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

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INTRODUCTION: Performing contractions with minimum force fluctuations is essential for everyday life as reduced force steadiness impacts on the precision of voluntary movements and functional ability. Several studies have investigated the effect of experimental or clinical musculoskeletal pain on force steadiness but with conflicting findings. The aim of this systematic review is to summarise the current literature to determine whether pain, whether it be clinical or experimental, influences force steadiness.

METHODS AND ANALYSIS: This protocol for a systematic review was informed and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols and the Cochrane Handbook for Systematic Reviews of Interventions. Key databases will be searched from inception to 31 August 2020, including MEDLINE, EMBASE, PubMed, CINAHL Plus, ZETOC and Web of Science. Grey literature and key journals will be also reviewed. Risk of bias will be assessed with the Newcastle-Ottawa tool, and the quality of the cumulative evidence assessed with the Grading of Recommendations, Assessment, Development and Evaluation guidelines. If homogeneity exists between groups of studies, meta-analysis will be conducted. Otherwise, a narrative synthesis approach and a vote-counting method will be used, while the results will be presented as net increases or decreases of force steadiness.

ETHICS AND DISSEMINATION: The findings will be presented at conferences and the review will be also submitted for publication in a refereed journal. No ethical approval was required.



Original languageEnglish
Article numbere042525
JournalBMJ open
Issue number1
Publication statusPublished - 8 Jan 2021


  • adult orthopaedics, musculoskeletal disorders, rehabilitation medicine, sports medicine

ASJC Scopus subject areas