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Musculoskeletal disorders in school-aged children: An overview of systematic reviews
Lisseth Barra-Cabello1, Giselle Horment-Lara1, Giovanni Olivares-Péndola1
1Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.
Insights
Musculoskeletal disorders (MSDs) affect many children, leading to disability. This overview synthesizes evidence on MSD prevalence, risk factors, assessment, and interventions in school-aged children, highlighting exercise and psychological therapies.
Area of Science:
- Pediatrics
- Public Health
- Orthopedics
Background:
- Musculoskeletal disorders (MSDs) in children represent a significant public health concern, contributing to disability and reduced quality of life.
- Existing evidence on pediatric MSDs is fragmented, hindering practical application and policy development.
Purpose of the Study:
- To conduct an overview of systematic reviews to synthesize evidence on the prevalence, risk factors, assessment methods, and interventions for musculoskeletal disorders in school-aged children.
Main Methods:
- An overview of systematic reviews was performed following the PRIOR guidelines.
- Searches were conducted across multiple databases (CENTRAL, MEDLINE/PubMed, Scopus) with reference checking.
- Data extraction and quality assessment (AMSTAR-2) were independently performed by two reviewers, followed by descriptive synthesis.
Main Results:
- Thirty-six systematic reviews were included, analyzing prevalence, risk factors, assessment, and interventions.
- Prevalence varied significantly by condition (e.g., scoliosis ~1% to chronic pain >20%).
- Consistent risk factors included female sex, obesity, family history, low socioeconomic status, low bone mineral density, and joint hypermobility. Exercise-based and psychological interventions showed benefits.
Conclusions:
- Musculoskeletal disorders are prevalent in school-aged children, with identifiable risk factors.
- Assessment methods for pediatric MSDs are heterogeneous.
- Exercise-based and psychological interventions demonstrate efficacy for managing pediatric musculoskeletal conditions.
Background:
Musculoskeletal disorders in children are a significant public health problem, associated with disability and reduced quality of life. Despite growing evidence, it remains fragmented across conditions, limiting its application in practice and policy.
Objective:
To synthesize evidence from systematic reviews on the prevalence, risk factors, assessment methods, and interventions for musculoskeletal disorders in school-aged children.
Methods:
We conducted an overview of systematic reviews following the PRIOR guidelines. Searches were conducted in CENTRAL, MEDLINE/PubMed, and Scopus on April 8, 2025, supplemented by reference checking. Two reviewers independently selected studies, extracted data, and assessed methodological quality using AMSTAR-2. A descriptive synthesis was performed.
Results:
From 1137 records, 36 systematic reviews were included. Findings were grouped into prevalence, risk factors, assessment methods, and interventions. Prevalence estimates varied widely, ranging from approximately 1% for scoliosis to over 20% for chronic pain and up to 70% for spinal pain in some populations. Risk factors consistently associated with MSDs included female sex, overweight/obesity, family history of pain, low socioeconomic status, low bone mineral density, and joint hypermobility; sedentary behaviors and psychosocial factors showed weaker associations. Valid assessment methods included multimodal scoliosis screening and footprint/posture indices for flatfoot, though heterogeneity limited comparability. Evidence suggests that exercise-based and psychological therapies are beneficial, including Pilates-based programs and physiotherapeutic scoliosis-specific exercises, with orthoses beneficial only in symptomatic flatfoot.
Conclusion:
Musculoskeletal disorders are reported across systematic reviews in school-aged children. Evidence from systematic reviews indicates consistent risk factors, heterogeneous assessment methods, and benefits associated with exercise-based and psychological interventions.
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