Reliability, Validity, and Predictive Value of the Landing Error Scoring System in Soccer Players: A Systematic Review.

CONTEXT: Lower-limb injuries are common in soccer. The landing error scoring system (LESS) is used widely for field-based movement screening, yet its psychometric properties and prognostic value in soccer populations remain uncertain.

OBJECTIVE

To synthesize evidence on the reliability, validity, and prognostic utility of the LESS among soccer participants.

DATA SOURCES: PubMed, Web of Science, Cochrane Library, CNKI, and Wanfang were searched from inception to August 2025.

STUDY SELECTION: Studies were included if they involved soccer participants and reported LESS-related reliability, validity, or prognostic outcomes. Modified versions of the LESS were included only when their scoring framework was clearly described and broadly comparable with the original tool.

STUDY

DESIGN

Systematic review with exploratory meta-analysis.

LEVEL OF EVIDENCE: Level 2 to 4.

DATA EXTRACTION: Two reviewers independently screened studies, extracted data, and assessed methodological quality using a modified Newcastle-Ottawa Scale. Reliability and validity outcomes, including intraclass correlation coefficients (ICCs) and agreement with 3-dimensional (3-D) motion analysis, were summarized descriptively. Prognostic metrics, including odds ratios (ORs) and area under the curve values, were extracted when available. When ≥2 comparable prospective cohorts were available, an exploratory random-effects meta-analysis was performed.

RESULTS

A total of 10 studies met the inclusion criteria. In soccer settings, the LESS demonstrated excellent intra-rater reliability (ICC ≈ 0.90-0.95) and good inter-rater reliability (ICC ≈ 0.84-0.95), with item-dependent convergent validity versus 3-D kinematics. Evidence for prognostic utility was inconsistent across cohorts. Exploratory pooling of 2 comparable prospective studies showed that higher preseason LESS scores were associated with greater odds of subsequent lower-limb injury (pooled OR, 9.31; 95% CI, 3.11-27.91; I² = 0%). However, this pooled estimate should be interpreted cautiously because it was based on only 2 studies with variable injury definitions.

CONCLUSION

The LESS is reliable and shows acceptable construct validity in soccer participants, but evidence for its prognostic utility remains inconsistent. It should not be interpreted as a stand-alone predictor of injury risk. Clinically, the LESS may serve as a low-cost, field-based assessment of landing movement quality within a broader multifactorial screening framework.