Range of motion (rom)
Range of motion is traditionally performed three different ways:
Normative Values for ROM of the hand, wrist, and elbow.
7. How would you measure wrist flexion? What is the normal ROM for this movement?
8. How would you measure radial deviation? What is the normal ROM for this movement?
9. How would you measure elbow flexion? What is the normal ROM for this movement?
10. How would you measure pronation? What is the normal ROM for this movement?
Information retrieved form:
Norkin, C., White, D. (2009). Measurement of Joint Motion. A Guide to Goniometry.
- Active Range of Motion (AROM) where the athlete performs the movement under their own power
- Passive Range of Motion (PROM) where the examiner takes athlete through the full ROM or up until the point of pain
- Resistive Range of Motion (RROM) the examiner resists the athlete as they move through the motion. If the athlete experience moderate to severe pain with the previous ROM you would not perform this step. Additionally is the athlete is experiencing pain with any of the RROM you would also discontinue the movement.
Normative Values for ROM of the hand, wrist, and elbow.
- Wrist Flexion:
- Center the fulcrum on the lateral aspect of the wrist over the triquetrum.
- Align proximal arm with the lateral mid-line of the ulna, using the olecranon and ulnar styloid processes.
- Align the distal arm with the lateral mid-line of the fifth metacarpal. Do not use soft tissue of the hypothenar eminence for reference.
- Normal ROM: 60-80 degrees.
- Normal end feel: Firm
- Wrist Extension:
- Center the fulcrum on the lateral aspect of the wrist over the triquetrum.
- Align proximal arm with the lateral mid-line of the ulna, using the olecranon and ulnar styloid processes.
- Align the distal arm with the lateral mid-line of the fifth metacarpal. Do not use soft tissue of the hypothenar eminence for reference.
- Normal ROM: 60-75 degrees
- Normal end feel: Firm
- Wrist Radial Deviation:
- Center the fulcrum on the dorsal aspect of the wrist over the capitate.
- Align proximal arm with the dorsal mid-line of the the forearm. If the shoulder is in 90 degrees of abduction and the elbow is in 90 degrees of flexion, the lateral epicondyle of the humerus can be used for reference.
- Align distal arm with the dorsal mid-line of the third metacarpal. Do not use the third phalanx for reference.
- Normal ROM: 20-25 degrees
- Normal end feel: Hard
- Wrist Ulnar Deviation:
- Center the fulcrum on the dorsal aspect of the wrist over the capitate.
- Align proximal arm with the dorsal mid-line of the the forearm. If the shoulder is in 90 degrees of abduction and the elbow is in 90 degrees of flexion, the lateral epicondyle of the humerus can be used for reference.
- Align distal arm with the dorsal mid-line of the third metacarpal. Do not use the third phalanx for reference.
- Normal ROM: 30-39 degrees
- Normal end feel: Firm
- Metacarpophalangeal Flexion:
- Center fulcrum over the dorsal aspect of the MCP joint.
- Align proximal arm over the dorsal mid-line of the metacarpal.
- Align distal arm over the dorsal mid-line of the proximal phalanx.
- Normal ROM: 90-100 degrees
- Normal end feel: Hard
- Metacarpophalangeal Extension:
- Center fulcrum over the dorsal aspect of the MCP joint.
- Align proximal arm over the dorsal mid-line of the metacarpal.
- Align distal arm over the dorsal mid-line of the proximal phalanx.
- Normal ROM: 20-45 degrees
- Normal end feel: Firm
- Metacarpophalangeal Abduction
- Center fulcrum of the over the dorsal aspect of the MCP joint.
- Align proximal arm over the dorsal mid-line of the metacarpal.
- Align distal arm over the dorsal mid-line of the proximal phalanx.
- Normal ROM: No measured values
- Normal end feel: Firm
- Metacarpophalangeal Adduction
- Center the fulcrum over the dorsal aspect of the PIP joint.
- Align proximal arm over the dorsal mid-line of the proximal phalanx.
- Align distal arm over the dorsal mid-line of the middle phalanx.
- Normal ROM: Not usually measured or recorded.
- Normal end feel: Hard
- Proximal Interphalangeal Extension
- Center the fulcrum over the dorsal aspect of the PIP joint.
- Align proximal arm over the dorsal mid-line of the proximal phalanx.
- Align distal arm over the dorsal mid-line of the middle phalanx.
- Normal ROM: 0 degrees
- Normal end feel: Firm
- Distal Interphalangeal Flexion
- Center fulcrum over the dorsal aspect of the DIP joint.
- Align the proximal arm over the dorsal mid-line of the middle phalanx.
- Align distal arm over this distal mid-line of the distal phalanx.
