Most physical interventions for musculoskeletal pain in children and adolescents cannot be reproduced in clinical practice

Abstract

Introduction: Conservative treatments are usually the most indicated for the management of musculoskeletal pain; consequently, a detailed description of interventions enables the reproducibility of interventions in clinical practice and future research. The objective of this study is to evaluate the description of physical interventions for musculoskeletal pain in children and adolescents. Methods: We considered randomised controlled trials that included children and adolescents between 4 and 19 years old, with an acute or chronic/persistent musculoskeletal pain. We considered interventions including active and passive physical therapies – related to all types of physical modalities aimed to reduce the intensity of pain or disability in children and adolescents with musculoskeletal pain. The description of interventions was assessed using the TIDieR checklist. We searched on CENTRAL, MEDLINE, EMBASE, CINAHL, PsyINFO and PEDro up to October 2021. The description of physical interventions was presented using frequencies, percentages and 95% confidence intervals (CIs). We also calculated the total TIDieR score for each study. Results: We included 13 randomised controlled trials. The overall quality of description measured through the TIDieR checklist was poor, with an average of 11 (4.3) points out of 24. The item of the TIDieR that was mostly described was item 1 (brief name). The item that the description was mostly absent was item 10 (modifications). Conclusion: The descriptions of physical interventions for the treatment of musculoskeletal pain in children and adolescents are usually poorly described, indicating the need for strategies to improve the quality of description to enable truly clinical reproducibility.