Utku KURTARAN, Tuba YERLİKAYA, Ahmet ÖZGÜL
Cyprus Journal of Medical Sciences - 2026;11(3):223-230
BACKGROUND/AIMS: This study aimed to investigate the relationships among acromio-humeral distance (AHD), ultrasonographic tendon thicknesses, pain intensity, kinesiophobia, functional status, and postural parameters in individuals with subacromial impingement syndrome (SAPS). MATERIALS AND METHODS: Forty-four individuals diagnosed with SAPS were included in this cross-sectional study. AHD and rotator cuff tendon thicknesses were assessed using ultrasonography. Pain intensity was evaluated using the visual analog scale and the McGill Pain Questionnaire. Upper extremity disability was assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) scale, while kinesiophobia levels were evaluated using the Fear-Avoidance Beliefs Questionnaire (FABQ). Postural alignment was analyzed with the AI-based Posture Evaluation and Correction System(R) (APECS(R)) system. Associations among the study variables were analysed using Pearson correlation analysis. RESULTS: No significant relationships were found between AHD and pain intensity, disability, or tendon thickness (p>0.05). However, a weak negative correlation was observed between AHD and the kyphotic posture parameter [APECS- lateral body alignment (LBA)]. Pain intensity and higher FABQ scores were positively associated with greater upper extremity disability (DASH). FABQ showed a moderate-to-strong positive correlation with DASH scores. Among postural parameters, LBA was associated with AHD and with the thicknesses of supraspinatus tendon, infraspinatus tendon, and long head of biceps tendon. Additionally, anterior knee alignment and head tilt were positively correlated with tendon thickness measurements. CONCLUSION: Our findings suggest that postural deviations may be associated with tendon characteristics and subacromial space parameters in individuals with SAPS. Additionally, the observed relationships between kinesiophobia, pain, and disability may highlight the importance of psychosocial factors. However, these findings should be interpreted with caution due to the cross-sectional design, and further longitudinal studies are needed.
