Upper Extremity Range of Motion
Upper Extremity Range of Motion ChartName:DOB:School Years:LeftRightDatesNormalNormal180?Shoulder Flexion180? 180?Shoulder Abduction180?70?Shoulder internal rotation70?90?Shoulder external rotation90?145?Elbow flexion 145? (0)Elbow extension(0)80?-90?Forearm neutral positionSupination (elbow bent)80?-90?80?-90?Pronation (elbow bent)80?-90?80?Wrist flexion80?70?Wrist extension70?20?Wrist radial deviation20?30?Wrist ulnar deviation30?70?Thumb abduction70?Note: All measurements are PROM, unless specified by A for Active Range of Motion.WFL= Within Functional LimitsWNL= Within Normal LimitsStudent Name:________________________ DOB:_______________________DateComments____________________________________________________________________________ ____________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________Please note position, medication, surgeries or anything that might effect ROM measurements. ................
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