Execution
- 1Position the patient on a decline board or step, commonly around 20 to 25 degrees decline.
- 2Ask the patient to stand on the tested limb.
- 3Ask the patient to slowly step down or squat in a controlled manner.
- 4Observe knee valgus, trunk control, hip strategy, and patellar tracking.
- 5Record anterior knee pain reproduction and movement quality.
Positive outcome
Reproduction of the patient's anterior knee pain during the decline step-down is positive. Dynamic valgus, poor control, or inability to perform the task are relevant impairments but not diagnostic by themselves. The test is functional rather than structure-specific.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Cook et al. (2010) | NA | NA | NA | NA | NA |
CommentDecline step-down loads the patellofemoral joint and is useful as a comparable sign. It is not as diagnostically specific as a validated cluster. Use it to assess symptom irritability, movement control, and treatment response.
Low Clinical Value