UPPER EXTREMITY
RANGEOF
MOTION
Preceptor : dr. Samiah Rachmawati,
[Link]
ASSESSMENT OF RANGE OF MOTION
GENERAL PRINCIPLES
-ROM testing is used to assess the integrityof
a joint
- to monitor the efficacy of treatment regiment
- to determine the mechanical cause of an
impairment
ASSESSMENT TECHNIQUES
-Range is measured with a universal
goniometer, a device that has a
pivoting arm attached to a
stationary arm divided into 1-
degree intervals (Figure 1-3).
-Joints are measured in their plane of
movement with the stationary arm
parallel to the long axis of the
proximal body
segment or bony landmark.
-The moving arm of the goniometer
should also be aligned with a bony
landmark or parallel to the moving
body segment.
-The impaired joint should always be
c o m p a re d with the
c o n t r a l a t e r a l unimpaired joint, if
possible.
UPPER EXTREMITY
▸
Shoulder
▸ Elbow
▸ Wrist
▸ Phalanx
SHOULDER
FLEXION & EXTENSION
BRADDOM DE LISA
Average R.O.M Flexion: 0-180 Flexion: 0-180
extension : 0-60 extension : 0-60
Position of patient supine or sitting flexion : supine
extension :
prone
starting position arm at side arm at side,
elbow elbow
extended extended, hand
in prone
Stationary arm remains at parallel to
of goniometer 0 degrees midaxillary line
of trunk
Axis of centered on lateral to joint &
goniometer lateral shoulder just below
acromion
Movable arm parallel to parallel to
of humerus midline
goniometer humerus
SHOULDER
ABDUCTION & ADDUCTION
BRADDOM DE LISA ISOM
Average abduction abduction Abduction : 0-
R.O.M : 0-180 : 0-180 180
adduction :
0-45 (in
front of the
body)
Position of supine or supine
patient sitting
starting arm at arm at
side elbow side
position extended elbow
extended
Stationary remains at parallel
arm of 0 degrees to
goniomete midline of
r trunk
axis of centered anterior to
goniomete on joint and
r posterior or in line
anterior with
SHOULDER
INTERNAL & EXTERNAL
ROTATION
BRADDOM DE LISA
Average R.O.M internal rot : 0- internal rot : 0-
90 ext. rot :0- 70 ext. rot : 0-
90 90
Position of patient supine supine
starting position shoulder shoulder
abducted abducted 90,
90, elbow flexed 90,
elbow flexed hand pronated
90, hand
pronated
Stationary arm remains at perpendicular to
of goniometer 0 degrees floor
axis of elbow joint throught
goniometer throught longitudinal axis
longitudinal of humerus
axis of
humerus
ELBOW
FLEXION & EXTENSION
BRADDOM DE LISA
Average R.O.M flexion : 0- flexion : 0-150
150 extention : 0-10
extention : -
Position of supine or supine
patient sitting
starting position arm at side arm at side
hand : hand :
supine supine
Stationary arm remains at parralel middle
of goniometer 0 degrees of humerus
axis of centered lateral to joint &
goniometer on lateral through
elbow epycondylus of
humerus
Movable arm parallel parallel to forearm
of to
goniometer forearm
ELBOW
PRONATION & SUPINATION
BRADDOM DE LISA
Average R.O.M pronation : 0-90 pronation : 0-80
supination : 0-90 supination : 0-80
Position of patient sitting sitting
starting position elbow flexed 90 elbow flexed 90
hand : hold hand : hold
pencile pencile
Stationary arm of remains at 0 degrees paralell middle of humerus
goniometer
axis of goniometer longitudinal axis through longitudinal
of forearm axis of forearm
Movable arm of parallel to pencil held parallel to pencil (on
goniometer thumb side)
ELBOW PRONATION &
