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Published on: June 11, 2019
Exercise interventions improve landing error scoring system scores in athletes: a systematic review and meta‑analysis
Ali Asghar Maleki1, Hooman Minoonejad1, Seyed Hamed Mousavi2
1Department of Sport Injuries and Biomechanics, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran.
Scientific Reports
|July 21, 2026
Summary
Structured neuromuscular training programs, including plyometrics, effectively improve jump-landing biomechanics (LESS scores) in athletes. While these interventions enhance risk markers, direct reductions in anterior cruciate ligament (ACL) injury incidence require further investigation.
Area of Science:
- Sports Medicine
- Biomechanics
- Injury Prevention
Background:
- The Landing Error Scoring System (LESS) assesses jump-landing biomechanics to identify risks for non-contact injuries like ACL tears.
- Evaluating exercise interventions is crucial for improving athlete landing mechanics and reducing injury risk.
Purpose of the Study:
- To systematically review the effects of various exercise interventions on improving LESS scores in athletes.
- To synthesize evidence on the efficacy of different training modalities for enhancing jump-landing performance.
Main Methods:
- Systematic literature search across major databases (PubMed, Web of Science, Scopus, Embase) up to June 2025.
- Included 24 trials (n=1,153) with diverse athletic populations and exercise interventions (neuromuscular training, SportsMetrics™, FIFA 11+, TRX).
- Meta-analyses (random-effects model) and GRADE assessment were used to evaluate intervention effectiveness and evidence certainty.
Main Results:
- Integrated neuromuscular training and SportsMetrics™ significantly reduced LESS scores, indicating improved landing mechanics.
- Interventions like integrated neuromuscular training, especially with progressive plyometrics, showed effectiveness in enhancing biomechanical risk markers.
- Results for FIFA 11+ interventions were heterogeneous, suggesting variability in outcomes.
Conclusions:
- Structured multimodal neuromuscular interventions, including plyometrics, are effective for improving athlete LESS scores and landing mechanics.
- Current evidence supports improvements in biomechanical risk markers, but direct links to reduced ACL injury incidence need further research.
- Future studies should focus on translating improved LESS scores into tangible reductions in ACL injury rates.
