Acromio-humeral distance : its meaasurement reliability, sensitivity and the influence of scapular position

• Main Author: Bdaiwi, A. H.
• Published: University of Salford 2014
• Subjects: 610; Health and Wellbeing
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.640594

The assessment of the acromiohumeral distance (AHD) is an essential part of the clinical shoulder joint examination. Changes of normal AHD occur frequently in individuals with subacromial impingement syndrome (SAIS). Real time ultrasound scanning (RTUS) is a useful imaging technique. It allows for the assessment of distances between the humeral head and scapular landmarks, such as the acromion and the humeral head in several shoulder positions. This thesis investigates the within-day and between-day reliability of both RTUS in measuring the AHD and the Palpation Meter (PALM) while measuring the scapular position and motion in healthy individuals. Intra-class correlation, standard error of measurement and the smallest detectable difference values were used to determine the intra-tester within-day and intra-tester between-days reliability of both RTUS and PALM devices. A paired t-test was used to determine the differences between the dominant shoulder versus non-dominant shoulder in two positions; neutral and 60 degrees of passive abduction for the AHD by using RTUS and by using the PALM. A paired t-test was used to determine the differences between the dominant shoulder and the non-dominant shoulder at resting position, 60 degrees of passive abduction and full elevation. Both RTUS and PALM were found to be reliable and precise when measuring AHD and scapular position. Moreover, a correlation analysis was used to determine whether there was a relationship between the AHD and the scapular upward rotation angle (SURA) measurements in 35 healthy volunteers. A moderate correlation between AHD and SURA during 60 degrees of passive abduction was noted. The case study of five patients who suffered from SAIS was evaluated in comparison to normative data for both AHD measurements by using RTUS and the scapular position measurements by using the PALM to detect the sensitivity of these tools in the presence of pathology. The injured arm demonstrated smaller AHD and SURA during 60 degrees of abduction tasks. The last phase assessed the effect of modifying the scapular position on the AHD and SURA by using taping, and the effect of the muscle stimulation on AHD. The findings from this intervention programme did show position effects on AHD in healthy individuals, yet its effect should be evaluated in patients who suffered from SAIS.