MOVEMENT POSITION & FULCRUM STATIONARY MOVING ARM NORMAL

STABILIZATION ARM VALUES

Wrist Flexion ●​ sitting lateral aspect of lateral midline lateral midline 60 (AMA)
●​ Push ●​ elbow flexed the wrist over of the ulna, of the fifth 80 (AAOS)
on the 90 degs the triquetrum using the metacarpal. Do
dorsal ●​ palm olecranon and not use the soft
surface towards the ulnar styloid tissue of the
of the ground processes for hypothenar
third ●​ stabilize ate reference eminence as
metacar radius and reference
pal ulna

-put wrist down

Wrist extension ●​ Sitting, lateral aspect lateral midline of lateral midline of the 60-70
●​ Extend the forearm of the wrist the ulna, using the fifth metacarpal. Do
wrist by pronated on over the olecranon and not use the soft
pushing the table triquetrum ulnar styloid tissue of the
evenly ●​ elbow flexed processes for hypothenar
across the 90 degs reference eminence as
palmar ●​ palm towards reference
surface of the ground
metacarpals ●​ stabilize ate
radius and
ulna
 Wrist Radial ●​ sitting dorsal aspect of dorsal midline dorsal midline 20-25
Deviation ●​ elbow the wrist over of the forearm of the third
●​ Radially flexed the capitate if the shoulder metacarpal
deviate 90 degs is 90 deg
the wrist ●​ palm abducted,
by towards lateral
moving the epicondyle of
the hand ground humerus can be
toward ●​ stabilize used as
the ate reference
thumb radius
and ulna

(move towards thumb side)

Wrist Ulnar ●​ sitting dorsal aspect dorsal midline dorsal midline 30-40
Deviation ●​ elbow of the wrist of the forearm of the third
●​ Deviation flexed 90 over the if the shoulder metacarpal
the wrist degs capitate is 90 deg
in the ●​ palm abducted,
ulnar towards lateral
direction the epicondyle of
by ground humerus can be
moving ●​ stabilize used as
the ate reference
hands radius
toward and ulna
the little
finger
 (move toward pinky)

Extensor ●​ sitting lateral aspect of lateral midline lateral midline 35-50

Digitorum, Indicis, ●​ elbow in full the wrist over of the ulna, of the fifth degrees
and Extensor extension triquetrum using the metacarpal
Digiti Minimi ●​ MCP, PIP, olecranon and
Muscle Length DIP in full ulnar styloid
●​ hold MCP, flexion process
PIP, DIP in ●​ stabilize
full flexion forearm to
while prevent
flexing the elbow flexion
wrist

Flexor Digitorum ●​ sitting lateral aspect lateral lateral midline of the 60-75
Profundus and ●​ elbow in of the wrist midline of the fifth metacarpal degrees
Superficialis full over ulna, using
Muscle Length extension triquetrum the
●​ hold MCP, ●​ MCP, PIP, olecranon
PIP, DIP in DIP in full and ulnar
extension extension styloid
while ●​ stabilize process
extending forearm to
the wrist prevent
elbow
flexion

MOVEMENT POSITION & FULCR STATIO MOVING NORMAL

STABILIZATION UM NARY ARM VALUES
ARM

MCP Flexion ●​ Sitting with Dorsal Dorsal Dorsal 90-100

●​ Push dorsal forearm and hand aspect of midline midline of degrees
surface of on supporting MCP of proximal
the proximal surface joint metacar phalanx
phalanx, ●​ Forearm midway pal
moving between pronation
finger toward and supination
palm ●​ Wrist and MCP in
neutral position
●​ Stabilize
metacarpal
MCP Extension ●​ Sitting with Dorsal Dorsal Dorsal 20-45 degrees
●​ Push on the forearm and hand aspect of midline of midline of
palmar on a supporting MCP joint metacarpal proximal
surface of surface phalanx
the ●​ Forearm midway
proximal between pronation
phalanx, and supination
moving ●​ Wrist and MCP in
finger away neutral position
from the ●​ Stabilize
palm metacarpal
MCP ●​ Sitting with Dorsal Dorsal midline Dorsal midline 25-30 degrees
Abduction forearm and aspect of of metacarpal of proximal
hand on a MCP joint phalanx
supporting
surface
●​ Wrist and
MCP in
neutral
position
●​ Forearm in
full pronation
●​ Stabilize
metacarpal

-move finger towards pinky

PIP ●​ Position the subject Over dorsal Align Align over the 100-105
Flexion sitting with forearm aspect of the over the distal arm over
and hand resting on PIP joint. dorsal the dorsal
a supporting surface. midline midline of the
●​ Forearm: 0 degrees aspect of middle phalanx.
of supination and the PIP
pronation. joint.
●​ Wrist: 0 degrees of
flexion, extension,
and radial and ulnar
deviation.
●​ MCP joint: 0 degrees
of flexion, extension,
abduction, and
adduction.
PIP ●​ Place the subject sitting, Over the Align over the Align 0
Extension with the forearm and hand dorsal dorsal midline of over the degrees
resting on a supporting aspect of the proximal dorsal
surface. the PIP phalanx. midline
●​ Forearm: 0 degrees of joint. of the
supination and pronation. middle
●​ Wrist: 0 degrees of flexion, phalanx.
extension, radial and ulnar
deviation.
●​ MCP joint: 0 degrees of
flexion, extension,
abduction, and adduction.

