Ultrasonographic measures of the acromiohumeral distance and supraspinatus tendon thickness in manual wheelchair users with spinal cord injury

Publication date: Available online 16 July 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Amélie Fournier Belley, Dany H. Gagnon, François Routhier, Jean-Sébastien Roy
Objective1) To evaluate the reliability of ultrasonographic (US) measures of acromiohumeral distance (AHD) in shoulder positions linked to wheelchair propulsion in manual wheelchair users (MWU) with spinal cord injury (SCI) and able-bodies; 2) to compare US measures of AHD, supraspinatus tendon thickness and occupation ratio between MWU with SCI with and without shoulder pain (rotator cuff [RC] tendinopathy); and 3) to compare these US measures between MWU with SCI and able-bodies.DesignCross-sectionalSettingTwo rehabilitation centers (Quebec City and Montreal)ParticipantsObjective 1: 16 MWU with SCI and 16 able-bodies; Objectives 2 and 3: 37 MWU with SCI (17 with/20 without RC tendinopathy) and 26 able-bodies.InterventionsNot applicable.Main outcome measureAHD and supraspinatus tendon thickness measured using US-imaging systems, as well as the occupation ratio of the supraspinatus tendon.Results1) Excellent intra- and interrater reliability of AHD was obtained in each arm position (ICC > 0.85); 2) MWU without shoulder pain have thicker tendon than MWU with RC tendinopathy; and 3) a significant Group x Position interaction was found for AHD measures when comparing MWU with SCI to able-bodies (greater AHD at the end of push phase for MWU with SCI). A thicker tendon and a higher occupation ratio were also found in MWU with SCI compared to able-bodies.ConclusionUS is a reliable technology to evaluate AHD in MWUs in shoulder positions linked to wheelchair propulsion. Supraspinatus tendon thickness and occupation ratio of AHD adequately discriminate between MWU with SCI and able-bodies. This shows that these US measurements can be used in future studies on SCI populations to better understand the changes at the shoulder joint in MWUs.



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