Sensory and motor profiles of the contralateral upper limb and neuroplastic changes in individuals with unilateral rotator cuff related shoulder pain – a systematic review protocol

Abstract

Background

Numerous studies have established bilateral changes that underpin a reorganization of the central nervous system in individuals with unilateral tendinopathy. The evidence for sensory and motor profiles of the contralateral limb and neuroplastic (cortical) changes have not been specifically reviewed for rotator cuff related shoulder pain (RCRSP).

Objectives

To systematically review, summarize and appraise the evidence for sensory and motor profiles of the contralateral (non-injured) upper limb and neuroplastic changes in individuals with unilateral RCRSP.

Methods

This review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and the guidelines for performing a Meta-analysis and Systematic Review of Observational Studies in Epidemiology (MOOSE). Two reviewers will screen, appraise, and extract the data using a customized data extraction tool, and synthesize findings from all studies irrespective of their methodological quality. The methodologically quality of the included studies will be assessed using a modified Downs and Black index. Statistical and clinical heterogeneity associated with the outcomes of interest will be assessed, and a meta-analysis will be done if appropriate. The certainty of evidence will be synthesized using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE).

Discussion

Previous studies indicate a reorganization of the nervous system with chronic musculoskeletal pain. If bilateral sensory/motor impairments or neuroplastic changes are evident in individuals with unilateral RCRSP, interventions may need to be tailored to include bilateral impairments as well as interventions that consider neuroplasticity.

PROSPERO registration: CRD42020202756

KEYWORDS:

• Cortical reorganization
• neuroplasticity
• shoulder pain
• tendinopathy

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

No internal or external funding was received for the review.

Source of funding

This research work has not received any internal or external funding.

Additional information

Notes on contributors

Kavitha Vishal

Kavitha Vishal is an assistant professor and is currently pursuing PhD at the department of Physiotherapy, Manipal College of Health professions, MAHE (Manipal Academy of Higher Education), Manipal, India. She is a musculoskeletal physiotherapist and has over 12 years of teaching and clinical experience towards patients with musculoskeletal disorders. Her current area of research includes designing management approaches for optimal care of patients with shoulder disorders, understanding sensorimotor impairments following musculoskeletal injury in the upper quadrant, and generating normative data for outcome measures in the upper extremity.

Ashokan Arumugam

Ashokan Arumugam is an Assistant Professor of Physiotherapy at University of Sharjah (UOS), United Arab Emirates. He is an Orthopedic Manual Physiotherapist with a special interest in physical activity analysis in sedentary and diseased populations, biomechanical analyses of the lower limbs, and neuroplastic changes in individuals with and without musculoskeletal ligament injuries. He received his PhD with a Doctoral Scholarship from the School of Physiotherapy, University of Otago, New Zealand. He completed his postdoctoral fellowship at Umeå University, Sweden. He is an active member of Prof. Charlotte Häger’s U-motion Laboratory, Sweden. His primary research interests, amongst others, include physical activity analysis in sedentary and healthy individuals and those with infectious (e.g., COVID-19) or noncommunicable diseases. He had worked as a clinician and/or an academic in various professional capacities in India, New Zealand, Sweden, and Saudi Arabia. He has published around 40 research articles in peer-reviewed journals. He is an Associate Editor of BMC Musculoskeletal Disorders and a member of Sedentary Behavior Research Network, Emirates Physiotherapy Society, International Association for the Study of Pain (IASP), and the Indian Association of Physiotherapists.

Gisela Sole

Gisela Sole is an Associate Professor at the Centre of Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand. She is an Associate Editor for the Journal of Science and Medicine in Sports. She teaches Sports and Musculoskeletal Physiotherapy at undergraduate level and leads Sports Physiotherapy as part of the post-graduate programme. Her research explores patient education and self-management as part of rehabilitation of patients with rotator cuff related shoulder pain. She explores long term effects of pain and injury on physical performance and quality of life, and the beliefs of patients and health professionals in managing injuries.

Shetty Shrija Jaya

Shetty Shrija Jaya is a PhD Scholar at the department of physiotherapy, Manipal College of Health Professions, MAHE, Manipal, India.

Arun G. Maiya

Arun G Maiya is currently Dean, Manipal College of Health Professions and a professor at the Department of Physiotherapy, MAHE, Manipal, India. He is also the chief of Centre for Diabetic Foot Care and Research at Kasturba Hospital, MAHE, Manipal. He is the president of Indian Podiatry Association-Karnataka Chapter, Bengaluru, Karnataka, India. He is also the Membership Director of World Association for photobiomodulation Therapy. He is an Expert for the Biomedical device and technology development programme, Department of Science and Technology (DST), Government of India. He has over 30 years of experience in teaching, research and clinical experience in the field of physiotherapy. He has received ten research grants from both national and international funding agencies. He has 169 publications in various indexed journals. His area of research interest include diabetes and its complications, occupational health, chronic pain and tissue healing. He is the recipient of the prestigious research grant by the World Diabetic foundation for the project “diabetic foot care-stepping ahead’ which aimed to capacity build healthcare professionals working in the field of diabetic foot complications. He was also the nodal officer for the ICF team, Central Bureau of Health Intelligence, Ministry of Health and Family Welfare, Government of India (2008).