Sonographic Evaluation of the Acromiohumeral Distance in Elite and Recreational Female Overhead Athletes

Abstract

The AHD is larger on the dominant side compared with the nondominant side and in elite female athletes compared with recreational female athletes. Moreover, less reduction of the AHD occurs in the elite athlete group during the first 45 degrees of abduction.

Acromiohumeral distance measurement in rotator cuff tendinopathy: is there a reliable, clinically applicable method? A systematic review

“…Since study methods were similar across the ultrasound studies, forest plots were constructed to illustrate the range of ICC values reported (figures 3 and 4). The SE of measurement values for AHD were more variable; they were below 1 mm in the high quality studies by Duerr24 and Seitz et al 31 and in a number of lower quality studies;26 28 29 however, Kalra et al 25 reported higher SEM values of 0.9–1.6 mm in their high quality study. Three studies reported the minimal detectable change (MDC) for AHD measurement, which is an important concept representing the amount of change required to exceed measurement variability.…”

“…There were varied time intervals used for the repeated scans, ranging from within-session scans to others taken up to 2 weeks26 or 6 weeks later 29. While various factors may influence the normal variation in AHD over time (such as posture, fatigue, activity), no studies described controlling for these factors.…”

Ultrasonographic measurement of the acromiohumeral distance in spinal cord injury: Reliability and effects of shoulder positioning

“…For example, excellent intra-rater reliability (0.87-0.94) and moderate-toexcellent inter-rater reliability (0.64-0.92) of the AHD have been demonstrated using ultrasound in ablebodied individuals with healthy and impinged shoulders. 9,17,20,21 Moderate intra-and inter-observer reliability using unmarked sonograms has also been reported. 17 Discriminant validity of the AHD between affected and unaffected shoulders was determined in a hemiplegic population.…”

“…22 Maenhout et al reported similar AHD reduction in 29 elite athletes and 33 recreational athletes using sonographic elevation during the first 45°active shoulder abduction. 21 However, no information was provided on the actual AHD at 90°of abduction in these populations. Our findings are also consistent with a previous MRI study that found the co-contraction imbalance between deltoids and shoulder depressors was most prominent around 90°abduction, resulting in a narrower Figure 4 Bland-Altman plot of average rater 1 and 2 of the AHD measurement in MWUs with SCI (A) and able-bodied (B).…”

“…16 Similar group differences were also found in athlete populations, where the AHD was narrower during 45A in recreational athletes compared with elite handball athletes. 21 The etiological mechanisms responsible for this reduction in space are unclear. Possible explanations for these mechanisms include glenohumeral instability, humeral translations and decreased scapular posterior tipping and upward rotation reported during scapular plane humeral elevation in previous studies among persons with SIS.…”