The Effectiveness of School-Based Interventions on Pain and Disability Outcomes in Adolescents With Persistent Pain. A Systematic Review

IF 3.4 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-08-15 DOI:10.1002/ejp.70101

Henriette Jahre, Maren Hjelle Guddal, Erik Grasaas, Kaja Smedbråten, Kirsti Riiser, Are Hugo Pripp, Margreth Grotle, Britt Elin Øiestad

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Abstract

Background and Objective

Persistent pain is common among adolescents, with significant consequences. School-based interventions have the potential to reach most adolescents, but there is a lack of systematic reviews addressing school-based pain interventions. This systematic review aimed to identify and evaluate the effectiveness of school-based interventions for reducing persistent pain and disability in adolescents compared to control interventions.

Databases and Data Treatment

The PRISMA guidelines were followed (CRD42023477721). Searches in Medline, EMBASE, PEDro, CINAHL, Web of Science, Cochrane, AMED, PsycINFO, and Google Scholar identified 6651 studies. We included randomised controlled trials (RCTs) and controlled trials (CTs) of interventions conducted at schools involving adolescents aged 10–19 years with persistent pain lasting ≥ 3 months. Risk of bias was measured using the Cochrane RoB 2 tool for RCTs and ROBINS-I for CTs. Results were synthesised narratively.

Results

Sixteen studies met the inclusion criteria (n = 12 RCTs, n = 3 CTs, n = 1 pilot RCT) including 2873 participants. The identified interventions were relaxation, education, exercise, taping, and tailored pain management. Relaxation reduced headache activity in four out of five studies; exercise was effective for back and menstrual pain; education showed conflicting results; and person-centred care was not better than usual school health care for reducing pain. All included studies had a high risk of bias.

Conclusion

Relaxation and exercise showed promising effectiveness on reducing persistent pain in adolescents, although with a high risk of bias. The need for higher-quality studies remains imperative to strengthen the evidence base and inform future interventions.

Significance Statement

This systematic review highlights the potential of school-based interventions, particularly relaxation and exercise, in reducing persistent pain among adolescents, although in studies with a high risk of bias. These findings underscore the need for higher-quality studies to establish robust evidence and inform effective, equitable pain management strategies in school settings.

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以学校为基础的干预对青少年持续性疼痛和残疾结局的影响。系统回顾

背景与目的持续性疼痛在青少年中很常见，后果严重。以学校为基础的干预措施有可能覆盖大多数青少年，但缺乏针对以学校为基础的疼痛干预措施的系统综述。本系统综述旨在识别和评估与对照干预相比，以学校为基础的干预措施在减少青少年持续性疼痛和残疾方面的有效性。数据库和数据处理遵循PRISMA指南（CRD42023477721）。在Medline， EMBASE, PEDro， CINAHL, Web of Science, Cochrane， AMED， PsycINFO和b谷歌Scholar中搜索了6651项研究。我们纳入了在学校进行的干预措施的随机对照试验（rct）和对照试验（ct），涉及年龄在10-19岁、持续疼痛≥3个月的青少年。对随机对照试验使用Cochrane RoB 2工具，对ct使用ROBINS-I工具来测量偏倚风险。对结果进行叙述性综合。结果16项研究（n = 12 RCTs, n = 3 ct, n = 1先导RCT）共2873名受试者符合纳入标准。确定的干预措施包括放松、教育、锻炼、贴敷和量身定制的疼痛管理。在五分之四的研究中，放松可以减少头痛活动；运动对背痛和经期疼痛有效；教育显示出相互矛盾的结果；在减轻疼痛方面，以人为中心的护理并不比通常的学校保健好。所有纳入的研究都有较高的偏倚风险。结论放松和运动对减轻青少年持续性疼痛有较好的效果，但存在较高的偏倚风险。为了加强证据基础和为未来的干预措施提供信息，仍然迫切需要进行高质量的研究。本系统综述强调了以学校为基础的干预措施，特别是放松和锻炼，在减少青少年持续疼痛方面的潜力，尽管在研究中存在很高的偏倚风险。这些发现强调需要进行高质量的研究，以建立有力的证据，并为学校环境中有效、公平的疼痛管理策略提供信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.