Materials: (1) 20 cm high step.


  • The patient is asked to stand in single limb support with the hands on the waist, the knee straight and the foot positioned close to the edge the step
  • The contralateral leg is positioned over the floor adjacent to the step and is maintained with the knee in extension
  • The patient then bends the tested knee until the contralateral leg gently contacts the floor and then re-extends the knee to the starting position
  • This maneuver is repeated for 5 repetitions


Criteria Interpretation Score
Arm Strategy Removal of hand from waist +1
Trunk Alignment Leaning in any direction +1
Pelvic Plane Loss of horizontal plane +1
Knee Position Tibial Tuberosity medial to second toe +1
Tibial Tuberosity medial to medial border of foot +2
Steady Stance Patient stepped onto non-tested limb, or foot wavered from side to side +1
  • Total score of 0 or 1 was classified as good quality of movement
  • Total score of 2 or 3 was classified as medium quality
  • Total score of 4 or above was classified as poor quality of movement


Study Population Kappa (% Agreement)
Piva et al., 2006 Patients diagnosed with PFPS (Average age= 29.1) 0.67 (80%)
Rabin et al., 2010 Healthy Females (Average age= 24.3) 0.59 (83%)
Rabin et al., 2014 Patients diagnosed with PFPS (Average age= 19.9-20.8) 0.81 (91%)


1. Piva SR, Fitzgerald K, Irrgang JJ, et al. Reliability of measures of impairments associated with patellofemoral pain syndrome. BMC Musculoskeletal Disorders. 2006; 7(1): 1-13.

2. Piva SR, Fitzgerald GK, Irrgang JJ, et al. Associates of Physical Function and Pain in Patients with Patellofemoral Pain Syndrome. Archives of Physical Medicine and Rehabilitation. 2009;90(2):285-295. doi:10.1016/j.apmr.2008.08.214.

3. Rabin A, et al. Measures of Range of Motion and Strength Among Healthy Women With Differing Quality of Lower Extremity Movement During the Lateral Step Down Test. Journal of Orthopaedic & Sports Physical Therapy. 2010; 40(12): 792–800.

4. Rabin A, et al. Factors Associated With Visually-Assessed Quality of Movement During a Lateral Step Down Test Among Individuals With Patellofemoral Pain. Journal of Orthopaedic & Sports Physical Therapy. 2014. [Epub Ahead of Print]

5. Jones D, et al. Observational Ratings of Frontal Plane Knee Position Are Related to the Frontal Plane Projection Angle But Not Knee Abduction Angle During a Step Down Task. Journal of Orthopaedic & Sports Physical Therapy. 2014. [Epub Ahead of Print]

Continued Reading…


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