Acromio-humeral distance variation measured by ultrasonography and its association with the outcome of rehabilitation for shoulder impingement syndrome.
OBJECTIVE
First, to validate an ultrasonographic measure of the acromio-humeral distance (AHD); second, to compare the AHD variation during active abduction in patients with shoulder impingement syndrome (SIS) and healthy subjects; and third, to evaluate the relationship between functional status and AHD variations before and after rehabilitation in SIS subjects.


METHODS
This study has 3 components: (1) a reliability study, (2) a case-control study, and (3) a preliminary pretreatment/posttreatment clinical trial.


METHODS
Primary care hospital setting.


METHODS
Seven SIS patients and 13 healthy subjects.


METHODS
For the clinical trial, the SIS subjects participated in 12 sessions of a rehabilitation program over 4 weeks.


METHODS
First, intraclass correlation coefficient for interobserver reliability; second, AHD measured at 0 degrees, 45 degrees, and 60 degrees of active abduction; and third, Western Ontario Rotator Cuff Index.


RESULTS
Intraclass correlation coefficient for interobserver reliability ranged from 0.86 to 0.92 for the 3 shoulder positions. A significant reduction of the AHD was found within groups between rest and active abduction (P < 0.05). Comparison of AHD between groups was not statistically different (P = 0.06; beta < 0.80). In pre-post rehabilitation analysis, improvement of the Western Ontario Rotator Cuff Index score was positively correlated to the reduction of the AHD narrowing as the arm was abducted (r = 0.86; P = 0.01).


CONCLUSIONS
The ultrasound measure of AHD is reliable and sensitive. Although a distinct pattern of AHD variation in SIS patients could not be confirmed, a strong positive relationship was found between the reduction of AHD narrowing and functional improvement following rehabilitation. Ultrasound measurement of AHD might help identify SIS patients who will benefit from rehabilitation.
Laval University Hospital Research Center, Laval University, Québec, Canada.
François
F
Desmeules
Luc
L
Minville
Barbara
B
Riederer
Claude H
CH
Côté
Pierre
P
Frémont
D000174:Acromion / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D000328:Adult; D016022:Case-Control Studies; D006801:Humans; D006811:Humerus / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D017063:Outcome Assessment, Health Care; D016059:Range of Motion, Articular / Q000502:physiology; D015203:Reproducibility of Results; D012146:Rest / Q000502:physiology; D019534:Shoulder Impingement Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000534:rehabilitation*; D014463:Ultrasonography