Use of clinical movement screening tests to predict injury in sport

Table 3 Landing Error Scoring System scoring criteria

LESS item	Operational definition of error
Knee flexion: Initial contact	Knee is flexed less than 30° at initial contact
Hip flexion: Initial contact	Thigh is in line with the trunk at initial contact
Trunk flexion: Initial contact	Trunk is vertical or extended on the hips at initial contact
Ankle plantar flexion: Initial contact	Foot lands heel to toe or with flat foot at initial contact
Medial knee position: Initial contact	Center of patella is medial to midfoot at initial contact
Lateral trunk flexion: Initial contact	Midline of trunk flexed to left/right side body at initial contact
Stance width: Wide	Feet positioned > shoulder width apart at initial contact
Stance width: Narrow	Feet positioned < shoulder width apart at initial contact
Foot position: External rotation	Foot is internally rotated more than 30° between initial contact and maximum knee flexion
Foot position: Internal rotation	Foot is externally rotated more than 30° between initial contact and maximum knee flexion
Symmetric initial foot contact	One foot lands before other or one foot lands heel to toe and other lands toe to heel
Knee flexion displacement	Knee flexes less than 45° between initial contact and max knee flexion
Hip flexion displacement	Thigh does not flex more on trunk between initial contact and maximum knee flexion
Trunk flexion displacement	Trunk does not flex more between initial contact and maximum knee flexion
Medial knee displacement	At maximum medial knee position, the center of patella is medial to midfoot
Joint displacement	Soft: Participant demonstrates large amount of trunk, hip, and knee displacement Average: Participant has some but not large amount of trunk, hip, and knee displacement Stiff: Participant goes through very little, if any, trunk, hip, or knee displacement
Overall impression	Excellent: Participant displays soft landing with no frontal or transverse plane motion Poor: Participant displays large frontal or transverse plane motion, or participant displays stiff landing with some frontal or transverse plane motion Average: All other landings

Flaws 1-15 scored as present: 1 and absent = 0; Flaw 16 scored as soft: 0, average = 1, stiff = 2; Flaw 17 scored as excellent: 0, average = 1, poor = 2. LESS: Landing Error Scoring System.