

et al. 2016

Clinical Biomechanics

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Background: Whilst many studies measure large numbers of biomechanical parameters and associate these to anterior cruciate ligament injury risk, they cannot be considered as anterior cruciate ligament injury risk factors without evidence from prospective studies. A review was conducted to systematically assess the in vivo biomechanical literature to identify biomechanical risk factors for non-contact anterior cruciate ligament injury during dynamic sports tasks; and to critically evaluate the research trends from retrospective and associative studies investigating non-contact anterior cruciate ligament injury risk. Methods: An electronic literature search was undertaken on studies examining in vivo biomechanical risk factors associated with non-contact anterior cruciate ligament injury. The relevant studies were assessed by classification; level 1 -a prospective cohort study, level 2 -a retrospective study or level 3 -an associative study. Findings: An initial search revealed 812 studies but this was reduced to 1 level 1 evidence study, 20 level 2 evidence studies and 175 level 3 evidence studies that met all inclusion criteria. Level 1 evidence showed that the knee abduction angle, knee abduction moment and ground reaction force were biomechanical risk factors. Nine level 2 studies and eightythree level 3 studies used these to assess risk factors in their study. Inconsistencies in results and methods were observed in level 2 and 3 studies. Interpretation: There is a lack of high quality, prospective level 1 evidence related to biomechanical risk factors for non-contact anterior cruciate ligament injury. More prospective cohort studies are required to determine risk factors and provide improved prognostic capability.

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Section: Search Resultsmentioning

confidence: 99%

Mapping current research trends on anterior cruciate ligament injury risk against the existing evidence: In vivo biomechanical risk factors

Sharir

Rafeeuddin

Staes

et al. 2016

Clinical Biomechanics

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“…It is important to note that several studies have commented on the limitations of injury prevention screening techniques aimed at ACL risk reduction [33,34]. Bahr [33] explicitly proposes three essential methodological steps to improve the development of injury risk screening procedures.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in frontal and transverse plane hip and knee kinematics during the modified Star Excursion Balance Test

Willis¹,

Razu²,

Baggett³

et al. 2018

Hum Mov.

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Purpose. The modified Star Excursion Balance Test (mSEBT) assesses dynamic neuromuscular control, with predictive ability regarding lower extremity injury risk. Previous kinematic mSEBT analyses are limited to sex differences between injured or fatigued populations or non-fatigued groups in the sagittal plane only. We hypothesize that sex differences exist in the frontal and transverse plane kinematics of the hip and knee in healthy, non-fatigued subjects during the mSEBT. Methods. The descriptive laboratory study involved 38 healthy subjects: 20 males (aged 24.8 ± 2.7 years) and 18 females (24.1 ± 3.7 years). Peak kinematics, obtained by a VICON TM motion system, of the hip and knee in the sagittal, frontal, and transverse plane were compared during the anterior, posteromedial, and posterolateral reach of the mSEBT. Wilcoxon rank test with significant differences at p < 0.05 was used. Results. Kinematic differences existed between the groups in the frontal and transverse plane of the hip and knee in all reach directions (p < 0.05). No differences were found in the sagittal plane of the hip or knee between the groups. Conclusions. Sex differences exist in frontal and transverse plane kinematics of the hip and knee during the mSEBT. The mSEBT may be enhanced as an injury prediction tool, if frontal and transverse plane kinematics were included during risk assessment screening.

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“…12,13 Evaluations of the LESS and pKAM were done using data collected from the same prospective study with a nested case-control analysis.…”

Section: Evaluation Of Acl Injury Screening Toolsmentioning

confidence: 99%

“…13 Over the 3-year study period, 28 participants sustained a first-time, noncontact ACL injury. The LESS data obtained from ACL-injured participants were then compared with data from 64 uninjured control participants matched for age, sex, involvement with the same team, and screening day.…”

Section: Evaluation Of Acl Injury Screening Toolsmentioning

confidence: 99%

“…12,13 Measurements of knee-valgus motion, knee-flexion range of motion, and tibial length were obtained from the drop vertical-jump video. We entered video-based measurements, participant mass, and a surrogate measure of the quadriceps-to-hamstrings ratio 15 into the algorithm as described by Myer et al to determine the pKAM.…”

Section: Evaluation Of Acl Injury Screening Toolsmentioning

confidence: 99%

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A Sex-Stratified Multivariate Risk Factor Model for Anterior Cruciate Ligament Injury

Beynnon¹,

Sturnick

Argentieri³

et al. 2015

Journal of Athletic Training

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A nterior cruciate ligament (ACL) injuries produce significant joint trauma and have been implicated as the inciting event for both short-term and longterm changes within the articular structures of the knee. [1][2][3][4][5][6][7][8] Regardless of whether a patient chooses surgical or nonsurgical treatment, ACL injury is associated with the onset of posttraumatic arthritis. 9 Consequently, recent researchers have focused on understanding the mechanisms and factors that place individuals at increased risk for sustaining this severe injury. However, variations in study designs and methods have led to conflicting reports regarding these relationships. For example, exclusion criteria used for control participants (eg, combining control participants who have a history of knee pain with those who have normal, pain-free knees) and the approaches used to match case and control participants vary widely among studies. In addition, previous authors have obtained data from the affected knees of ACL-injured patients after the injury. This approach does not take into consideration that the ACL injury itself is capable of producing both shortterm and long-term changes in knee-joint geometry. 1,5 Furthermore, few investigators have used measurement techniques with established interobserver and intraobserver measurement reliability.10 Finally, many researchers have evaluated men and women as a combined group. However, in light of the disparities that exist between the sexes in ACL injury rates, knee-joint geometry, anatomical alignment, joint laxity, demographic characteristics, and strength, male and female models of injury risk should be considered separately. 11This keynote presentation provided a summary of findings from our group's previous and ongoing research efforts that have focused on identifying the factors associated with increased risk of ACL injury. For clarity, the findings are organized in 3 sections: ''Epidemiology of ACL Injury,'' ''Evaluation of ACL Injury Screening Tools,'' and ''Development of ACL Injury Risk Models.'' Epidemiology of ACL InjuryOur epidemiology investigation evaluated the independent effects of athlete sex, level of competition, and sport on the risk of sustaining an ACL injury. 11 We prospectively followed athletes from 26 institutions (8 colleges, 18 high schools) over 4 years to determine the incidence of firsttime, noncontact ACL injuries. After controlling for differences in level of play and sport, we found that an athlete's sex had an independent influence on the risk of injury: female athletes' risk of experiencing a noncontact ACL injury was 2.10 times greater than that of their male counterparts.11 When athlete sex and sport were controlled, collegiate athletes were at greater risk for incurring a noncontact ACL injury than were high school athletes (relative risk [RR] ¼ 2.38). 11When controlling for athlete sex and level of play, we observed that the risk of sustaining a noncontact ACL injury was greatest in soccer (RR ¼ 1.77) and rugby (RR ¼ 2.23) compared with all other sports s...

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A Prospective Evaluation of the Landing Error Scoring System (LESS) as a Screening Tool for Anterior Cruciate Ligament Injury Risk

Abstract: The LESS did not predict ACL injury in our cohort of high school and college athletes.

Cited by 174 publications

References 25 publications

Mapping current research trends on anterior cruciate ligament injury risk against the existing evidence: In vivo biomechanical risk factors

Mapping current research trends on anterior cruciate ligament injury risk against the existing evidence: In vivo biomechanical risk factors

Sex differences in frontal and transverse plane hip and knee kinematics during the modified Star Excursion Balance Test

A Sex-Stratified Multivariate Risk Factor Model for Anterior Cruciate Ligament Injury

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