Active range of motion of the shoulder: a cross-sectional study of 6635 subjects

Normative data for passive range of motion are well established, but daily living is comprised of active motion. The purpose of this study was to establish normative values for active range of motion of the shoulder across age, sex, and arm. Our hypotheses were that active range of motion of the shoulder (1) decreases with age group, (2) differs between males and females, and (3) differs between the right arm and left arm.

Shoulder active range of motion was captured with an eight-camera markerless motion capture system. Data were collected for a heterogenous sample of 6635 males and females of all ages. For each subject, 6 shoulder motions were collected with maximum values measured: external rotation, internal rotation, flexion, extension, abduction, and horizontal abduction. Three-way repeated measures analyses were performed, with 2 between-subject factors (age group and sex) and 1 within-subject factor (arm). The unadjusted threshold for statistical significance was α = 0.05.

External rotation decreased with age (approximately 10° decrease from below 30 years to above 60 years). External rotation was approximately 5° greater in the right arm, whereas internal rotation was approximately 5° greater in the left arm. Flexion decreased with age (approximately 15° decrease from below 20 years to above 60 years). For age groups from 10 to 59 years, extension and horizontal abduction were approximately 5° to 10° greater in females than males. Abduction was greater for females than males. Abduction was also greater in younger people (aged 10-29 years) than older people.

In general, active range of motion of the shoulder decreases with age. Sex (male/female) and arm side (right/left) also influence shoulder range of motion.