Functional Testing

LESS Procedures

The LESS is a reliable and valid clinical assessment tool that was developed to identify individuals at risk for lower extremity injuries. Therefore, to assess your patient’s ability to safely return to dynamic sport-specific activities, it is important implement tools like the LESS to place objective criteria on their performance.

While many assessment tools evaluate movement technique during squatting, stepping, and lunging tasks, few account for the dynamic, sport-specific tasks that are associated with injury mechanisms. The utilization of the LESS tool should be implemented no sooner than the end of phase 3 (approximately 4 months post-op), due to the high forces placed on the surgical construct during jumping. Specifically, this is sensitive to identifying athletes who may be at risk for a non-contact ACL injury.

Instructions

1. Position subject on a 30 centimeter box
2. Place tape line on ground at distance = 50% height of the patient
3. Ask subject to jump forward and upon landing, jump vertically as high as he or she can
4. Emphasize jumping as high as they can with arms straight overhead once landing from the box
5. Do not provide feedback or coaching on landing technique unless task is performed incorrectly
6. After task instruction, allow subject to perform practice trials until the task is successfully performed
7. Record 4 successful trials

   A successful jump is characterized by:

   • Jumping off of both feet from the box
   • Jumping forward, but not vertically to reach the ground
   • Completing the task in a fluid motion

Grading Criteria

• Frontal (Items 1-3) - Stance width, foot rotation, and initial foot contact
• Frontal (Items 4-5) - Knee and trunk frontal-plane motion
• Sagittal (Items 6-7) – Foot position when landing and knee sagittal-plane motion
• Sagittal (Item 8) - Trunk sagittal-plane motion

SL hop for distance

Hop Testing Form

Single-Leg Hop for Distance

Trial 1 Trial 2 Trial 3 Ave.

Right: ________ ________ ________ ________

Left: ________ ________ ________ ________

% Normal: ________

• From static SL stance, toes behind starting line, athlete jumps as far as possible, landing on same foot.
• Athlete must hold landing for 2 seconds.
• Distance is measured from starting line to heel.
• Athlete crosses midline again and runs around cone 1 in a counter-clockwise direction, then repeats first motion of rounding cone 2 in a clockwise direction.
• Athlete finishes by sprinting back across staring line.

Crossover Hop for Distance

Trial 1 Trial 2 Trial 3 Ave.

Right: ________ ________ ________ ________

Left: ________ ________ ________ ________

% Normal: ________

• From static SL stance, toes behind starting line, athlete takes three jumps as far as possible, landing on same foot and crossing midline with each jump.
• Athlete must hold final landing for 2 seconds.
• Distance is measured from starting line to heel after final jump.

6 Meter Timed Hop

Trial 1 Trial 2 Trial 3 Ave.

Right: ________ ________ ________ ________

Left: ________ ________ ________ ________

% Normal: ________

• From static SL stance, toes behind starting line, athlete performs multiple single leg hops across a distance of 6 meters as quickly as possible.
• Athlete must hold final landing for 2 seconds.Time is measured from first single leg hop to final hop across 6 meter line.

Figure

• 5-10-5 Agility