Sensory and motor deficits exist on the non-injured side of patients with unilateral tendon pain and disability - implications for central nervous system involvement: a systematic review with meta-analysis

Heales, L. J., Lim E. C. W., Hodges, P. W. and Vicenzino, B. (2013) Sensory and motor deficits exist on the non-injured side of patients with unilateral tendon pain and disability - implications for central nervous system involvement: a systematic review with meta-analysis. British Journal of Sports Medicine, 48 19: 1400-1406. doi:10.1136/bjsports-2013-092535

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Author Heales, L. J.
Lim E. C. W.
Hodges, P. W.
Vicenzino, B.
Title Sensory and motor deficits exist on the non-injured side of patients with unilateral tendon pain and disability - implications for central nervous system involvement: a systematic review with meta-analysis
Journal name British Journal of Sports Medicine   Check publisher's open access policy
ISSN 0306-3674
1473-0480
Publication date 2013-10-31
Year available 2013
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1136/bjsports-2013-092535
Volume 48
Issue 19
Start page 1400
End page 1406
Total pages 10
Place of publication London, United Kingdom
Publisher B M J Group
Language eng
Formatted abstract
Introduction Tendinopathy manifests as activity-related tendon pain with associated motor and sensory impairments. Tendon tissue changes in animals present in injured as well as contralateral non-injured tendon. This review investigated evidence for bilateral sensory and motor system involvement in unilateral tendinopathy in humans.

Methods A comprehensive search of electronic databases, and reference lists using keywords relating to bilateral outcomes in unilateral tendinopathy was undertaken. Study quality was rated with the Epidemiological Appraisal Instrument and meta-analyses carried out where appropriate. Analysis focused on comparison of measures in the non-symptomatic side of patients against pain-free controls.

Results The search revealed 5791 studies, of which 20 were included (117 detailed reviews, 25 met criteria). There were 17 studies of lateral epicondylalgia (LE) and one each for patellar, Achilles and rotator cuff tendinopathy. Studies of LE were available for meta-analysis revealing the following weighted pooled mean deficits: pressure pain thresholds (−144.3 kPa; 95% CI −169.2 to −119.2 p<0.001), heat pain thresholds (−1.2°C; 95% CI −2.1 to −0.2, p<0.001), cold pain thresholds (3.1°C; 95% CI 1.8 to 4.4, p<0.001) and reaction time (37.8 ms; 95% CI 24.8 to 50.7, p<0.001).

Discussion Deficits in sensory and motor systems present bilaterally in unilateral tendinopathy. This implies potential central nervous system involvement. This indicates that rehabilitation should consider the contralateral side of patients. Research of unilateral tendinopathy needs to consider comparison against pain-free controls in addition to the contralateral side to gain a complete understanding of sensory and motor features.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published Online First 21 October 2013

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2014 Collection
School of Health and Rehabilitation Sciences Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 22 times in Thomson Reuters Web of Science Article | Citations
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Created: Thu, 20 Mar 2014, 21:31:33 EST by Professor Paul Hodges on behalf of School of Health & Rehabilitation Sciences