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People with bleeding disorders, such as hemophilia and Von Willebrand Disease may develop chronic joint disease from repeated bleeding into their joints. Over time, the joint disease results in decreased mobility of the joints. People without bleeding disorders also lose mobility in their joints with aging. However, there are very few studies of joint mobility over time in people without bleeding disorders.

Data from the joint range of motion study provide a baseline to learn more about loss of mobility due to joint bleeding.

About the Study

To have a baseline with which to compare people with bleeding disorders, the joints of more than 600 people in the general population without bleeding disorders were measured as part of the study. CDC collected range of motion (ROM) measurements of the elbow, shoulder, hip, knee and ankle from a sample of individuals without known medical or physical conditions affecting the joint mobility.

The objective was to generate data that could be used to:

  • Provide reference values for normal joint ROM for males and females and across the life span for comparison to people with hemophilia and other bleeding disorders.
  • Provide a public database of joint ROM measures that could be used to assess impairment in joint mobility for other patient populations.

Reference Values for Normal Joint Range of Motion

The following table provides the reference values along with 95% confidence intervals for normal range of motion for 11 measurements taken on 5 joints. Values are provided separately by sex and age.

Age 2–8

Motion

Females

Males

Hip extension

26.2 (23.9 – 28.5)

28.3 (27.2 – 29.4)

Hip flexion

140.8 (139.2 – 142.4)

131.1 (129.4 – 132.8)

Knee flexion

152.6 (151.2 – 154.0)

147.8 (146.6 – 149.0)

Knee extension

5.4 (3.9 – 6.9)

1.6 (0.9 – 2.3)

Ankle dorsiflexion

24.8 (22.5 – 27.1)

22.8 (21.3 – 24.3)

Ankle plantar flexion

67.1 (64.8 – 69.4)

55.8 (54.4 – 57.2)

Shoulder flexion

178.6 (176.9 – 180.3)

177.8 (176.7 – 178.9)

Elbow flexion

152.9 (151.5 – 154.3)

151.4 (150.8 – 152.0)

Elbow extension

6.8 (5.2 – 8.4)

2.2 (0.9 – 3.5)

Elbow pronation

84.6 (82.8 – 86.4)

79.6 (78.8 – 80.4)

Elbow supination

93.7 (91.4 – 96.0)

86.4 (85.3 – 87.5)

Age 9–19

Motion

Females

Males

Hip extension

20.5 (18.6 – 22.4)

18.2 (16.6 – 19.8)

Hip flexion

134.9 (133.0 – 136.8)

135.2 (133.0 – 137.4)

Knee flexion

142.3 (140.8 – 143.8)

142.2 (140.4 – 144.0)

Knee extension

2.4 (1.5 – 3.3)

1.8 (0.9 – 2.7)

Ankle dorsiflexion

17.3 (15.6 – 19.0)

16.3 (14.9 – 17.7)

Ankle plantar flexion

57.3 (54.8 – 59.8)

52.8 (50.8 – 54.8)

Shoulder flexion

171.8 (169.8 – 173.8)

170.9 (169.1 – 172.7)

Elbow flexion

149.7 (148.5 – 150.9)

148.3 (146.8 – 149.8)

Elbow extension

6.4 (4.7 – 8.1)

5.3 (3.6 – 7.0)

Elbow pronation

81.2 (79.6 – 82.8)

79.8 (77.8 – 81.8)

Elbow supination

90.0 (88.0 – 92.0)

87.8 (85.7 – 89.9)

Age 20–44

Motion

Females

Males

Hip extension

18.1 (17.0 – 19.2)

17.4 (16.3 – 18.5)

Hip flexion

133.8 (132.5 – 135.1)

130.4 (129.0 – 131.8)

Knee flexion

141.9 (140.9 – 142.9)

137.7 (136.5 – 138.9)

Knee extension

1.6 (1.1 – 2.1)

1.0 (0.6 – 1.4)

Ankle dorsiflexion

13.8 (12.9 – 14.7)

12.7 (11.6 – 13.8)

Ankle plantar flexion

62.1 (60.6 – 63.6)

54.6 (53.2 – 56.0)

Shoulder flexion

172.0 (170.9 – 173.1)

168.8 (167.3 – 170.3)

Elbow flexion

150.0 (149.1 – 150.9)

144.6 (143.6 – 145.6)

Elbow extension

4.7 (3.9 – 5.5)

0.8 (0.1 – 1.5)

Elbow pronation

82.0 (81.0 – 83.0)

76.9 (75.6 – 78.2)

Elbow supination

90.6 (89.2 – 92.0)

85.0 (83.8 – 86.2)

Age 45–69

Motion

Females

Males

Hip extension

16.7 (15.5 – 17.9)

13.5 (12.5 – 14.5)

Hip flexion

130.8 (129.2 – 132.4)

127.2 (125.7 – 128.7)

Knee flexion

137.8 (136.5 – 139.1)

132.9 (131.6 – 134.2)

Knee extension

1.2 (0.7 – 1.7)

0.5 (0.1 – 0.9)

Ankle dorsiflexion

11.6 (10.6 – 12.6)

11.9 (10.9 – 12.9)

Ankle plantar flexion

56.5 (55.0 – 58.0)

49.4 (47.7 – 51.1)

Shoulder flexion

168.1 (166.7 – 169.5)

164.0 (162.3 – 165.7)

Elbow flexion

148.3 (147.3 – 149.3)

143.5 (142.3 – 144.7)

Elbow extension

3.6 (2.6 – 4.6)

-0.7 (-1.5 – 0.1)

Elbow pronation

80.8 (79.7 – 81.9)

77.7 (76.5 – 78.9)

Elbow supination

87.2 (86.0 – 88.4)

82.4 (80.9 – 83.9)

Reference: Soucie JM, Wang C, Forsyth A, Funk S, Denney M, Roach KE, Boone D, and the Hemophilia Treatment Center Network. Range of motion measurements: reference values and a database for comparison studies. Haemophilia 2010; e-pub November 11, 2010.

Public Use Data and Resources

The normal range of motion dataset is available for download as a public use dataset in either Microsoft Excel or Statistical Analysis Software (SAS) format. Please read the Data Use Restrictions Policy located on this webpage for important information about the conditions for use of these data files. Also, please download and refer to the “Methods and Materials” as well as the “Description and Sample Tables” documents below. Important information is contained in these files about how to use and properly interpret the data contained in the dataset.

Warning! Data Use Restrictions Read Carefully Before Using

The Public Health Service Act (Section 308 (d)) provides that the data collected by the Centers for Disease Control and Prevention (CDC) may be used only for the purpose of health statistical reporting and analysis.
 

Any effort to determine the identity of any reported case is prohibited by this law.
CDC does all it can to assure that the identity of data subjects cannot be disclosed. All direct identifiers, as well as any characteristics that might lead to identification, are omitted from the dataset. Any intentional identification or disclosure of a person or establishment violates the assurances of confidentiality given to the providers of the information. Therefore, users will:

  1. Use the data in this dataset for statistical reporting and analysis only.
  2. Make no use of the identity of any person or establishment discovered inadvertently.
  3. Not link this dataset with individually identifiable data from other CDC or non-CDC datasets.

By using these data you signify your agreement to comply with the above-stated statutorily based requirements.

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