Musculoskeletal pain in 13-year-old children: the generation R study

Benefits of musculoskeletal health promotion in school communities through service-learning: a mixed-method approach

Background

Service-learning (S-L) is an educational method that enhances social and civic engagement among health science students, addressing unmet community needs. Musculoskeletal disorders (MSKD) represent a public health issue with increasing prevalence among school-aged population as reported by at least 1 on 5 children. Prevention programs for MSKD in schools are scarce, although evidence supports the efficacy of health education provided by physical therapists. This study aimed to evaluate the impact of a musculoskeletal health promotion program through S-L on school students, teachers, and physical therapy students.

Methods

A mixed-methods approach was used. A quasi-experimental design assessed the learning and satisfaction of school students and teachers using pre-and post-intervention questionnaires. Additionally, qualitative data from reflective diaries of fourth-year physical therapy students were analyzed to capture their experiences. The intervention was conducted in 10 schools in Spain over two academic years, targeting children aged 10-14 and their teachers.

Results

A total of 1,051 school students and 32 teachers participated. Pre-post evaluations revealed significant learnings on MSKD prevention and body awareness in both groups (p < 0.05), highlighting the increase in knowledge about MSKD prevention and self-treatment for school students and on MSKD derived from inadequate postures for schoolteachers. Satisfaction was high, with students and teachers rating the program 4.4/5. Teachers highlighted the value of training for their professional practice, while students appreciated learning about self-care. Physical therapy students were 4 and reflected on their motivation for the project, learning experiences, as well as positive and negative aspects of the service.

Discussion

The S-L community-based intervention effectively increased awareness of musculoskeletal health and self-management skills. The peer learning environment and participatory approach encouraged engagement and knowledge retention in both students and teachers.

Conclusion

S-L is a valuable strategy for promoting musculoskeletal health in schools while improving health education skills among the future physical therapists through experiential learning.

Influence of chronotype on pain incidence during early adolescence

ABSTRACT

During adolescence major shifts in sleep and circadian systems occur with a notable circadian phase delay. Yet, the circadian influence on pain during early adolescence is largely unknown. Using 2 years of data from the Adolescent Brain Cognitive Development study, we investigated the impact of chronotype on pain incidence, moderate-to-severe pain, and multiregion pain 1 year later in U.S. adolescents. Based on the Munich ChronoType Questionnaire, chronotype was calculated as the midpoint between sleep onset and offset on free days, corrected for sleep debt over the week. Adolescents reported pain presence over the past month, and if present, rated pain intensity (0-10 numerical rating scale; ≥ 4 defined as moderate-to-severe pain) and body site locations (Collaborative Health Outcomes Information Registry Body Map; ≥2 regions defined as multiregion pain). Three-level random intercept logistic regression models were specified for each pain outcome, adjusting for baseline sociodemographic and developmental characteristics. Among 5991 initially pain-free adolescents (mean age 12.0 years, SD 0.7), the mean chronotype was 3:59 am (SD 97 minutes), and the 1-year incidence of pain, moderate-to-severe pain, and multiregion pain was 24.4%, 15.2%, and 13.5%, respectively. Each hour later chronotype at baseline was associated with higher odds of developing any pain (odds ratio [OR] = 1.06, 95% confidence interval [CI] = 1.01, 1.11), moderate-to-severe pain (OR = 1.10, 95% CI = 1.05-1.17), and multiregion pain (OR = 1.08, 95% CI = 1.02-1.14) during 1-year follow-up. In this diverse U.S. adolescent sample, later chronotype predicted higher incidence of new-onset pain.