Prevalence of femoral nerve neurodynamic disorder in patients with patellofemoral pain syndrome: a cross-sectional study

Soheila Zamani; Maryam Abbaszadeh-Amirdehi; Ghadamali Talebi; Mehdi Tavassoli; Seyed Mokhtar Esmaeilnejadganji; Hemmat Gholinia

doi:10.1186/s12891-025-08951-y

Prevalence of femoral nerve neurodynamic disorder in patients with patellofemoral pain syndrome: a cross-sectional study

BMC Musculoskelet Disord. 2025 Jul 24;26(1):700. doi: 10.1186/s12891-025-08951-y.

Authors

Soheila Zamani¹, Maryam Abbaszadeh-Amirdehi², Ghadamali Talebi³, Mehdi Tavassoli⁴, Seyed Mokhtar Esmaeilnejadganji⁴, Hemmat Gholinia⁵

Affiliations

¹ Department of Physiotherapy, School of Rehabilitation, Babol University of Medical Sciences, Babol, Iran.
² Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, IR, Iran. abbaszadeh_m@alumnus.tums.ac.ir.
³ Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, IR, Iran.
⁴ Department of Orthopedic, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
⁵ Health Research Center, Babol University of Medical Sciences, Babol, Iran.

Abstract

Background: Patellofemoral pain syndrome (PFPS) is among the most prevalent causes of knee pain in young adults. Emerging evidence suggests that musculoskeletal pain syndromes, including PFPS, may be associated with neurodynamic disorders. The aim of this study was to investigate the prevalence of femoral nerve neurodynamic disorders in patients with PFPS and to examine the association between these disorders and various clinical and demographic variables, including age, sex, body mass index, pain intensity, history of low back pain, functional ability, and rectus femoris shortness.

Methods: In this cross-sectional study, one hundred patients with unilateral PFPS aged 18-44 years participated. The femoral slump test (FST) and the prone knee bending (PKB) test were employed to assess neurodynamic disorders of the femoral nerve. The associations between the results of neurodynamic tests and selected clinical and demographic variables were evaluated using logistic regression analysis.

Results: The prevalence of femoral nerve neurodynamic disorder in PFPS patients based on FST and PKB was 25% and 36% respectively. No significant associations were observed between FST results and the demographic or clinical variables of PFPS patients. In contrast, PKB results demonstrated significant associations with functional ability (OR = 0.96; 95% CI = 0.93-0.99), rectus femoris shortness (OR = 2.9; 95% CI = 1.15-7.33), and pain intensity (OR = 2.04; 95% CI = 1.36-3.07).

Conclusion: More than one-quarter of PFPS patients exhibited increased mechanosensitivity of the femoral nerve, indicating a notable prevalence of neurodynamic disorders within this population. Nevertheless, the cross-sectional design and use of convenience sampling may limit the generalizability of these findings. These findings underscore the importance of incorporating neurodynamic assessments into the clinical evaluation of PFPS patients to facilitate more effective management.

Keywords: Femoral nerve; Femoral slump test; Knee joint; Neurodynamic; Patellofemoral pain syndrome; Prone knee bending.

MeSH terms

Adolescent
Adult
Cross-Sectional Studies
Female
Femoral Nerve* / physiopathology
Femoral Neuropathy* / diagnosis
Femoral Neuropathy* / epidemiology
Femoral Neuropathy* / physiopathology
Humans
Male
Pain Measurement
Patellofemoral Pain Syndrome* / diagnosis
Patellofemoral Pain Syndrome* / epidemiology
Patellofemoral Pain Syndrome* / physiopathology
Prevalence
Young Adult