This study aimed to assess the quality of the description of physical interventions for musculoskeletal pain in children and adolescents. We included 13 randomised controlled trials and the most common conditions were low back pain and neck pain. The overall TIDieR checklist score of the included studies was 11 points out of a total of 24 points. The individual TIDieR items that were mostly commonly described were item 1 – brief name; item 6 – how and item 4 – what (procedures). The TIDieR items poorly described were item 10 – modifications; item 12 – how well – actual; and item 11 – how well – planned.
Studies evaluating physical interventions in children with musculoskeletal pain are scarce compared to studies in adults. Making this the first study that assesses the reporting quality of these interventions. We selected the main electronic databases in the field of physical therapy to reach a greater number of relevant studies [27]. We used the TIDieR checklist, which is a checklist developed to guide authors on better report descriptions of interventions [9]. The control groups in this study included usual care, waiting list or minimal intervention, relaxation classes or social group meetings, which ended up not being satisfactory the use of the TIDieR checklist for this group, because it evaluates active interventions The criteria of the control groups limited the comparison and evaluation with other interventions such as active interventions, psychological interventions, medication or surgeries. Thus, we do not know how well described these interventions are. A previous systematic review described the reporting characteristics of 107 randomised controlled trials of persistent and recurrent pain in children and adolescents – including pharmacological and non-pharmacological interventions [10]. The authors found that fewer than fifty percent of the included studies do not report the primary outcomes (e.g., pain and frequency pain, function, health-related quality of life). In addition, less than forty-five percent of the studies reported the recommendations of adverse events of the Consolidated Standards of Reporting Trials (CONSORT). However, this study has included pharmacological and non-pharmacological interventions, our findings also demonstrated that randomised controlled trials of physical interventions presented poor quality of the description of musculoskeletal pain in children and adolescents [10].
A previous study assessed the completeness of the description in physical therapy interventions [7]. The study reported that most interventions in physiotherapy are poorly reported. Descriptions of control interventions were even worse, which was also in accordance with our findings [10]. This previous study found that items with major problems of description were those related to the modification, how (planned) and what (materials). In our study, we found that items with major problems of description were those related to modifications, how well (actual) and how well (planned). Item 4 (what: procedures) seems to have improved when comparing those findings from 2016 to our findings. The study reported that only 59% of studies well described the intervention group and 28% of the control group. In our study, we found that 69.2% of studies well-described procedures (intervention and control group together). This may be a result of an action in 2016, when editorials were published in the most important journals of the physical therapy area describing the importance of the use of the TIDieR checklist to better describe interventions [28].
The TIDieR assessment showed that the descriptions of physical interventions in this area are mostly incomplete. A study published in 2008 demonstrated that only 60% of reports in randomised controlled trials presented adequate information about the intervention [29]. If researchers are unable to comprehensively report all aspects of the interventions, the trial results may not be incorporated into clinical practice, or the intervention may be implemented incorrectly or with low fidelity, making them unusable. Also, the replication of the described intervention in randomised controlled trials is unable in other settings or populations. This implies an unplanned waste of tens of billions of dollars of investment in research every year for problems that could be corrected [30]. This study then allows us to have an idea of what specifically needs to be improved in the description of randomised controlled trials to possibly guide practice and future studies. We believe we still need strategies to reduce poor reporting of research. The responsibility for improving the intervention reports extends to clinical trial authors who should use the TIDieR checklist to guide their descriptions. The responsibility also extends to the editors and reviewers that could request the checklist at the time of submission to guarantee publishing reproductive studies. The action taken in 2016 seems to be a started point to improve the description of interventions. However, five years later, it seems we still face the same problem.