The prevalence of musculoskeletal pain and incidence of musculoskeletal injuries in adolescence are 20 to 40 percent and 30.9 injuries/ 100 adolescents/ year. This burden is especially relevant due to its association with future musculoskeletal pain, obesity, osteoarthritis, cardiovascular disease, and all-cause mortality.
Thus, it is crucial to address these issues early in life to avoid more serious complications in the future. Exercise therapy is the mainstay of the management of these conditions. However, adherence is a crucial factor in its effectiveness, and although multiple studies on this topic have been performed, a consensus about barriers and facilitators, especially in a specific population such as children and teenagers is still lacking.
A database search yielded 41 studies eligible for analysis which included 2,020 participants and 12 musculoskeletal conditions. Study quality was assessed with the Mixed Methods Appraisal Tool. Barriers, facilitators, and strategies to increase adherence were analysed using Braun and Clarke’s six-step guide.
The wide range of barriers and facilitators present in the literature shows the need to engage in a discussion with patients, regardless of their age, to identify barriers and facilitators unique to each patient. However, a need remains for studies linking adherence, exercise therapy effectiveness, and health-related outcomes.
> From: Holt et al., J Orthop Sport Phys Ther 50 (2020) 503-515 (Epub ahead of print). All rights reserved to Journal of Orthopaedic & Sports Physical Therapy. Click here for the online summary.
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Expert opinion
This review is an extremely useful resource for anyone dealing with children and teenagers with musculoskeletal conditions, as it not only identifies the most frequent barriers and facilitators of exercise adherence in a detailed manner, but also provides practical tips for implementing the findings in the clinical setting.
This is a great example of an intervention (increasing exercise adherence) that may have very little cost and bring huge benefits in the future by creating healthier citizens. Additionally, to be honest, we all know that strategies to make exercise fun and engaging can be applied even in 40- or 80-year old “teenagers”, so it is bound to have a wider scope of clinical use.
Best of all, the full text is free to access, so make sure you add it to your reading list!
