Pain and injury in adolescents and young adults

Abstract

This thesis aims to better the understanding of pain and injury in adolescents and young adults by investigating the prevalence, impact, risk factors, clinical course and diagnosis of common disorders. Chapters 2 and 3 presents the results of studies of large international data sets. Chapter 2 showed that back pain, headache, and stomach ache were very common in adolescents, more often coexisting with each other than occurring in isolation. In Chapter 3 investigated the association between pain and achieving 60 minutes of moderate to vigorous physical activity per day. Adolescents with pain generally had reduced odds of meeting physical activity recommendations. Chapter 4 investigated whether physical growth and development is a risk factor for musculoskeletal conditions in adolescents. A systematic review of the literature was conducted. A total of 208 estimates of association generally indicated no association or an unclear association between maturation, growth and musculoskeletal conditions in adolescents. In Chapter 5, a feasibility study was conducted to assess the recruitment, retention and response rates of weekly electronic follow-up, in adolescents with knee pain. Study feasibility was threatened by slow recruitment, participants that stopped responding prior to recovery, and high loss to follow-up. Electronic data collection alone seems insufficient to track knee pain recovery in young people. Anterior cruciate ligament injuries are common and impactful in young people. Chapter 6 reports on a systematic review conducted to evaluate the diagnostic accuracy of clinical tests for anterior cruciate ligament injury. Clinical tests in combination, but not individually, may assist the diagnosis of anterior cruciate ligament injury in clinical practice. Collectively, this thesis provides an important contribution to the body of knowledge underpinning the epidemiology of pain and injury in adolescents and young adults.