Does pain influence force steadiness? A protocol for a systematic review

Can baseline features predict a reduction in pain and disability following neck-specific exercise in people with chronic non-specific neck pain?: A systematic review and meta-analysis protocol

INTRODUCTION

Neck-specific exercises (NSEs) are commonly used for the treatment of chronic non-specific neck pain (CNSNP). However, it remains unclear whether baseline features can predict the response to neck-specific exercise (NSE) in people with CNSNP. This systematic review aims to assess whether baseline features such as age, gender, muscle activity, fatigability, endurance and fear of movement can predict pain and disability reduction following a NSE intervention.

METHODS AND ANALYSIS

This systematic review and meta-analysis will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Protocols guidelines checklist. The Web of Science, PubMed, Scopus, MEDLINE, Embase and CINAHL databases; key journals; and grey literature will be searched up until June 2023, including medical subject heading terms and keywords combinations. Included studies will investigate an association between the baseline features and pain and disability outcomes following NSE in people with CNSNP. Two independent reviewers will oversee the searching, screening, data extraction and assessment of risk of bias. The risk of bias will be assessed using the Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) and Risk-Of-Bias tool for randomised trials 2 (ROB 2). The quality of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach (GRADE). Using standardised forms, details regarding study characteristics, baseline features (predictive factors), intervention, primary outcome and effect size (OR and 95% CI of each predictive factor and p value) will be extracted from included studies. Meta-analyses will be considered, if the studies are sufficiently homogeneous and if three or more studies investigate the same or comparable factors that predict the same response (pain intensity or disability). In the event that less than three studies investigated the same factors, a narrative synthesis will be conducted.

ETHICS AND DISSEMINATION

Ethical approval will not be required as this review will be based on published studies. The results of this study will be submitted to a peer-reviewed journal and presented at conferences.

PROSPERO REGISTRATION NUMBER

CRD42023408332.

Neuromechanical changes in Achilles tendinopathy and the effects of exercise-induced mechanical tendon loading: a protocol for a systematic review

INTRODUCTION

Achilles tendinopathy (AT) is a debilitating overuse injury characterised by pain, impaired functional performance, morpho-mechanical changes to the Achilles tendon and triceps surae neuromuscular alterations. Loading-based exercise has become the principal non-surgical choice for the treatment of AT; however, mechanistic evidence by which loading-based treatment may help to resolve tendon pain remains unclear. This systematic review aims to summarise the evidence of the neuromechanical changes produced by AT and by exercise-induced mechanical loading.

METHODS AND ANALYSIS

This systematic review protocol was informed and reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA-P) and the Cochrane Handbook for Systematic Reviews of Interventions. Pubmed, MEDLINE, EMBASE, CINAHL Plus, Web of Science and SPORTDiscus electronic databases will be searched from inception to February 2021. Additionally, grey literature and key journals will be reviewed. Risk of bias will be determined independently by two reviewers using the version 2 of the Cochrane risk-of-bias tool for randomised trials (RoB 2) and the risk of bias in non-randomised studies - of interventions (ROBINS-I) tool according to Cochrane recommendations. Quality of the cumulative evidence will be assessed with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) guidelines. If homogeneity exists between groups of studies, a random-effects meta-analysis will be conducted. If not, results will be synthesised narratively.

ETHICS AND DISSEMINATION

Our findings will be disseminated through publication in a peer-reviewed journal and presented at conferences. No ethical approval was required.

PROSPERO REGISTRATION NUMBER

CRD42021231933.