A review of the measurement properties of disability measures used in children and adolescents with musculoskeletal pain

Veronica Souza Santos, Yasmin Brasileiro de Souza, Caique de Melo Espirito Santo, Giulia Giulia, Steven J Kamper, Jennifer N Stinson, Tiê Parma Yamato
Purpose:

We aimed to summarise the evidence of measurement properties of disability PROMs in children and adolescents with musculoskeletal pain. 

Methods:

We performed a systematic review of measurement properties per the COnsensus-based Standards for selecting health status Measurement INstruments (COSMIN). We considered any study of measurement properties of disability PROMs – either self-reported or proxy versions – in children and adolescents aged three to 19 years old with musculoskeletal pain. We searched four databases. We measured the included studies in three steps: 1) Risk of bias of individual studies (methodological quality); 2) Quality criteria for (in)sufficient measurement properties; and 3) Modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE). We also measured a recommendation of the PROMs according to Cohen’s “well-established assessment” criteria. 

Results:

We selected 139 studies of 35 PROMs. The evidence covered 35,748 children and adolescents with a mean age of 11.3 (SD: 2.8). The PROM development and content validity was from very low to moderate certainty of evidence of sufficient PROM development and content validity. The other measurement properties were from very low certainty of evidence to high certainty evidence of sufficient measurement properties. The Juvenile Arthritis Multidimensional Assessment Report (JAMAR) child version has a strong recommendation to be used in children and adolescents with juvenile idiopathic arthritis, and the Functional Disability Inventory (FDI) has a weak recommendation in children and adolescents with general musculoskeletal pain. 

Conclusion(s):

We found 35 PROMs used in children and adolescents with musculoskeletal pain. The JAMAR is strongly recommended to be used in children and adolescents with juvenile idiopathic arthritis, and the Functional Disability Inventory (FDI) is weakly recommended in children and adolescents with general musculoskeletal pain. 

Implications:

This study will better guide the selection of PROMs for clinical practice or future studies in children and adolescents with musculoskeletal pain. 

Funding acknowledgements:
We did not receive funding for this research.
Keywords:
Musculoskeletal pain
Questionnaires
Children
Primary topic:
Musculoskeletal
Second topic:
Disability and rehabilitation
Third topic:
Paediatrics
Did this work require ethics approval?:
No
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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