UPPER EXTREMITY

RANGE OF MOTION
ERINDA RAHMA
MULIA
ASSESSMENT OF RANGE OF MOTION GENERAL
PRINCIPLES

-ROM testing is used to assess the integrity of 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 r e d with the c o n t r a l a t e r a l
unimpaired joint, if possible.
TEXT
TEXT

▸
UPPER EXTREMITY

▸ Shoulder

▸ Elbow

▸ Wrist

▸ Phalanx
SHOULDER

FLEXION & EXTENSION

BRADDOM DELISSA

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 of remains at 0 parallel to

goniometer degrees midaxillary line of
trunk
Axis of goniometer centered on lateral lateral to joint & just
shoulder bellow acromion
Movable arm of parallel to humerus parallel to midline
goniometer humerus
SHOULDER

ABDUCTION & ADDUCTION

BRADDOM DELISSA ISOM

Average abduction: abduction : Abduction : 0-180

R.O.M 0-180 0-180 adduction : 0-45
(in front of the
body)

Position of supine or supine

patient sitting
starting arm at side arm at side
position elbow elbow
extended extended
Stationary remains at 0 parallel to
arm of degrees midline of
goniometer trunk
axis of centered on anterior to
goniometer posterior or joint and in
anterior line with
shoulder acromion
Movable arm abduction : abduction :
of parallel to parallel to
goniometer humerus midline
humerus
 SHOULDER

INTERNAL & EXTERNAL ROTATION

BRADDOM DELISSA

Average R.O.M internal rot : 0-90 internal rot : 0-70

ext. rot :0-90 ext. rot : 0-90
Position of patient supine supine
starting position shoulder shoulder abducted
abducted 90, 90, elbow flexed 90,
elbow flexed 90, hand pronated
hand pronated
Stationary arm of remains at 0 perpendicular to floor
goniometer degrees
axis of goniometer elbow joint throught longitudinal
throught axis of humerus
longitudinal axis
of humerus
Movable arm of parallel to parallel to forearm
goniometer forearm
 ELBOW

FLEXION & EXTENSION

BRADDOM DELISSA

Average R.O.M flexion : 0-150 flexion : 0-150

extention : - extention : 0-10
Position of patient supine or sitting supine
starting position arm at side arm at side
hand : supine hand : supine
Stationary arm of remains at 0 parralel middle of
goniometer degrees humerus
axis of goniometer centered on lateral to joint &
lateral elbow through epycondylus
of humerus
Movable arm of parallel to parallel to forearm
goniometer forearm
 ELBOW
PRONATION & SUPINATION
Average R.O.M
Position of patient
starting position
Stationary arm of goniometer
axis of goniometer
Movable arm of goniometer
BRADDOM DELISSA
pronation : 0-90 pronation : 0-80
supination : 0-90 supination : 0-80
sitting sitting
elbow flexed 90 elbow flexed 90
hand : hold pencile hand : hold pencile
remains at 0 degrees paralell middle of humerus
longitudinal axis of through longitudinal axis of
forearm forearm
parallel to pencile held parallel to pencil (on thumb
side)
ELBOW PRONATION & SUPINATION
BRADDOM DELISA
WRIST
FLEXION & EXTENSION
Average R.O.M
Position of patient
starting position
Stationary arm of goniometer
axis of goniometer
Movable arm of goniometer
BRADDOM
flexion : 0-80
extention : 0-70
- -
elbow flexed 90
radioulnar pronation
remains at 0 degrees
centered on lateral wrist
over ulnar styloid
parallel to fifth metacarpal
DELISSA
flexion : 0-80
extention : 0-70
elbow flexed 90
radioulnar pronation
flexion : mid dorsum of forearm
extention : mid ventral surface of
forearm
flexion : dorsum of wrist (in line
with third metacarpal bone)
extention : ventral survace of
wrist (in line with third
metacarpal bone)
flexion : mid dorsum of hand
extention : mid palmar surface of
hand
WRIST FLEXION & EXTENSION
BRADDOM DELISA
WRIST

RADIAL & ULNAR DEVIATION

BRADDOM DELISSA

Average R.O.M Radial dev. : 0-20 Radial dev. : 0-20

Ulnar dev.: 0-30 Ulnar dev.: 0-30
Position of patient - -
starting position elbow flexed 90 forearm pronate wrist
forearm pronation neutral position
Stationary arm of remains at 0 degrees mid dorsum of forearm
goniometer
axis of goniometer centered over dorsal centered over dorsal wrist at
wrist between distal midcarpal bone
radius & ulna
Movable arm of goniometer parallel to third third metacarpal bone
metacarpal
WRIST RADIAL & ULNAR DEVIATION
BRADDO DELIS
M A
TEXT

PHALAN
X
▸ 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 extended
flexed, forearm thumb
supinated,IP joint
extended
Stationary arm of - 1st IP: shaft parallel
goniometer to midline of
proximal phalanx 1st
MCP: shaft

axis of goniometer - 1st IP:Lateral IP

joint
Movable arm of - 1st IP: shaft parallel
goniometer to midline of distal
phalanx
1st MCP: shaft
1ST IP 1ST MCP
FLEXION FLEXION
1 ST ABDUCTION
2ND-5TH MCP/PIP/DIP FLEXION &
EXTENSION
Average R.O.M
Position of patient
starting position
Stationary arm of goniometer
axis of goniometer
Movable arm of goniometer
BRADDOM
2nd-5th MCP FLEXION:
0-90
2nd-5th PIP FLEXION: 0-100
2nd-5th DIP FLEXION: -
- -
2nd-5th MCP: elbow flexed,
radioulnar joint pronated, wrist in
neutral,fingers extended
2nd-5th PIP: elbow flexed,
radioulnar joint pronated, MCP
joint in slight flexion
2nd-5th DIP: -
2nd-5th MCP: remains at 00
2nd-5th PIP: remains at 00
2nd-5th MCP: Dorsum of each
MCP joint
2nd-5th PIP: Dorsum of each IP
joint
2nd-5th MCP: remains on dorsum
of each proximal phalanx
2nd-5th PIP: remains on dorsum
of each middle phalanx
DELISSA ISOM
2nd-5th MCP FLEXION: 0-90 2nd-5th MCP FLEXION:
0-90
2nd-5th PIP FLEXION: - 2nd-5th PIP FLEXION:
2nd-5th DIP FLEXION: - 0-100
2nd-5th DIP FLEXION:
0-45
2nd-5th DIP HYPEREXTENSION:
0-15
2nd-5th MCP: elbow flexed, hand
pronated, wrist in neutral position
2nd-5th PIP: -
2nd-5th DIP: -
2nd-5th MCP:shaft on mid dorsum
of metacarpal bone
2nd-5th MCP: mid dorsum of joint
2nd-5th MCP:shaft on mid dorsum
of proximal phalanx
2ND - 5TH MCP FLEXION

BRADDOM. DELISA
2ND - 5TH PIP FLEXION

2ND-5TH MCP
EXTENSION
REFERENCES
•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
• Reese, N.B. and Bandy, W.D., 2016. Joint range of motion
and muscle length testing-E-book. Elsevier Health
Sciences.