• Amélie Fournier Belley, Dany H Gagnon, François Routhier, and Jean-Sébastien Roy.
• Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec Rehabilitation Institute, Quebec City, Quebec, Canada.
• Arch Phys Med Rehabil. 2017 Mar 1; 98 (3): 517-524.

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.DesignCross-sectional study.SettingRehabilitation centers.ParticipantsThree 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).InterventionsNot applicable.Main Outcome MeasuresAHD, 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.ConclusionsUltrasonography 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.Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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