Shoulder range of movement in the general population: age and gender stratified normative data using a community-based cohort

Background An understanding of the average range of movement of the shoulder that is normally achievable is an important part of treatment for shoulder disorders. The average range of active shoulder flexion, abduction and external rotation was measured in a population cohort aged 20 years and over without shoulder pain and/or stiffness in order to provide normative shoulder range data. Methods Cross-sectional analysis using participants in a community-based longitudinal cohort study. There have been three stages of data collection - Stage 1 (1999-2003), Stage 2 (2004-2006) and Stage 3 (2008-2010). Each stage has consisted a of broad ranging computer assisted telephone interview, a self-complete questionnaire and a clinic assessment. Participants in this study are those who undertook assessments in Stage 2. The main outcome measures were active shoulder range of movement (flexion, abduction and external rotation) measured as part of the clinic assessment using a Plurimeter V inclinometer. Mean values were determined and analyses to examine differences between groups (sex and age) were undertaken using non-parametric tests. Results There were 2404 participants (51.5% male), mean age 45.8 years (SD 17.3, range 20-91). The average range of active right shoulder flexion was 161.5 degrees for males and 158.5 degrees for females, and active right shoulder abduction was 151.5 degrees and 149.7 degrees for males and females respectively. Shoulder range of movement declined with age, with mean right active shoulder flexion decreasing by 43 degrees in males and 40.6 degrees in females and right active shoulder abduction by 39.5 degrees and 36.9 degrees respectively. External rotation range also declined, particularly among females. Conclusion To our knowledge this is the largest community-based study providing normative data for active shoulder range of movement. This information can be used to set realistic goals for both clinical practice and clinical trials.