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Lateral Step Down Test Scoring

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Special Test

Lateral Step Down Test Scoring

Content List

Lateral Step Down Test is a functional task used to assess lower extremity movement quality involving weight-bearing stress as well as dynamic muscular control. It’s sometimes called lateral step down test (LSD Test).

See Also: Gait Cycle

How Step Down Test is performed?

  1. The patient stands on a 20 cm step, with the foot of the tested limb close to the edge of the step and the non-tested limb positioned in front of the step, with the knee straight and the ankle at maximum dorsiflexion.
  2. The patient is asked to keep the trunk straight and the hands on the waist and to bend the knee on the tested side until the heel of the non-tested limb touches the floor.
  3. The patient is asked not to apply any weight on the heel of the non-tested limb once it reaches the floor and to immediately reextend the knee of the tested limb to return to the starting position.
  4. The examiner rates the performance of the patient across five repetitions.
Step Down Test 2
Step Down Test

Step Down Test Scoring

CriteriaDescriptionScoring
Arm strategyPatient removes the hands from the waist (interpreted as a strategy to recover balance)1 point is given
Trunk movementPatient leans the trunk to either side (interpreted as a strategy to recover balance)1 point is given
Pelvic planeIf one side of the pelvis is rotated in the transverse plane or elevated in the frontal plane compared with the other side1 point is given
Knee position (only one score is given from this category)If the knee of the tested limb moves medially in the frontal plane and the tibial tuberosity crossed an imaginary vertical line positioned directly over the second toe of the tested foot, 1 point was given1 point is given
If the knee moves medially and the tibial tuberosity crossed an imaginary vertical line positioned directly over the medial border of the tested foot, 2 points were given2 points are given
Maintenance of a steady unilateral stanceSubject has to support body weight on the non-tested limb, or the foot of the tested limb moved during testing1 point is given
  1. A total score of 0 or 1 is classified as good movement quality,
  2. A total score of 2 or 3 is classified as moderate movement quality,
  3. A total score of 4 or more is classified as poor movement quality.
positive Step Down Test
Positive step down test with the pelvis tilting down and away from supporting limb (Trendelenburg sign) and supporting knee collapsing medially into valgus.

Accuracy

The kappa coefficient and percent agreement for rating the quality of movement on the Forward Step Down test were 0.80 (95% confidence interval: 0.57, 1.00) and 85%, respectively.

References & More

  1. Park KM, Cynn HS, Choung SD. Musculoskeletal predictors of movement quality for the forward step-down test in asymptomatic women. J Orthop Sports Phys Ther. 2013;43(7):504-10. doi: 10.2519/jospt.2013.4073. Epub 2013 Jun 11. PMID: 23756380.
  2. Silva RLE, Pinheiro YT, Lins CAA, de Oliveira RR, Scattone Silva R. Assessment of quality of movement during a lateral step-down test: Narrative review. J Bodyw Mov Ther. 2019 Oct;23(4):835-843. doi: 10.1016/j.jbmt.2019.05.012. Epub 2019 May 14. PMID: 31733769. Pubmed
  3. Netter’s Orthopaedic Clinical Examination An Evidence-Based Approach 3rd Edition Book.
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