Prone Knee Bend Test 1 – Femoral Nerve, L1-4 Nerve Root Bias

Purpose of Prone Knee Bend Test 1: To determine if the tension along the femoral nerve and L1-4 nerve roots contribute to the neurologic symptoms associated with radiculopathy (1, 2).

Patient position: Prone lying.

Examiner position: Standing beside the patient, at the side of the limb to be tested.

Procedure: Perform the limb/joint positioning sequence in the following order:

1. Neutral alignment at the lumbar and thoracic spine, while the patient is on prone lying,
2. Cervical spine rotation to the test side (3, 4),
3. Knee flexion (with the examiner’s hand around the patient’s ankle),
4. Hip in the neutral position,
5. Sensitizing position: Knee flexion or extension.

Outcome: This test is positive if (a) the limb/joint positioning sequence reproduces symptoms associated with radiculopathy, (b) the sensitizing position reproduces symptoms, and (c) there is a repeatable and measurable asymmetry between both sides along with the reproduction of symptoms.

Reference:

1. Cameron MH, Monroe L. Physical Rehabilitation – E-Book: Evidence-Based Examination, Evaluation, and Intervention: Elsevier Health Sciences; 2007.
2. Reiman M. Orthopedic Clinical Examination: Human Kinetics; 2015.
3. Magee DJ. Orthopedic Physical Assessment: Elsevier Health Sciences; 2013.
4. Butler DS, Jones MA, Gore R. Mobilisation of the nervous system: Churchill Livingstone Melbourne etc.; 1991.