Abstract
Objectives
(1) To evaluate the reliability of ultrasonographic measures of the acromiohumeral
distance (AHD) in shoulder positions linked to wheelchair propulsion in manual wheelchair
users (MWUs) with spinal cord injury (SCI) and able-bodied individuals; (2) to compare
ultrasonographic measures of AHD, supraspinatus tendon thickness, and occupation ratio
between MWUs with SCI with and without shoulder pain (rotator cuff [RC] tendinopathy);
and (3) to compare these ultrasonographic measures between MWUs with SCI and able-bodied
individuals.
Design
Cross-sectional study.
Setting
Rehabilitation centers.
Participants
Three groups of participants (N=95; aged between 18 and 60y) were recruited within
a convenience sample: objective 1: 16 MWUs with SCI (mean age, 43±9y; height, 172±13
cm, weight, 84±10 kg) and 16 able-bodied individuals (mean age, 28±9y; height, 176±11
cm, weight, 72±12 kg); objectives 2 and 3: 37 MWUs with SCI (17 with [mean age, 47±11y;
height, 172±14 cm, weight, 68±11 kg] and 20 without [mean age, 45±10y; height, 172±15
cm, weight, 84±30 kg] RC tendinopathy) and 26 able-bodied individuals (mean age, 31±5y;
height, 175±12 cm; weight, 89±14 kg).
Interventions
Not applicable.
Main Outcome Measures
AHD, supraspinatus tendon thickness, and occupation ratio of the supraspinatus tendon
measured using ultrasound imaging systems.
Results
(1) Excellent intra- and interrater reliability of AHD was obtained in each arm position
(intraclass correlation coefficient>.85); (2) MWUs without shoulder pain have thicker
tendon than do MWUs with RC tendinopathy; and (3) a significant Group × Position interaction
was found for AHD measures when comparing MWUs with SCI with able-bodied individuals
(greater AHD at the end of the push phase for MWUs with SCI). A thicker tendon and
a higher occupation ratio were also found in MWUs with SCI than in able-bodied individuals.
Conclusions
Ultrasonography 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 MWUs with SCI and able-bodied individuals.
This shows that these ultrasonographic measures can be used in future studies of populations
with SCI to better understand the changes at the shoulder joint in MWUs.
Keywords
List of abbreviations:
AHD (acromiohumeral distance), DASH (Disabilities of the Arm, Shoulder and Hand), ICC (intraclass correlation coefficient), MDC90 (minimal detectable change at 90%), MWU (manual wheelchair user), RC (rotator cuff), SCI (spinal cord injury)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 15, 2016
Footnotes
Supported by the Ontario Neurotrauma Foundation, the Quebec Rehabilitation Research Network (REPAR), and the Lindsay Rehabilitation Hospital Foundation.
Disclosures: F.R. and J.-S.R. hold a Junior 1 Research Career Award from the Fonds de la recherche en santé du Québec. The other authors have nothing to disclose.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