-extend finger
DIP ●​ Position the subject Over the Align over Align over the 70-90
Flexio sitting with forearm and dorsal the dorsal dorsal midline of degrees
n hand resting on a aspect of midline of the the distal
supporting surface. the DIP middle phalanx.
●​ Forearm: 0 degrees of joint. phalanx.
supination and pronation.
●​ Wrist: 0 degrees of
flexion, extension, radial
and ulnar deviation.
●​ MCP joint: 0 degrees of
flexion, extension,
abduction, and
adduction.
●​ PIP joint: 70 to 90
degrees of flexion.

-curl the fingers

DIP ●​ Position the subject sitting with Over the Align Align over 0
Exten forearm and hand resting on a dorsal over the the dorsal degrees
sion supporting surface. aspect of dorsal midline of
●​ Forearm: 0 degrees of the DIP midline the distal
supination and pronation. joint. of the phalanx
●​ Wrist: 0 degrees of flexion, middle
extension, radial and ulnar phalanx.
deviation.
●​ MCP joint: 0 degrees of
flexion, extension, abduction,
and adduction.
●​ PIP joint: 70 to 90 degrees of
flexion.
Fingers -​ Seat the subject -​ Tip of -​ Tip -​ Tip -​ 0 cm (if the
Composi with the forearm the of the of fingertip
te and hand finger finger the reaches
Flexion supported, wrist being being fing the distal
in neutral, and measure meas er palmar
fingers d ured crease)
extended.
-​ Prevent wrist
motion and
ensure MCP,
PIP, and DIP
joints move
freely without
compensation.

Thumb -​ Stabilize -​ Center -​ Align -​ Align

CMC the fulcrum proximal distal arm -​ Norma
Flexion carpals, of the arm with with the l ROM
radius, goniom the ventral ventral is 15
 and ulna eter midline of midline of degree
to prevent over the radius the first s
wrist the using the metacarp accord
motions. palmar ventral al. ing to
Movemen aspect surface of the
t of the of the the radial AAOS.
wrist will first head and -​ 0-55
affect the CMC radial
accuracy joint. styloid
of the process for
ROM reference.
measure
ment.

Thumb -​ Center -​ Align -​ Align Normal

CMC ●​ Seat the fulcrum proximal arm distal ROM:
Extensi subject with of the with the arm with 35°
on the forearm goniome ventral the (AMA),
and hand ter over midline of ventral 20°–80°
supported. the the radius, midline (AAOS).
●​ Position the palmar using the of the
forearm in full aspect of ventral first
supination, the first surface of metacar
wrist neutral, CMC the radial pal.
and CMC joint joint. head and the
of the thumb in radial styloid
0° abduction. process for
●​ Stabilize the reference
carpals, radius,
and ulna to
prevent wrist
motions
 -open ur thumb

Thumb CMC -​ Stabilize -​ Tip -​ Base of -​ Tip of -​ 0 cm (thumb

Opposition the fifth of the little the touching the
metacarp the finger thumb base of the
al to thu (proxima little finger)
prevent mb l digital
motion at crease)
the fifth
CMC joint
and wrist.

-tell patient to oppose thumb (measure from the tip

of the thumb to the proximal digital crease of little finger)
Thumb CMC forearm placed over Aligned Aligned with 0-30 dedrees
Adduction resting on a the CMC with the the first
table, and joint of the second metacarpal
the hand in thumb (the metacarpal (the thumb)
a neutral base of the (the index
position. first finger) or
metacarpal) along the
. midline of
the wrist.

-abduct thumb

Thumb CMC forearm placed over Aligned Aligned with 0-30 dedrees
Adduction resting on a the CMC with the the first
table, and joint of the second metacarpal
the hand in thumb (the metacarpal (the thumb)
a neutral base of the (the index
position. first finger) or
metacarpal) along the
. midline of
the wrist.

Thumb MCP Sitting, Over dorsal Dorsal Dorsal 50-60 degree

flexion forearm in aspect of midline of 1st midline of
supination MCP joint metacarpal first proximal
phalanx
 -pull thumb down

Thumb MCP Sitting Over dorsal Dorsal Dorsal 0-40 degress

extension forearm in aspect of midline of 1st midline of
supination MCP joint metacarpal first proximal
phalanx

Thumb IP Sitting,Forearm and Over the Align dorsal Align 67-80

Flexion hand in supination dorsal surface midline of dorsal degrees
of the IP joint the midline of
Stabilize the proximal the distal
proximal phalanx to phalanx phalanx
prevent flexion or
extension of the
MCP joint
 -curl the thumb

Thumb IP Sitting, Dorsal Align Dorsal Align dorsal 20-30

extension forearm and surface of the Midline of the midline of the
hand in IP point of the distal phalanx
supination proximal
phalanx
Stabilize the
proximal
phalanx to
prevent
extension or

flexion of the
MCP joint