Background/Purpose: Shoulder range of movement is integral to activities of daily living and the impact of pain on shoulder function has a significant effect on quality of life. However, while some studies have examined normative values for shoulder strength, few large studies have determined normative values for shoulder range of movement (ROM) across a wide age range.  The aim of this study was to provide normative data for shoulder ROM, using data from a population-based cohort.

Methods: Participants for this study were part of the North West Adelaide Study (NWAHS), a longitudinal cohort study of 4056 randomly selected adults aged 18 years and over (47.7% male) at the time of recruitment.  Three stages of data collection have been undertaken. Stage 1 was between 1999-2003, Stage 2, 2004-06 and Stage 3, 2008-10. As part of the Stage 2 assessment, range of flexion and abduction for both the right and left shoulders were measured using an inclinometer and standardised protocols and external rotation was measured by observation.  Participants were asked if they had ever had shoulder pain or stiffness, if they had ever been told by a doctor that they had rheumatoid arthritis (RA) and were defined as having diabetes by self-report and/or a fasting plasma glucose level of >= 7.0mmol/l. Those who reported having shoulder pain and/or stiffness and those with RA were excluded from the analysis. Data were weighted by age, sex and probability of selection in the household to correct for disproportionality of response. Age group analyses were undertaken using the following groupings (<40 years, 40-49, 50-59, 60-69, 70-79, 80 years and over).

Results: Overall, there was a significant mean difference (p<0.05) between the right and left sides for each movement. Males had higher mean abduction and flexion and lower mean external rotation compared to females (Table 1). 

Table 1: Mean shoulder ROM by sex (n=2404)

ROM generally declined with age for each movement with significant correlation between age and ROM (p<0.05). People with diabetes also demonstrated a significantly reduced ROM compared to those without (p<0.05, Table 2).

Table 2: Mean shoulder ROM for those with and without diabetes (n=2379)

Conclusion: This large population sample provides normative values for shoulder ROM which are important for comparison purposes, in order to determine if a level of impairment exists. Generally it is accepted that normal flexion and abduction range of movement is 180 degrees and external rotation is 90 degrees, however this does not appear to be the case. This needs to be taken into consideration when assessing and treating those with shoulder impairments.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/age-and-sex-stratified-normative-data-for-shoulder-range-of-movement/