UE ROM -- Hand: Fingers and Thumb

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dorsal DIP joint being tested

DIP extension: axis/fulcrum

MCP in 70-90 degrees of flexion (avoid full MCP and PIP flexion or extension)

DIP extension: common substitutions

firm

DIP extension: end feel

dorsal midline of distal phalanx being tested

DIP extension: moving arm/distal arm

0 -- 8 for AROM and 20 for PROM

DIP extension: normal ROM

dorsal midline of middle phalanx being tested

DIP extension: stationary arm/proximal arm

dorsal DIP joint being tested

DIP flexion: axis/fulcrum

MCP in 70-90 degrees of flexion (avoid full MCP and PIP flexion or extension)

DIP flexion: common substitutions

firm

DIP flexion: end feel

dorsal midline of distal phalanx being tested

DIP flexion: moving arm/distal arm

70-90

DIP flexion: normal ROM

dorsal midline of middle phalanx being tested

DIP flexion: stationary arm/proximal arm

(dorsal) scaphoid or radial styloid process

1st CMC abduction: axis/fulcrum

MCP and IP joints relaxed in slight flexion, wrist motions (specifically flexion)

1st CMC abduction: common substitutions

firm

1st CMC abduction: end feel

dorsal midline of 1st metacarpal

1st CMC abduction: moving arm/distal arm

40-50

1st CMC abduction: normal ROM

lateral 2nd metacarpal

1st CMC abduction: stationary arm/proximal arm

ventral 1st CMC joint

1st CMC extension - alternate: axis/fulcrum

MCP and IP joints relaxed in slight flexion, wrist motions (specifically RD)

1st CMC extension - alternate: common substitutions

firm

1st CMC extension - alternate: end feel

ventral midline of shaft of 1st metacarpal

1st CMC extension - alternate: moving arm/distal arm

15-35

1st CMC extension - alternate: normal ROM

ventral wrist at line between start of carpals

1st CMC extension - alternate: stationary arm/proximal arm

ventral 1st CMC joint

1st CMC extension: axis/fulcrum

MCP and IP joints relaxed in slight flexion, wrist motions (specifically RD)

1st CMC extension: common substitutions

firm

1st CMC extension: end feel

ventral midline of shaft of 1st metacarpal

1st CMC extension: moving arm/distal arm

15-35

1st CMC extension: normal ROM

ventral midline of radius (styloid process)

1st CMC extension: stationary arm/proximal arm

ventral 1st CMC joint

1st CMC flexion - alternation: axis/fulcrum

MCP and IP joints relaxed in slight flexion, wrist motions (specifically UD)

1st CMC flexion - alternation: common substitutions

firm

1st CMC flexion - alternation: end feel

ventral midline of shaft of 1st metacarpal

1st CMC flexion - alternation: moving arm/distal arm

15-25

1st CMC flexion - alternation: normal ROM

ventral wrist at line between start of carpals

1st CMC flexion - alternation: stationary arm/proximal arm

ventral 1st CMC joint

1st CMC flexion: axis/fulcrum

MCP and IP joints relaxed in slight flexion, wrist motions (specifically UD)

1st CMC flexion: common substitutions

soft, firm

1st CMC flexion: end feel

ventral midline of shaft of 1st metacarpal

1st CMC flexion: moving arm/distal arm

15-25

1st CMC flexion: normal ROM

ventral midline of radius (styloid process)

1st CMC flexion: stationary arm/proximal arm

wrist motions, forearm pronation, MCP/IP flexion of thumb

1st CMC opposition: common substitutions

soft

1st CMC opposition: end feel

variable -- more than 8 cm is impaired

1st CMC opposition: normal ROM

hard or firm

MCP flexion: end feel

dorsal midline of proximal phalanx being tested

MCP flexion: moving arm/distal arm

90-100

MCP flexion: normal ROM

dorsal midline of metacarpal being tested

MCP flexion: stationary arm/proximal arm

dorsal MCP joint being tested

MCP abduction: axis/fulcrum

wrist UD/RD

MCP abduction: common substitutions

firm

MCP abduction: end feel

dorsal midline of proximal phalanx being tested

MCP abduction: moving arm/distal arm

25

MCP abduction: normal ROM

dorsal midline of metacarpal being tested

MCP abduction: stationary arm/proximal arm

dorsal MCP joint being tested

MCP extension: axis/fulcrum

extreme flexion of PIP and DIP, full extension of other metacarpals, wrist extension

MCP extension: common substitutions

firm

MCP extension: end feel

dorsal midline of proximal phalanx being tested

MCP extension: moving arm/distal arm

20-45

MCP extension: normal ROM

dorsal midline of metacarpal being tested

MCP extension: stationary arm/proximal arm

dorsal MCP joint being tested

MCP flexion: axis/fulcrum

extreme flexion of PIP and DIP, full extension of other metacarpals, wrist flexion

MCP flexion: common substitutions

dorsal PIP joint being tested

PIP extension: axis/fulcrum

avoid full MCP flexion or extension

PIP extension: common substitutions

firm

PIP extension: end feel

dorsal midline of middle phalanx being tested

PIP extension: moving arm/distal arm

0 -- 7 for AROM or 16 for PROM

PIP extension: normal ROM

dorsal midline of proximal phalanx being tested

PIP extension: stationary arm/proximal arm

dorsal PIP joint being tested

PIP flexion: axis/fulcrum

avoid full MCP flexion or extension

PIP flexion: common substitutions

any

PIP flexion: end feel

dorsal midline of middle phalanx being tested

PIP flexion: moving arm/distal arm

100-110

PIP flexion: normal ROM

dorsal midline of proximal phalanx being tested

PIP flexion: stationary arm/proximal arm

dorsal 1st IP joint

thumb IP extension: axis/fulcrum

firm

thumb IP extension: end feel

dorsal midline of distal phalanx

thumb IP extension: moving arm/distal arm

20-30

thumb IP extension: normal ROM

dorsal midline of proximal phalanx

thumb IP extension: stationary arm/proximal arm

avoid wrist and MCP extension

thumb IP extension: substitutions

dorsal 1st IP joint

thumb IP flexion: axis/fulcrum

wrist flexion, MCP flexion/extension

thumb IP flexion: common substitutions

firm

thumb IP flexion: end feel

dorsal midline of 1st distal phalanx

thumb IP flexion: moving arm/distal arm

80

thumb IP flexion: normal ROM

dorsal midline of proximal phalanx

thumb IP flexion: stationary arm/proximal arm

dorsal 1st MCP joint

thumb MCP extension: axis/fulcrum

avoid full extension of thumb IP and wrist, avoid CMC flexion

thumb MCP extension: common substitutions

firm

thumb MCP extension: end feel

dorsal midline of 1st proximal phalanx

thumb MCP extension: moving arm/distal arm

0 -- PROM some say 8-40

thumb MCP extension: normal ROM

dorsal midline of 1st metacarpal

thumb MCP extension: stationary arm/proximal arm

dorsal 1st MCP joint

thumb MCP flexion: axis/fulcrum

avoid full flexion and thumb IP and wrist, avoid CMC flexion

thumb MCP flexion: common substitutions

hard, firm

thumb MCP flexion: end feel

dorsal midline of 1st proximal phalanx

thumb MCP flexion: moving arm/distal arm

50-60

thumb MCP flexion: normal ROM

dorsal midline of 1st metacarpal

thumb MCP flexion: stationary arm/proximal arm

from digital crease of little finger to tip of thumb OR proximal digital crease of thumb to distal palmar crease directly over 5th MCP joint

two ways to measure for 1st CMC opposition


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