Motor Analysis Laboratory, Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, Quebec, Canada; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
J Hand Ther. 2020 Oct-Dec;33(4):507-516. doi: 10.1016/j.jht.2019.06.002. Epub 2019 Aug 31.
Proprioception encompasses the submodalities of joint position sense (JPS), kinesthesia, sense of force, and velocity. Owing to the vast mobility of the shoulder, it heavily relies on an intact sense of proprioception. Moreover, shoulder injuries are associated with a decreased sense of proprioception. What remains unclear is how shoulder proprioception is affected by pain and competing nociceptive senses.
To summarize the literature evaluating the relationship between pain and shoulder proprioception.
A literature review was conducted from inception until 22 October 2018, using electronic databases (PubMed, Web of Science, Scopus, EBSCO, CINAHL, and Embase). Retrieved citations were screened for eligibility, and methodological quality was assessed using the Newcastle-Ottawa Scale (NOS).
Eleven studies were included (n = 447 participants with shoulder pain, n = 20 with experimentally induced pain [EIP]/n = 600 painful shoulders and n = 20 [EIP]). The mean methodological quality of the studies was good (76%). Five studies investigated active JPS, four investigated passive JPS, six investigated kinesthesia, sense of force was measured in one study, and no study investigated sense of velocity. There is moderate evidence for impaired kinesthesia and low evidence for reduced sense of force among painful shoulders. Conflicting evidence is seen for the other proprioceptive submodalities.
The overall impact of pain on shoulder JPS remains unclear, while moderate evidence for an affected sense of kinesthesia is possible. There is low evidence for an impaired sense of force among painful shoulders. Standardization between studies is lacking, limiting the range of our conclusions. Further investigation is required into well-controlled and pain-induced studies to better understand the influence of pain on shoulder proprioception.
本体感觉包括关节位置感（JPS）、运动觉、力量感和速度感等亚模式。由于肩部的活动范围非常大，它非常依赖于完整的本体感觉。此外，肩部受伤会导致本体感觉下降。目前尚不清楚疼痛和竞争的伤害性感觉如何影响肩部本体感觉。
总结评估疼痛与肩部本体感觉之间关系的文献。
从开始到 2018 年 10 月 22 日进行了文献回顾，使用电子数据库（PubMed、Web of Science、Scopus、EBSCO、CINAHL 和 Embase）。筛选检索到的引文以确定其是否符合纳入标准，并使用纽卡斯尔-渥太华量表（NOS）评估方法学质量。
纳入了 11 项研究（n=447 例肩部疼痛患者，n=20 例实验性诱导疼痛[EIP]/n=600 例疼痛性肩部和 n=20[EIP]）。研究的平均方法学质量较好（76%）。5 项研究调查了主动 JPS，4 项研究调查了被动 JPS，6 项研究调查了运动觉，1 项研究测量了力量感，没有研究调查了速度感。有中度证据表明疼痛性肩部的运动觉受损，低证据表明力量感降低。其他本体感觉亚模式的证据存在冲突。
疼痛对肩部 JPS 的总体影响仍不清楚，而运动觉受损的中度证据是可能的。疼痛性肩部的力量感可能受损。研究之间缺乏标准化，限制了我们结论的范围。需要进一步进行对照良好和疼痛诱导的研究，以更好地了解疼痛对肩部本体感觉的影响。
