Prone Knee Bend Test 2 – Lateral Femoral Cutaneous Nerve Bias

Purpose of Prone Knee Bend Test 2: To determine if the tension along the lateral femoral cutaneous nerve contributes 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 one hand around the patient’s ankle),
4. Hip extension (slightly about 10 – 20 degrees, with the examiner’s other hand holding the patient’s flexed knee),
5. Sensitizing position: Hip in the neutral position to slight extension (5).

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. Butler DS, Matheson J. The Sensitive Nervous System: Noigroup Publications; 2000.
2. Kopell HP, Thompson WAL. Peripheral entrapment neuropathies: Williams & Wilkins; 1963.
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.
5. Loudon JK, Swift M, Bell S. The Clinical Orthopedic Assessment Guide: Human Kinetics; 2008.