Use this self-assessment to evaluate your functional range of motion (ROM) for major joints and movements. Rate each movement on a scale of 1-5:
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1 - Severely limited: Unable to perform the movement or extreme discomfort
2 - Limited: Significant restriction in movement or moderate discomfort
3 - Moderate: Some restriction but can perform basic movements
4 - Good: Minor limitations but generally unrestricted
5 - Excellent: Full range of motion with no discomfort
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| Movement | Score (1-5) |
|---|---|
| Flexion | |
| Extension | |
| Lateral Flexion right | |
| Lateral Flexion left | |
| Rotation right | |
| Rotation left |
Head and Neck Score: [Sum of scores] / 6 = [ROM score]
| Movement | Score (1-5) |
|---|---|
| Elevation | |
| Depression | |
| Protraction | |
| Retraction | |
| Internal Rotation right | |
| Internal Rotation left | |
| External Rotation right | |
| External Rotation left | |
| Flexion right | |
| Flexion left | |
| Extension right | |
| Extension left | |
| Abduction right | |
| Abduction left | |
| Adduction right | |
| Adduction left |
Shoulder and Shoulder Blade Score: [Sum of scores] / 16 = [ROM score]
| Movement | Score (1-5) |
|---|---|
| Elbow Flexion right | |
| Elbow Flexion left | |
| Elbow Extension right | |
| Elbow Extension left | |
| Pronation right | |
| Pronation left | |
| Supination right | |
| Supination left |
Elbow and Forearm Score: [Sum of scores] / 8 = [ROM score]
| Movement | Score (1-5) |
|---|---|
| Wrist Flexion right | |
| Wrist Flexion left | |
| Wrist Extension right | |
| Wrist Extension left | |
| Radial Deviation right | |
| Radial Deviation left | |
| Ulnar Deviation right | |
| Ulnar Deviation left | |
| Finger Flexion right | |
| Finger Flexion right | |
| Finger Extension right | |
| Finger Extension left |
Wrist and Hand Score: [Sum of scores] / 12 = [ROM score]