Range of motion, or ROM, measurements are a vital tool used every day by physical therapists, occupational therapists, doctors, nurses and sports medicine specialists to define normal movement. Patients with deficits in their ROM experience decreased independence with activities of daily living, increased pain and decreased sports performance.
Testing Range of Motion
The most important component of conducting proper ROM is isolation of the joint being measured. Because the body is so complex, many of our muscles move more than one joint or move the joint in multiple directions. Therefore, the basic guideline for ROM testing is to place the tester's hand above and below the joint being measured and ensuring that the patient moves her body part only in the direction being tested.
Effects of Limited Range of Motion
Due to injury, illness or the aging process patients often experience decreased ROM that can affect the patient's quality of life. For example, patients with poor ROM in their hands will struggle to pick up objects and maintain their hold on the object. Decreased leg ROM can result in poor balance and a decline in ambulation independence.
Measurements for the Shoulder
Shoulder ROM is divided into multiple categories. Shoulder flexion, or lifting the arm straight over the head, is normally 180 degrees. Conversely, pushing the arm straight behind the body by up to 60 degrees is shoulder extension. Lifting the arm sideways away from the body, or abduction, is measured to 180 degrees. Rotation of the shoulder joint is broken into internal rotation-twisting toward the torso, which should be 70 degrees, and external rotation-twisting away from the torso, which should be 90 degrees.
Measurements for the Lower Arm
Flexion, or bending, the elbow should ideally be 150 degrees. Pronation, or "palms down" position, is measured to 80 degrees. "Palms up" position, or supination, should reach up to 80 degrees.
The wrist is broken into two planes of movement. Flexion is bending the palm of the hand toward the forearm and normally measures 80 degrees. However, extension, or bending the back of the hand toward the back of the forearm, should reach 70 degrees. Moving the wrist sideways is measured in ulnar deviation, or bending toward the thumb, at 30 degrees and radial deviation, bending toward the pinkie finger, at 20 degrees.
Fingers are measured in flexion up to 80 degrees in the finger joints and 50 degrees in the knuckles. Abduction, or fanning the fingers out, is normally 70 degrees.
Measurements for the Lower Body
Hip bending, or flexion, is normally measured up to 125 degrees. The opposite, pushing the leg behind the body, is considered extension and measures 30 degrees. Lifting the thigh sideways away from the body, abduction, is expected to be 45 degrees. Adduction, or crossing the feet, normally measures to 25 degrees. Internal rotation, or twisting the leg inward, and external rotation, which is twisting the leg outward, both normally measure 40 to 45 degrees.
Knee flexion, or bending, ideally measures to 130 degrees. Ankle upward flexion, also known as dorsiflexion, is expected to measure 20 degrees. Ankle flexion downward, or plantarflexion, should measure 50 degrees.
References
- Ball State University: Range of Motion Lab
- "Willard and Spackman's Occupational Therapy"; Maureen E. Neistadt and Elizabeth Blesedell Crepeau; 1998
