Ultrasound measurements on acromio-humeral distance and supraspinatus tendon thickness: Test-retest reliability and correlations with shoulder rotational strengths

Objectives: To establish the test-retest reliability of ultrasound measurements on acromio-humeral distance (AHD) and supraspinatus tendon thickness; and to explore their relationships with shoulder rotational strengths. Design: Test-retest observational study. Methods: Thirty-seven individuals (age: 21.5 +/- 1.4 years) participated in this study. Twenty-four were University volleyball players with 15 healthy and 9 players with shoulder impingement syndrome (SIS). Thirteen participants were healthy untrained individuals. Ultrasound measurements of AHD and supraspinatus tendon thickness were taken, and isokinetic testing of concentric shoulder internal rotation (IR) and external rotation (ER) at a speed of 90 degrees/s was performed. Results: The measurement of the AHD and the supraspinatus tendon thickness indicated excellent reliability (ICC=0.922, and ICC=0.933 respectively), and the minimum detectable difference (MDD) were 2.10 mm and 0.64 mm respectively. A cut-off AHD distance of 23.9 mm had a sensitivity of 0.67 and specificity of 0.71 (area under curve (AUC): 0.70;p=0.05) in identifying individuals with and without SIS. Hence, individuals with AHD larger than 23.9 mm had greater possibility of having SIS. Positive correlations were found in AHD with supraspinatus tendon thickness (r=0.36, p<0.05) and shoulder external rotational strengths (r=0.47-0.62, all p<0.05) and ER/IR ratios (r=0.56-0.58, all p<0.05). Conclusions: Ultrasound measurements of AHD and tendon thickness have excellent reliability. The reported cut-off AHD highlighted the potential role of ultrasound measurements in volleyball players for early identification of SIS. The AHD was related to the supraspinatus tendon thickness and shoulder external rotation strengths. Our findings provide a scientific basis for muscle training in overhead athletes such as volleyball players. (c) 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.