This systematic review aimed to identify and evaluate outcome measures used in school-based spinal health interventions for children and adolescents, to facilitate standardised evaluation and inform policy development.
This review adhered to PRISMA 2020 guidelines. A comprehensive search was conducted across multiple databases, including Scopus, CINAHL, PEDro, PubMed, Cochrane Library, Science-Direct, and Sabinet. Based on the PICO framework, Eligible studies were English-language interventional studies (RCTs and quasi-experimental designs) that focused on school-based interventions for children and adolescents, including educational programs, physical activities, and modifications to school furniture.
Out of 934 records screened, 42 studies met the inclusion criteria. The interventions varied, with educational programmes and exercise interventions being the most prevalent. Outcome measures were categorised into two main groups: pain assessment tools (e.g., Numerical Pain Rating Scale [NPRS], Visual Analog Scale [VAS], Wong-Baker Faces Pain Rating Scale) and spinal well-being indicators (e.g., posture assessment tools, physical activity questionnaires, knowledge quizzes).
This review highlights the diverse outcome measures used in school-based spinal health interventions. There is a need for standardised and comprehensive measures to enable effective comparisons across studies and to guide policy development. Future research should prioritise the development and validation of these measures to support long-term assessment and intervention effectiveness.
The findings of this review have significant implications for clinical practice and school health policies. Clinicians and school health professionals should consider using a combination of pain assessment tools and spinal well-being indicators when evaluating the effectiveness of spinal health interventions. The lack of standardised measures suggests that practitioners should exercise caution when comparing outcomes across different interventions or studies. Additionally, there is a clear need for the development of age-appropriate, validated tools specifically designed for assessing spinal health in school-aged children and adolescents. Implementation of evidence-based, standardised outcome measures could lead to more effective spinal health programmes in schools, potentially reducing the long-term burden of spinal disorders in the population.
school-based interventions
Outcome measures
