Functional Elbow Range of Motion for Contemporary Tasks

BACKGROUND: Elbow range of motion for functional tasks has been previously studied. Motion arcs necessary to complete contemporary tasks such as using a keyboard or cellular telephone have not been studied and could have implications on what is considered to be a functional arc of motion for these tasks. The purpose of this study was to determine elbow range of motion, including flexion-extension, pronation-supination, and varus-valgus angulation, with use of three-dimensional optical tracking technology for several previously described positional and functional tasks along with various contemporary tasks. METHODS: Twenty-five patients performed six positional and eleven functional tasks (both historical and contemporary). Elbow flexion-extension, varus-valgus, and forearm rotation (pronation and supination) ranges of motion were measured. RESULTS: Positional tasks required a minimum (mean and standard deviation) of 27° ± 7° of flexion and a maximum of 149° ± 5° of flexion. Forearm rotation ranged from 20.0° ± 18° of pronation to 104° ± 10° of supination. Varus and valgus angulations ranged between 2° ± 5° of varus to 9° ± 5° of valgus. For functional tasks, the maximum flexion arc was 130° ± 7°, with a minimum value recorded as 23° ± 6° and a maximum value recorded as 142° ± 3°. All of these were for the cellular telephone task. The maximum pronation-supination arc (103° ± 34°) was found with using a fork. Maximum pronation was found with typing on a keyboard (65° ± 8°). Maximum supination was found with opening a door (77° ± 13°). Maximum varus-valgus arc of motion was 11° ± 4°. Minimum valgus (0° ± 6°) was found with cutting with a knife, while maximum valgus (13° ± 6°) was found with opening a door. CONCLUSIONS: Functional elbow range of motion necessary for activities of daily living may be greater than previously reported. Contemporary tasks, such as using a computer mouse and keyboard, appear to require greater pronation than other tasks, and using a cellular telephone usually requires greater flexion than other tasks.