In terms of chronic diseases that impact ROM, people with diabetes have a higher reported prevalence of shoulder pain with subsequently increased levels of disability and reductions in activities of daily living, however one community-based study has also reported reduced average ranges of active flexion, abduction and external rotation, even among those with diabetes without a history of shoulder pain and/or stiffness. Shoulder range of movement (ROM) may be influenced by age, sex, work history and hand dominance, in addition to the measurement equipment being used and the assessor variability. However the population and methods used to obtain these values, and potential measurement error have not been described, and there have been no published studies of normative values in samples representative of the general population. Normal range of active movement of the shoulder has been specified by the American Academy of Orthopedic Surgeons (AAOS) to be 180° for flexion and abduction and 90° for external rotation. Internal rotation, extension and adduction are required to reach into the back pocket and abduction, flexion and external rotation are required to comb hair. For example, a combination of adduction and flexion are required to reach up to a high shelf or wash hair. Each movement contributes in different ways to the ability to undertake activities of daily living. There are generally considered to be six movements of the shoulder: flexion, extension, abduction, adduction, external and internal rotation. Īn important part of the clinical assessment is to determine a person’s range of active movement, the degree to which a person can move their shoulder in different directions, as this will assist in making a diagnosis and provide valuable information about a person’s functional limitations.
People with shoulder complaints also commonly visit physiotherapists, either as the first point of call or following referral from a GP. In 2014–15, shoulder complaints were the third most common musculoskeletal problem seen by general practitioners (GPs) in Australia, behind back and knee problems.
Their assessment and management comprise a significant proportion of general practice encounters. Shoulder problems are a common cause of disability in the community, are often chronic and have a significant impact on the ability to undertake activities. This information can be used to set realistic goals for both clinical practice and clinical trials. To our knowledge this is the largest community-based study providing normative data for active shoulder range of movement. External rotation range also declined, particularly among females. Shoulder range of movement declined with age, with mean right active shoulder flexion decreasing by 43° in males and 40.6° in females and right active shoulder abduction by 39.5° and 36.9° respectively. The average range of active right shoulder flexion was 161.5° for males and 158.5° for females, and active right shoulder abduction was 151.5° and 149.7° for males and females respectively. Mean values were determined and analyses to examine differences between groups (sex and age) were undertaken using non-parametric tests.
The main outcome measures were active shoulder range of movement (flexion, abduction and external rotation) measured as part of the clinic assessment using a Plurimeter V inclinometer. Participants in this study are those who undertook assessments in Stage 2. Each stage has consisted a of broad ranging computer assisted telephone interview, a self-complete questionnaire and a clinic assessment. MethodsĬross-sectional analysis using participants in a community-based longitudinal cohort study. The average range of active shoulder flexion, abduction and external rotation was measured in a population cohort aged 20 years and over without shoulder pain and/or stiffness in order to provide normative shoulder range data. An understanding of the average range of movement of the shoulder that is normally achievable is an important part of treatment for shoulder disorders.
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