Cognitive-Motor Dual-Task Performance of the Landing Error Scoring System.

Abstract

Context: The Landing Error Scoring System (LESS) is a common assessment used to determine biomechanical landing errors. However, this assessment is completed as a single motor task, which does not require additional attentional resources. It is unclear if the LESS can be used to detect cognitive-motor interference (ie, dual-task cost) in biomechanical errors associated with lower extremity injury.

Objective: To determine if the LESS is a suitable clinical assessment of dual-task performance in uninjured women and to evaluate whether specific landing criteria are more affected by an additional cognitive load than others.

Design: Cross-sectional study.

Setting: University research laboratory.

Patients or other participants: A total of 20 uninjured, physically active female participants (age = 22.4 ± 2.5 years, height = 1.68 ± 0.07 m, mass = 67.0 ± 13.8 kg, Tegner Activity Scale = 5.9 ± 1.1).

Intervention(s): Participants performed the LESS under 3 different conditions: baseline landing with no cognitive distraction (Single), a visual-based dual task (Visual), and a number-based dual task (Number).

Main outcome measures(s): Mean sagittal-plane, frontal-plane, and total LESS scores were compared between conditions using a 1-way repeated-measures analysis of variance with Tukey post hoc correction. A Cohen d effect size with a 95% confidence interval was used to determine the magnitude of differences. The frequency of errors for each LESS item under the 3 conditions was compared using χ2 analysis.

Results: Participants exhibited greater sagittal-plane (P = .02, d = 0.91; 95% confidence interval, 0.26-1.56) and total (P = .008, d = 1.03; 95% confidence interval, 0.37-1.69) errors during the Visual condition than during the Single condition. The frequency of errors observed for each LESS item did not differ between conditions (all P > .05).

Conclusions: The LESS was able to detect a dual-task cost in landing errors during both the Visual conditions. We recommend developing clinically oriented solutions to incorporate similar dual-task paradigms in traditional injury risk-reduction programs.