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Forward Step Down Test

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Other Names

  • Eccentric Step Test
  • Step-Down Test
  • Forward Step Down Test


The forward step down test[1]
  • Evaluate the cause of a patients knee pain


  • The patient is stands on a ~20 cm box on affected leg
  • Patient should stand with arms folded across chest
  • Examiner instructs patient to squat down on one lower extremity 5-10 times consecutively
  • Movement should be slow, controlled at a rate of 1 squat per 2 seconds
  • Positive test
    • Reproduction of patients pain



Patellofemoral Pain Syndrome

  • Nijs et al[2]
    • Sensitivity: 42%
    • Specificity: 82%
    • LR+: 2.3
    • LR-: 0.7
    • PPV: 72
    • NPV: 56

See Also


  1. Park, Kyung-Mi, Heon-Seock Cynn, and Sung-Dae Choung. "Musculoskeletal predictors of movement quality for the forward step-down test in asymptomatic women." Journal of Orthopaedic & Sports Physical Therapy 43.7 (2013): 504-510.
  2. Nijs, J., Van Geel, C., Van der Auwera, C., & Van de Velde, B. (2006). Diagnostic value of five clinical tests in patellofemoral pain syndrome. Manual Therapy, 11(1), 69e77.
Created by:
John Kiel on 16 February 2021 17:52:30
Last edited:
25 May 2023 03:43:30