their association with future musculoskeletal pain, 31,35,74 obesity, 92 osteoarthritis, 95 cardiovascular disease, 45 and all-cause mortality. 1,98 Additionally, musculoskeletal pain in adolescence can reduce participation in school and sport 42 and alter career choice later in life. 74 These long-term consequences underlie the importance of appropriate care for youth (ie, children and adolescents) with musculoskeletal conditions. An essential treatment component for musculoskeletal conditions is exercise therapy. Distinct from general physical activity, "exercise therapy" is a regimen or plan of physical activities designed and prescribed in a precise dose to address specific therapeutic goals. 62 In youth with musculoskeletal conditions, exercise therapy effectiveness is associated with adherence, 10,49,76,78 defined as the extent to which someone's behavior corresponds with agreed recommendations from a health care provider. 100 Despite the importance of adherence, consensus on how to define, measure, or improve adherence to exercise therapy is lacking. 5 T he worldwide burden of musculoskeletal conditions (ie, diseases and injuries) is high and impacts people of all ages. 28,33,82 In adolescence, the high prevalence of musculoskeletal pain (estimated to be between 20% and 40%) 17,34,47 and incidence of musculoskeletal injuries (estimated at 30.9 injuries per 100 adolescents per year) 20 are concerning, given