Proprioception: How is it affected by shoulder pain? A systematic review

Area of Science:

• Orthopedics
• Neuroscience
• Sports Medicine

Background:

• Proprioception, crucial for shoulder function, includes joint position sense (JPS), kinesthesia, and force/velocity senses.
• Shoulder injuries often correlate with diminished proprioception.
• The impact of pain and nociception on shoulder proprioception requires further elucidation.

Purpose of the Study:

• To systematically review existing literature on the relationship between shoulder pain and proprioception.
• To synthesize findings regarding how pain affects various submodalities of shoulder proprioception.

Main Methods:

• A comprehensive literature search was performed across multiple electronic databases (PubMed, Web of Science, Scopus, etc.) up to October 2018.
• Eleven studies involving 447 participants with shoulder pain and 20 with experimentally induced pain were included.
• Methodological quality was assessed using the Newcastle-Ottawa Scale, with a mean score indicating good quality.

Main Results:

• Moderate evidence suggests impaired kinesthesia in painful shoulders.
• Low evidence indicates a reduced sense of force in painful shoulders.
• Conflicting evidence exists for the impact of pain on active and passive JPS and sense of velocity.

Conclusions:

• The effect of pain on shoulder JPS remains uncertain.
• Moderate evidence supports an impact on kinesthesia, and low evidence on the sense of force.
• Lack of standardization across studies limits definitive conclusions; further well-controlled, pain-induction studies are recommended.