Relationship Between Proprioception and Pain and Disability in People With Non-Specific Low Back Pain

Abstract

Study Design. Systematic review with meta-analysis. Objective. To examine the association between proprioception and pain and disability in people with non-specific low back pain (NSLBP) and the impact of potential moderators on the strength of the association. Summary of Background Data. NSLBP is a common musculoskeletal disorder and a leading cause of disability. Proprioception deficit has been associated with low back pain and correlated with pain and disability; however, the correlation coefficients presented are conflicting. Methods. Systematic literature search was performed in eight databases and Google scholar. Two independent reviewers assessed the literature and extracted data. Data of interest included participant characteristics of NSLBP group, pain and disability, proprioception test protocol, and the correlation coefficient between proprioception and pain/disability. Meta-analysis of data from homogeneous studies was performed according to proprioception test methods. Subgroup of movement directions was analyzed. The methodological quality of studies was assessed. Results. The literature search identified 3067 records of which 14 studies were included for meta-analysis. Proprioception was measured by active joint repositioning sense (AJRS), passive joint repositioning sense (PJRS), and threshold to detect passive motion (TTDPM). Meta-analysis revealed no significant correlation coefficient between any proprioception measures and pain or disability (P > 0.05). The subgroup analysis showed little correlation between absolute error (AE) of passive lumbar flexion and pain (r = 0.225, 95% CI 0.040–0.395), and between AE of passive lumbar extension and disability (r = 0.196, 95%CI 0.010–0.369). Conclusion. AJRS and TTDPM are not correlated with pain and disability in people with NSLBP. The AE of passive lumbar movement is correlated to a small degree with pain and disability. However, the degree of correlation is small and should be interpreted with caution. Therefore, the differences in proprioception observed between people with pain and people without pain seem to be independent of the symptoms. Level of Evidence: 1

Lumbo-pelvic proprioception in sitting is impaired in subgroups of low back pain–But the clinical utility of the differences is unclear. A systematic review and meta-analysis

“…By subgrouping according to symptoms' severity, low and very low certainty evidence suggests no difference in error variability, significantly greater AE in NSLBP patients, and inconsistent results regarding error direction. The lack of a dose-response relationship between proprioceptive deficit and pain and disability [19] can probably explain this variation and the significant or not effects can be attribute to sample characteristics, or diversity in methodology implemented in included studies. Very low certainty evidence suggests greater AE (medium effect) between NSLBP patients and asymptomatic individuals in a blindfolded repositioning task, and no difference with vision available.…”

“…It has been suggested that these proprioceptive deficits might be associated with the underlying characteristics and mechanisms of NSLBP development [17,18]. However, the precise association between NSLBP and proprioceptive deficits is unclear, as spinal proprioceptive impairments are not correlated with pain and disability [19,20].…”

Explicit and Implicit Own's Body and Space Perception in Painful Musculoskeletal Disorders and Rheumatic Diseases: A Systematic Scoping Review

“…However, existing studies on SoP, SpP, and BO were largely conducted on healthy subjects (Longo et al, 2008a;Fuentes et al, 2013;Longo, 2017), and clinical research has mostly investigated neurological conditions (Haggard and Wolpert, 2005;Pia et al, 2013Pia et al, , 2016, eating disorders (Keizer et al, 2011;Scarpina et al, 2014;Spitoni et al, 2015;Gadsby, 2017), and neuropathic pain syndromes such as Complex Regional Pain Syndrome-CRPS (Galer and Jensen, 1999;Förderreuther et al, 2004;Lewis et al, 2007;Reinersmann et al, 2013). A large body of literature on the field of MDRDs has instead investigated primary somatosensations (Tsay et al, 2015), mainly tactile acuity (Catley et al, 2013(Catley et al, , 2014Harvie et al, 2018) and proprioceptive precision (Stanton et al, 2016;Tong et al, 2017;Lin et al, 2019), referring generically to disturbances at the level of perception or mental representations. However, both two-point discrimination and joint repositioning error (two of the most frequently investigated tasks) cannot be considered as having a higher-order somatoperceptual involvement Hillier et al, 2015;Spitoni et al, 2015).…”

A Clinical Shoulder Proprioception Test Shows Good Reliability, and Decreased Shoulder Joint Position Sense Due to Local Fatigue in Handballers: A Repeated Measures Design

“…Studies of the shoulder have shown a reduction in proprioception amongst subjects with joint laxity [9], in athletes undertaking overhead sports [10], in conjunction with shoulder pain [11], rotator cuff injuries [12] and amongst athletes who are fatigued [7,[13][14][15][16]. Although the role of proprioception in musculoskeletal disorders has been extensively researched in the lumbar and cervical spine [17][18][19] comparatively, there is limited research within the shoulder complex.…”