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3. The columns designated with asterisks (*) are used for
Recording: indicating limitation of range of motion and referenc-
1. The Neutral Zero Method defined by the American ing for summarization.
Academy of Orthopaedic Surgeons1 is used for mea- 4. Space is left at the end of each section to record hyper-
surement and recording. mobile ranges and comments regarding positioning of
2. Average ranges defined by the American Academy of the patient or body part, measuring instrument,
Orthopaedic Surgeons,1 are provided in parentheses. edema, pain, and/or end feel.
Date of Measurement
Mandible: Depression
Protrusion
Lateral deviation
Extension (0–45°)
Rotation (0–60°)
Extension (0–20–30°)
Rotation (0–45°)
Hypermobility:
Comments:
Date of Measurement
Scapula
Elevation
Depression
Abduction
Adduction
Shoulder Complex
Flexion (0–120°)2
Extension (0–60°)
Hypermobility:
Comments:
Flexion (0–150°)
Supination (0–80°)
Pronation (0–80°)
Hypermobility:
Comments:
Date of Measurement
Wrist
Flexion (0–80°)
Extension (0–70°)
Hypermobility:
Comments:
Thumb
CM flexion (0–15°)
CM extension (0–20°)
Abduction (0–70°)
IP flexion (0–80°)
Opposition
Hypermobility:
Comments:
Fingers
extension (0–45°)
abduction
adduction
extension (0–45°)
abduction (radial)
adduction (ulnar)
extension (0–45°)
abduction
adduction
Date of Measurement
extension (0–45°)
abduction
adduction
3 flexion (0–100°)
4 flexion (0–100°)
5 flexion (0–100°)
3 flexion (0–90°)
4 flexion (0–90°)
5 flexion (0–90°)
Thumb–digit 2
Digit 2–digit 3
Digit 3–digit 4
Digit 4–digit 5
Hypermobility:
Comments:
Date of Measurement
Hip
Flexion (0–120°)
Extension (0–30°)
Abduction (0–45°)
Adduction (0–30°)
Hypermobility:
Comments:
Knee
Flexion (0–135°)
Tibial rotation
Hypermobility:
Comments:
Ankle
Dorsiflexion (0–20°)
Plantarflexion (0–50°)
Inversion (0–35°)
Eversion (0–15°)
Hypermobility:
Comments:
Date of Measurement
Toes
extension (0–70°)
abduction
extension (0–40°)
extension (0–40°)
extension (0–40°)
extension (0–40°)
Hypermobility:
Comments:
Summary of Limitation:
Additional Comments:
1
American Academy of Orthopaedic Surgeons: Joint Motion: Method of Measuring and Recording. Chicago: AAOS; 1965.
2
Levangie PK, Norkin CC. Joint Structure and Function: A Comprehensive Analysis. 3rd ed. Philadelphia: FA Davis; 2001.