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Validity of the modified landing error scoring system (LESS-M) for screening non-contact ACL injury risk using a
Miraj Subedi1, Komsak Sinsurin2, Jatuporn Suttiwong3
1Biomechanics and Sports Research Unit, Faculty of Physical Therapy, Mahidol University, Thailand; Hospital for Advanced Medicine and Surgery, Mandikhatar, Kathmandu, Nepal.
Objectives:
To develop the Landing Error Scoring System-Modified (LESS-M) and assess its content and concurrent validity.
Design:
Content and concurrent validity study.
Setting:
Online expert survey and laboratory-based testing.
Participants:
Five field experts and 29 healthy individuals.
Main Outcome Measures:
Content Validity Index (CVI) and Spearman's rank correlation between LESS-M scores and standard 3D motion analysis.
Results:
All experts endorsed the lateral single-leg jump-landing task and the modified assessment tool. The ave-CVI and I-CVI were 0.97 and 0.8-1.0, respectively. Moderate correlations were found between the LESS-M score and both knee valgus (ρ = 0.425; p = 0.001) and hip adduction moment (ρ = 0.446; p = 0.001) at peak vertical ground reaction force (vGRF).
Conclusions:
The LESS-M demonstrated strong content validity based on expert consensus and showed moderate concurrent validity with 3D motion capture for assessing lateral single-leg jump landing. It may be a potential tool for identifying individuals at risk for non-contact ACL injury. Nonetheless, further investigation is required to determine an appropriate cutoff score and to assess the reliability of the LESS-M for broader application.
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