Most Physical Interventions for Musculoskeletal Pain in Children and Adolescents Cannot Be Reproduced in Clinical Practice: a Systematic Review of Randomized Clinical Trials

Methods We considered randomized controlled trials that included children and adolescents between 4 and 19 years old with acute or chronic/persistent musculoskeletal pain. We considered interventions including active and passive physical therapies related to all types of physical modalities aimed at reducing the intensity of pain or disability in children and adolescents with musculoskeletal pain. The description of interventions was assessed using the Template for Intervention Description and Replication (TIDieR) checklist. We performed electronic searches in the following databases: CENTRAL, MEDLINE, EMBASE, CINAHL, PsyINFO and PEDro up to October 2021. The study selection, data extraction and analysis procedures were carried out by two independent reviewers. The description of physical interventions was presented using frequencies, percentages and 95% confidence intervals (CIs) of the TIDieR checklist items described in each study. We also calculated the total TIDieR score for each study and presented these data as mean and standard deviation. Results We included 14 randomized controlled trials. The overall quality of description measured through the TIDieR checklist was poor, with an average of 12 (4.3) points out of 24. The item of the TIDieR that was mostly described was item 1 (brief name). The item for which 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 true clinical reproducibility.