- Normal ROM: 70-90 degrees
- Normal end feel: Firm
- Distal Interphalangeal Extension
- Center fulcrum over the dorsal aspect of the DIP joint.
- Align the proximal arm over the dorsal mid-line of the middle phalanx.
- Align distal arm over this distal mid-line of the distal phalanx.
- Normal ROM: 0 degrees
- Normal end feel: Firm
- Carpometacarpal Flexion
- Center fulcrum over the palmar aspect of the first CMC joint.
- Align proximal arm with the ventral mid-line of the radius using the ventral surface of the radial head and styliod process.
- Align distal arm with the ventral mid-line of the first metacarpal.
- Normal ROM: 15 degrees
- Normal end feel: Soft
- Carpometacarpal Extension
- Center fulcrum over the palmar aspect of the first CMC joint.
- Align proximal arm with the ventral mid-line of the radius using the ventral surface of the radial head and styliod process.
- Align distal arm with the ventral mid-line of the first metacarpal.
- Normal ROM: 35 degrees
- Normal end feel: Firm
- Carpometacarpal Abduction
- Center fulcrum over the lateral aspect of the radial styloid process.
- Align proximal arm with the lateral mid-line of the second metacarpal, using second MCP joint for reference.
- Align distal arm with the lateral mid-line of the first metacarpal, using the first MCP joint for reference.
- Normal ROM: 70 degrees
- Normal end feel: Firm
- Carpometacarpal Adduction
- Center fulcrum over the lateral aspect of the radial styloid process.
- Align proximal arm with the lateral mid-line of the second metacarpal, using second MCP joint for reference.
- Align distal arm with the lateral mid-line of the first metacarpal, using the first MCP joint for reference.
- Normal ROM: Not measured
- Normal end feel: Hard
- Metacarpophalangeal Flexion
- Center fulcrum over the dorsal aspect of the MCP joint.
- Align proximal arm over the dorsal mid-line of the metacarpal.
- Align distal arm with the dorsal mid-line of the proximal phalanx.
- Normal ROM: 50-60 degrees
- Normal end feel: Hard
- Metacarpophalangeal Extension
- Center fulcrum over the dorsal aspect of the MCP joint.
- Align proximal arm over the dorsal mid-line of the metacarpal.
- Align distal arm with the dorsal mid-line of the proximal phalanx.
- Normal ROM: 14-23 degrees
- Normal end feel: Firm
- Interphalangeal Flexion
- Center fulcrum over the dorsal surface of the IP joint.
- Align the proximal arm with the dorsal mid-line of the proximal phalanx.
- Align the distal arm with the dorsal mid-line of the distal phalanx.
- Normal ROM: 67-80 degrees
- Normal end feel: Firm
- Interphalangeal Extension
- Center fulcrum over the dorsal surface of the IP joint.
- Align the proximal arm with the dorsal mid-line of the proximal phalanx.
- Align the distal arm with the dorsal mid-line of the distal phalanx.
- Normal ROM: 23-30 degrees
- Normal end feel: Firm
- Elbow Flexion
- Center fulcrum over the lateral epicondyle of the humerus.
- Align proximal arm with the lateral mid-line of the humerus, using the center of the arcomion process for reference.
- Align the distal arm with the lateral mid-line of the radius, using the radial styliod process for reference.
- Normal ROM: 140-150 degrees
- Normal end feel: Soft
- Elbow Extension
- Center fulcrum over the lateral epicondyle of the humerus.
- Align proximal arm with the lateral mid-line of the humerus, using the center of the arcomion process for reference.
- Align the distal arm with the lateral mid-line of the radius, using the radial styliod process for reference.
- Normal ROM: 0 degrees
- Normal end feel: Hard
- Pronation
- Center fulcrum laterally and proximally to the ulnar styloid process.
- Align proximal arm parallel to the anterior mid-line of the humerus.
- Place distal arm across the dorsal aspect of the forearm.
- Normal ROM: 76-84 degrees
- Normal end feel: Hard
- Supination
- Center fulcrum laterally and proximally to the ulnar styloid process.
- Align proximal arm parallel to the anterior mid-line of the humerus.
- Place distal arm across the dorsal aspect of the forearm.
- Normal ROM: 80 degrees
- Normal end feel: Firm
7. How would you measure wrist flexion? What is the normal ROM for this movement?
8. How would you measure radial deviation? What is the normal ROM for this movement?
9. How would you measure elbow flexion? What is the normal ROM for this movement?
10. How would you measure pronation? What is the normal ROM for this movement?
Information retrieved form:
Norkin, C., White, D. (2009). Measurement of Joint Motion. A Guide to Goniometry.