Normative values and affecting factors for the elbow range of motion

Elisa L. Zwerus*, Nienke W. Willigenburg, Vanessa A. Scholtes, Matthijs P. Somford, Denise Eygendaal, Michel P.J. van den Bekerom

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Introduction: Abnormalities in the elbow range of motion (ROM) can be subtle; therefore, it is important that the examiner can compare findings with reliable reference values, matching the patients’ characteristics. Primarily, we aimed to provide normative values for the elbow ROM in subpopulations based on age, sex, dominance and body mass index (BMI). The secondary objective was to determine intra- and inter-rater reliability. Methods: aROM (active range of motion) and pROM (passive range of motion) were measured bilaterally in healthy adults using a universal goniometer. The influence of factors affecting the ROM was calculated using Pearson’s correlation coefficient. In two samples of subjects, intra-rater and inter-rater reliability were determined. Results: The study population (n = 352) consisted of 47.2% male and 52.8% female subjects. For aROM (dominant hand), mean flexion was 146°, extension –2°, pronation 80° and supination 87°. Male subjects had smaller ROM compared to females (p < 0.001). Differences between dominant and nondominant hand were less than one degree. pROMs were 3° to 5° larger than aROMs (p < 0.001). Intra- and inter-rater reliability was good. Conclusions: Elbow ROM is influenced by age, sex and BMI. In the general population, the ROM of the uninjured side can serve as a reference in case of an injured elbow.

Original languageEnglish
Pages (from-to)215-224
Number of pages10
JournalShoulder and Elbow
Issue number3
Publication statusPublished - 1 Jun 2019
Externally publishedYes


  • elbow
  • joint mobility
  • normative values
  • range of motion
  • reference values


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