Predictive relationship between psychological, social, physical activity, and sleep measures and somatosensory function in individuals with musculoskeletal pain: a systematic review and meta-analysis protocol

Abstract

Background: Alteration in somatosensory function, assessed via responses to quantitative sensory testing (QST), has been associated with heightened pain severity and interference in individuals with musculoskeletal (MSK) pain. However, a range of factors may confound the relationship between QST and clinical outcomes of pain. Therefore, there is a need for a comprehensive systematic review establishing the relationships between a range of factors (psychological, social, sleep, and physical activity) and QST responses among individuals with MSK pain.

Objective: To establish the level of evidence of associations between psychological, social, physical activity, and sleep measures and QST responses among patients with MSK pain.

Method and analysis: A comprehensive literature search will be conducted in the following electronic database (CINAHL, Ovid-MEDLINE, Scopus, PsycINFO, PubMed, and Web of Science) from their inception to June 2018. Two reviewers will assess the methodological quality using a modified QUIPS tool, which is tailored for the need of this review and supplemented by recommendations from CHARMS checklist and QUADAS-2 tool. The level of evidence will be assessed using GRADE criteria. Data pertinent to statistical measures of relationships from the included studies will be pooled to evaluate the strength of the relationship for each factor with a somatosensory abnormality, through meta-analysis. Appropriate subgroup and sensitivity analyses will be conducted. Where statistical pooling of data not feasible, a narrative review of the findings will be conducted.

Significance: This systematic review will provide evidence of modifiable factors associated with altered sensory processing in individuals with MSK pain. Such evidence may also direct to test interventions targeting those factors to influence somatosensory function, thereby improve pain outcomes.

Keywords:

• Musculoskeletal pain
• somatosensory function
• sensory psychophysical testing
• psychosocial factors

Disclosure statement

No potential conflict of interest was reported by the authors. This review protocol is a part of an ongoing PhD thesis (Rani Othman) on ‘Exploring the role of psychological, social, and physical factors on somatosensory function in individuals with musculoskeletal pain’.

Additional information

Notes on contributors

Rani Othman

Rani Othman is a PhD student at the Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand. As part of the PhD thesis, he is investigating the relationships between somatosensory abnormalities and psychosocial factors in patients with musculoskeletal pain.

Prasath Jayakaran

Prasath Jayakaran is a lecturer at the School of physiotherapy, University of Otago, New Zealand. Prasath's main focus of research is around balance, particularly around peripheral sensory information processing. He is the lead researcher for balance and vestibular research at the School of physiotherapy.

Steve Tumilty

Steve Tumilty is Associate Professor at the School of physiotherapy, University of Otago, New Zealand. Tumilty's research is focused on intervention studies combining clinical outcomes with physiological outcomes related to musculoskeletal and sports injuries.

Nicola Swain

Nicola Swain is Associate Professor at the Psychological medicine, Dunedin School of Medicine, University of Otago. Nicola is current President of the New Zealand Pain Society. Her research is focused on understanding and management chronic pain conditions.

Ramakrishnan Mani

Ramakrishnan Mani is a senior lecturer at the School of physiotherapy, University of Otago, New Zealand. He is the deputy director of the pain@otago research theme and the lead of pain education research subtheme. Ram's primary research interest is to profile bio-psycho-social pain mechanisms for developing targeted management of musculoskeletal pain. Other key research areas include life-course predictors of pain development and chronicity, and pain education.