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Relationship between growth, maturation and musculoskeletal conditions in adolescents: a systematic review
  1. Michael Swain1,2,3,
  2. Steven J Kamper1,3,
  3. Christopher G Maher1,4,
  4. Carolyn Broderick5,6,
  5. Damien McKay5,7,
  6. Nicholas Henschke1
  1. 1School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
  2. 2Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Sydney, New South Wales, Australia
  3. 3Centre for Pain, Health and Lifestyle, Sydney, New South Wales, Australia
  4. 4Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, New South Wales, Australia
  5. 5Children’s Hospital Institute of Sports Medicine, The Sydney Children’s Hospitals Network, Sydney, New South Wales, Australia
  6. 6School of Medical Sciences, The University of New South Wales, Sydney, New South Wales, Australia
  7. 7Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Mr Michael Swain, School of Public Health, Sydney Medical School, University of Sydney, Sydney, NSW 2050, Australia; michael.swain{at}mq.edu.au

Abstract

Objective To determine whether there is a relationship between physical growth and development, as determined by markers of biological maturation, and musculoskeletal conditions in adolescents.

Design Systematic review.

Data sources Electronic databases (PubMed, EMBASE and the Cumulative Index to Nursing and Allied Health Literature) were searched up to 6 September 2017.

Eligibility criteria for selecting studies Studies that evaluated the association between biological maturation or growth and musculoskeletal conditions in adolescents (chronological age 10–19 years).

Results From 20 361 titles identified by the searches, 511 full-text articles were retrieved and assessed for eligibility; 56 studies, all at high risk of bias, evaluating the relationship between maturation and/or growth and musculoskeletal conditions were included. A total of 208 estimates of association were identified across the included studies, which generally indicated no association or an unclear association between maturation, growth and musculoskeletal conditions.

Summary/Conclusions While the relationship between maturation, growth and musculoskeletal conditions remains plausible, the available evidence is not supportive. The current body of knowledge is at high risk of bias, which impedes our ability to establish whether biological maturity and growth are independent risk factors for musculoskeletal conditions.

  • adolescent
  • growth
  • injuries
  • fracture

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Footnotes

  • Contributors All authors conceived the study and wrote the study protocol. MSS, NH and SJK selected the studies. MSS extracted the data. NH and SJK checked the extracted data. MSS analysed the data. All authors interpreted the data. MSS wrote the first draft of the manuscript and all authors contributed to the writing of the final version.

  • Funding CGM’s (APP1103022) and SJK’s research fellowships are funded by Australia’s National Health and Medical Research Council. CGM holds a programme grant funded by Australia’s National Health and Medical Research Council (APP1113532).

  • Competing interests None declared.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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