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 of a 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° for males and 158.5° for females, and active right shoulder abduction was 151.5° and 149.7° for males and females respectively. Shoulder range of movement declined with age, with mean right active shoulder flexion decreasing by 43° in males and 40.6° in females and right active shoulder abduction by 39.5° and 36.9° 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.Tiffany K. Gill, E. Michael Shanahan, Graeme R. Tucker, Rachelle Buchbinder and Catherine L. Hil