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

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.