Pediatric Normative Values for Upper and Lower Extremity Joint Motions: A Review

Abstract

<b>Purposes:</b> To report current status of normative values for upper and lower extremity joint motions in the pediatric population and effects of side of body, age, gender and ethnicity/race, and to summarize available joint motion measurement values to serve as a reference. <b>Methods:</b> PubMed searches were performed using combinations of the following terms: pediatric, children, normal range of motion, with upper extremity, shoulder, elbow, wrist, finger, and thumb; and with lower extremity, hip, knee, ankle, and foot. Inclusion criteria were 1-21 years of age, passive or active joint motion measured with goniometer, normal range of motion, and in English. <b>Results:</b> Seven upper extremity studies, 3 lifespan and 4 pediatrics only, and 11 lower extremity, 6 lifespan and 5 pediatrics only, were reviewed. Any left/right or dominant/non-dominant differences found were not statistically/clinically significant. For age-related comparisons: in lifespan studies, joint motion decreased as age increased; in pediatric only studies, variable findings were no relationship between amount of motion and age, motion decreased as age increased, and for a single motion (active), motion increased as age increased. Pediatric gender difference analyses produced mixed results of no differences, varying as a function of age and motion, and statistically significant differences. Ethnicity/race effect was addressed rarely. <b>Discussion:</b> Currently available upper and lower extremity joint motion normative values, which includes multiple measurements for some motions and few/none for others, were summarized. Lower extremity motions were examined to a greater extent than upper extremity motions. Further assessment is required to establish normative values for all passive motions and to clarify effects of side of body, age, gender, and ethnicity/race.