SUPINATION BRADDOM DE LISA
WRIST
FLEXION & EXTENSION
BRADDOM DE LISA
Average R.O.M flexion : 0-80 flexion : 0-80
extention : 0-70 extention : 0-70
Position of patient - -
starting position elbow flexed 90 elbow flexed 90
radioulnar radioulnar
pronation pronation
Stationary arm of remains at 0 degrees flexion : mid dorsum of
goniometer forearm extention : mid
ventral surface of forearm
axis of goniometer centered on lateral flexion : dorsum of wrist (in
wrist over ulnar line with third metacarpal
styloid bone) extention : ventral
survace of wrist (in line
with third metacarpal
bone)
Movable arm of parallel to fifth flexion : mid dorsum of hand
goniometer metacarpal extention : mid palmar
surface of hand
WRIST FLEXION &
EXTENSION BRADDOM DE LISA
RADIAL & ULNAR
DEVIATION
BRADDOM DE LISA
Average R.O.M Radial dev. : 0- Radial dev. : 0-
20 Ulnar dev.: 20 Ulnar dev.: 0-
0-30 30
Position of patient - -
starting position elbow flexed 90 forearm pronate
forearm wrist neutral
pronation position
Stationary arm remains at 0 degrees mid dorsum of forearm
of goniometer
axis of goniometer centered over centered over dorsal wrist
dorsal wrist at midcarpal bone
between distal
radius & ulna
Movable arm of goniometer parallel to third metacarpal bone
third
metacarpal
WRIST RADIAL & ULNAR
DEVIATION
BRADDOM DE LISA
PHALANX
▸ 1st IP/MCP Flexion
▸ 1st IP/MCP Extension
▸ 1st Abduction
▸ 1st Adduction
▸ 1st Opposition
▸ 2nd-5th MCP/PIP/DIP
Flexion
1ST IP/MCP FLEXION
BRADDOM DELISSA Buckup ISOM
Average R.O.M - 1st IP FLEXION: 1st MCP FLEXION : 1st IP FLEXION:
0-80 0-50 0-65
1st MCP FLEXION: 1st MCP FLEXION:
- 0-60
Position of - -
patient
starting position - 1st IP : elbow fully
flexed, forearm extended
supinated,IP thumb
joint extended
Stationary arm - 1st IP: shaft
of goniometer parallel to
midline of
proximal phalanx
1st MCP: shaft
axis of - 1st IP:Lateral
goniometer IP joint
Movable arm - 1st IP: shaft
of parallel to
goniometer midline of distal
phalanx
1st MCP: shaft
1ST IP N
FLEXION
1 ST ABDUCTION
2ND-5TH MCP/PIP/DIP
FLEXION & EXTENSION BRADDOM DELISSA ISOM
Average R.O.M 2nd-5th MCP FLEXION: 2nd-5th MCP FLEXION: 0-90 2nd-5th MCP FLEXION:
0-90 0-90
2nd-5th PIP FLEXION: 0-100 2nd-5th PIP FLEXION: - 2nd-5th PIP FLEXION:
2nd-5th DIP FLEXION: - 2nd-5th DIP FLEXION: - 0-100
2nd-5th DIP FLEXION:
0-45
2nd-5th DIP HYPEREXTENSION:
0-15
Position of patient - -
starting position 2nd-5th MCP: elbow flexed, 2nd-5th MCP: elbow flexed,
radioulnar joint pronated, hand pronated, wrist in
wrist in neutral,fingers neutral position 2nd-5th
extended PIP: -
2nd-5th PIP: elbow flexed, 2nd-5th DIP: -
radioulnar joint
pronated, MCP joint in
slight flexion
2nd-5th DIP: -
Stationary arm of goniometer 2nd-5th MCP: remains at 00 2nd-5th MCP:shaft on mid
2nd-5th PIP: remains at 00 dorsum of metacarpal bone
axis of goniometer 2nd-5th MCP: Dorsum of 2nd-5th MCP: mid dorsum of
each MCP joint joint
2nd-5th PIP: Dorsum of
each IP joint
Movable arm of goniometer 2nd-5th MCP: remains on 2nd-5th MCP:shaft on mid
2ND - 5TH MCP FLEXION
BRADDO DE
M. LISA
2ND - 5TH PIP FLEXION
2ND-5TH MCP
EXTENSION
ES
•Braddom’s Physical medicine and
Rehabilitation. Philadelphia.2016. W.B.
Saunders Co. 5th Edition
• Buckup. 2008. Clinical Tests for The
Musculoskeletal
System
•De Lisa’s Physical Medicine and Rehabilitation.
Philadelphia .2010. Lippincott Williams &
Wilkins. Fifth Edition
