Functional Range of Motion

Functional range of motion means that the client has adequate range of motion (ROM) necessary to complete everyday tasks to their full extent. It is important to remember that clients can have functional range of motion but not be able to reach full range of motion.

(Gett & Romaniw, 2021)

How can functional ROM in the upper extremities (UE) be assessed clinically?

The client will move through active range of motion movements in the UE. The therapist will watch to see if there are differences between the two sides of the body or if there is an inability to perform ROM for a certain movement. The therapist is watching to see if the client might have any difficulties performing daily occupations by watching their active range of motion for the following movements:

If the client is unable to perform a movement, further assessment using the goniometer is needed to get quantitative data.

(Gett & Romaniw, 2021)

Functional ROM Verbiage and Examples of Functional Tasks:

Shoulder flexion: “Can you rise your arms above your head as far as you can go?”
- Determines if client can
  - Reach overhead to grab an object
  - Put dishes or groceries away in a cabinet

Shoulder extension: “Can you reach for something behind you?”
- Determine if client can
  - Perform toilet hygiene
  - Reach backwards to put on a jacket

Shoulder internal and external rotation: “Can you touch the back of your head and can you touch your lower back with both hands?”
- Determines if client can
  - Turn a doorknob handle
  - Dress
  - Use a screwdriver
  - Eat and drink

Elbow flexion: “Can you touch your face?”
- Determines if the client can
  - Shave face
  - Bring food to mouth to eat

Elbow extension: “With your arms at your side, can you straighten your arms as much as possible?
- Determines if client can
  - Reach down to tie shoes
  - Donn pants
  - Push off of a chair to stand up

Pronation/Supination: “Can you put your hands palm up and then palm side down?”
- Determines if client can
  - Turn pages of a book
  - Wringing out a wash cloth after doing dishes

Wrist flexion and extension: “Can you bend your wrists down as far as you can and up as far as you can?”
- Determines if client can
  - Tie shoes
  - Cook a meal

(George & Killingsworth, 2018; Shurtleff &Kaskutas, 2018)

References

Gett, M., & Romaniw, A. (2021, October 26-28). Joint Range of Motion [PowerPoint slides]. Department of Health Sciences, Occupational Therapy, Chatham University. https://mylearning.chatham.edu/d2l/le/content/21252/viewContent/296101/View

George, A. H., & Killingsworth, A. P. (2018) Occupation-based functional motion assessment. In L. W. Pedretti, H. M. H. Pendleton, & W. Schultz-Krohn (Eds.), Pedretti’s occupational therapy: Practice skills for physical dysfunction (8th ed., pp. 470-476) Elsevier.

Shurtleff, T., & Kaskutas, V. (2018) Joint range of motion. In L. W. Pedretti, H. M. H. Pendleton, & W. Schultz-Krohn (Eds.), Pedretti’s occupational therapy: Practice skills for physical dysfunction (8th ed., pp. 477-511) Elsevier.