The Functional Forearm Rotation: Is It the Same for Everyone?

Introduction A functional range of forearm rotation has been stated to be 50° of pronation and supination (total arc of 100°),¹ with a more recent suggestion that contemporary tasks need 65° of pronation and 75° of supination.² Our research involved 24 healthy university students, each subjected to objective hand testing with the Perdue, Jebsen, and Minnesota Manual function tests before and after the application of a long-arm cast brace that fixed the forearm rotation alternatively in 45° of pronation, 45° of supination, or neutral. The varied positional casts were worn for one day in each position and at removal, a subjective functional evaluation was obtained.

Results

Conclusions Our conclusions were a compromise. The most functional position is in supination (30° to 45°). For a dominant hand and desk worker (computer), 30° to 45° of pronation is best. For a nondominant hand or dominant hand and not a “desk worker,” 30° to 45° of supination is best.

“Time” (clinical experience with multiple patients) has shown that the functional ROM guidelines are useful, but one must include: the patient's needs, whether pain is part of the presentation, the function of the ipsilateral and contralateral other upper extremity joints, and (before offering treatment) the risk and/or benefit of the treatment or procedure offered must be known and discussed. These demands make offering a simple numerical range of motion, as a basis for treatment, less meaningful.

References

References

1 Morrey BF, Askew LJ, Chao EY. A biomechanical study of normal functional elbow motion. J Bone Joint Surg Am 1981;63(6):872–877

2 Sardelli M, Tashjian RZ, MacWilliams BA. Functional elbow range of motion for contemporary tasks. J Bone Joint Surg Am 2011;93(5):471–477