Subacromial Motion Metrics in Painful Shoulder Impingement: A Dynamic Quantitative Ultrasonography Analysis

Wei-Ting Wu; Che-Yu Lin; Yi-Chung Shu; Lan-Rong Chen; Levent Özçakar; Ke-Vin Chang

doi:10.1016/j.apmr.2022.08.010

Subacromial Motion Metrics in Painful Shoulder Impingement: A Dynamic Quantitative Ultrasonography Analysis

Arch Phys Med Rehabil. 2023 Feb;104(2):260-269. doi: 10.1016/j.apmr.2022.08.010. Epub 2022 Aug 31.

Authors

Wei-Ting Wu¹, Che-Yu Lin², Yi-Chung Shu², Lan-Rong Chen³, Levent Özçakar⁴, Ke-Vin Chang⁵

Affiliations

¹ Department of Physical Medicine and Rehabilitation and Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei, Taiwan.
² Institute of Applied Mechanics, College of Engineering, National Taiwan University, Taipei, Taiwan.
³ Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei, Taiwan.
⁴ Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.
⁵ Department of Physical Medicine and Rehabilitation and Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: kvchang011@gmail.com.

PMID: 36055380
DOI: 10.1016/j.apmr.2022.08.010

Abstract

Objectives: To explore the subacromial motion metrics in patients with and without subacromial impingement syndrome (SIS) and to investigate whether the abnormality was associated with rotator cuff pathologies.

Design: This cross-sectional observational study used dynamic quantitative ultrasonography imaging for shoulder joint assessment.

Setting: Outpatient rehabilitation clinic.

Participants: Individuals with SIS on at least 1 shoulder (n=32) and asymptomatic controls (n=32) (N=64).

Interventions: Not applicable.

Main outcome measures: Frame-by-frame, the humeral greater tuberosity against the lateral edge of the acromion was traced to obtain the minimal vertical acromiohumeral distance (AHD). The rotation angle and radius of the humerus were computed using the least-squares curve fitting method.

Results: Approximately two-thirds of the shoulders with SIS did not have any sonographically identifiable rotator cuff pathologies. There was a consistent trend of nonsignificantly increased humeral rotation angles in painful shoulders. The generalized estimating equation demonstrated that the decreased minimal vertical AHD was associated with painful subacromial impingement (β coefficient: -0.123cm, 95% confidence interval [CI], -0.199 to -0.047). The area under the curve for the minimal vertical AHD to discriminate painful or impinged shoulders ranged from 0.624-0.676. The increased rotation angle (β coefficient: 10.516°; 95% CI, 3.103-17.929) and decreased rotation radius (β coefficient: -2.903cm; 95% CI, -5.693 to -0.111) were shown to be significantly related to the presence of supraspinatus tendinopathy.

Conclusions: Shoulders with SIS were characterized by a decreased minimal vertical AHD during dynamic examination. Abnormal subacromial metrics can develop in patients with mild (or no) rotator cuff pathologies. More prospective cohort studies are warranted to investigate the changes in subacromial motion metrics in populations at risk for painful or impinged shoulders.

Keywords: Diagnostic imaging; Pain; Rehabilitation; Shoulder impingement syndrome; Sports.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Humans
Pain
Prospective Studies
Range of Motion, Articular
Shoulder
Shoulder Impingement Syndrome* / diagnostic imaging
Shoulder Joint*
Ultrasonography