The ‘neutral position’ (starting point) is the position in which the 3rd metacarpal bone is in line with the lower arm [Figure 104]. For pronation and supination, the palm should be located in the sagittal plane (mid-position). The elbow should be bent in both situations. Range of motion should be assessed in relation to these positions.
Figure 104
Procedure
- The patient sits at an examination table and leans on their elbows, if required.
- The examiner is seated opposite the patient.
- Inspect the movements and assess:
- The course of the movement.
- The maximum range of motion.
- Occurrence of pain.
- Occurrence of crepitations.
Distal Radioulnar Joint
- Pronation: Elbow should be in 90° flexion [Figure 105].
- Supination: Elbow should be in 90° flexion [Figure 106].
Figure 105
Figure 106
Wrist Joint
- Dorsal flexion [Figure 107].
Figure 107
- Palmar flexion [Figure 108].
Figure 108
- Radial abduction [Figure 109].
Figure 109
- Ulnar abduction [Figure 110].
Figure 110
Finger Joints II Through To V
- Metacarpophalangeal joints:
- Flexion [Figure 111].
Figure 111
-
- Extension [Figure 112].
Figure 112
-
- Abduction/adduction (spreading apart/bringing together) [Figures 113, 114].
Figure 113
Figure 114
Proximal and Distal Interphalangeal Joints
- Flexion [Figure 111].
Figure 111
- Extension [Figure 112].
Figure 112
Thumb Joints
- Carpometacarpal Joint:
- Opposition [Figure 115] and reposition [Figure 116] (spatially these movements consists of flexion/adduction, extension/abduction).
Figure 115
Figure 116
Metacarpophalangeal Joint
- Flexion [Figure 111].
- Extension [Figure 112].
Interphalangeal Joint
- Flexion [Figure 111].
- Extension [Figure 112].
Figure 111
Figure 112