Moutafakir R, Strilinsky-Pérez OD, Zamora-Tortosa J, Raya-Benítez J, Benítez-Feliponi Á, Valenza MC, Granados-Santiago M. Beliefs, attitudes, knowledge, and behaviours of physical therapists towards pediatric complex regional pain syndrome. World J Clin Pediatr 2026; 15(1): 110584 [DOI: 10.5409/wjcp.v15.i1.110584]
Corresponding Author of This Article
Marie Carmen Valenza, PhD, Associate Professor, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Av. De la Ilustración, 60, Granada 18071, Spain. cvalenza@ugr.es
Research Domain of This Article
Pediatrics
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. Mar 9, 2026; 15(1): 110584 Published online Mar 9, 2026. doi: 10.5409/wjcp.v15.i1.110584
Beliefs, attitudes, knowledge, and behaviours of physical therapists towards pediatric complex regional pain syndrome
Ranya Moutafakir, Oriana Denise Strilinsky-Pérez, Jesús Zamora-Tortosa, Julia Raya-Benítez, Ángela Benítez-Feliponi, Marie Carmen Valenza, María Granados-Santiago
Ranya Moutafakir, Institut de Formation en Masso-Kinésithérapie-Assas, Université Versailles-Saint Quentin en Yvelines, Paris 75015, France
Oriana Denise Strilinsky-Pérez, Jesús Zamora-Tortosa, Ángela Benítez-Feliponi, Marie Carmen Valenza, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada 18071, Spain
Julia Raya-Benítez, María Granados-Santiago, Department of Nursing, University of Granada, Granada 18071, Andalusia, Spain
Author contributions: Moutafakir R and Valenza MC designed the research study; Moutafakir R, Zamora-Tortosa J, Raya-Benítez J, and Benítez-Feliponi A performed the research; Strilinsky-Pérez OD, Valenza MC, and Granados-Santiago M analyzed the data and wrote the manuscript; All authors have read and approved the final manuscript.
Institutional review board statement: According to the General Data Protection Regulation (GDPR) and French data protection laws, research projects using non-sensitive data may proceed without ethics committee approval, provided they adhere to data protection principles and respect individuals’ rights. Informed consent was obtained from all subjects involved in this study, which was conducted in accordance with the Declaration of Helsinki. No personal or sensitive participant data were collected, and all applicable ethical principles were upheld throughout the research.
Informed consent statement: Informed consent was obtained from all subjects involved in the study.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest to disclose regarding the publication of this manuscript.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Data sharing statement: The data generated and analyzed during the current study are not publicly available due to privacy and confidentiality agreements with participants.
Corresponding author: Marie Carmen Valenza, PhD, Associate Professor, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Av. De la Ilustración, 60, Granada 18071, Spain. cvalenza@ugr.es
Received: June 11, 2025 Revised: July 7, 2025 Accepted: October 21, 2025 Published online: March 9, 2026 Processing time: 270 Days and 0.7 Hours
Abstract
BACKGROUND
Pediatric complex regional pain syndrome (CRPS) is a debilitating chronic condition that affects the quality of life and psychosocial development of children and adolescents. Despite increasing recognition, significant diagnostic and therapeutic challenges persist, partly due to the lack of clinical criteria tailored to the pediatric population.
AIM
To evaluate current diagnostic and therapeutic practices in pediatric CRPS, identifying barriers to timely intervention and gaps in provider knowledge.
METHODS
Physiotherapists who had treated at least one pediatric CRPS case in the past two years were surveyed. The online questionnaire included 40 questions divided into three sections: Professional knowledge, therapeutic approaches, and personal perceptions. Data were analyzed using descriptive statistics and χ2 tests.
RESULTS
Most participants worked in private clinics (71%) and collaborated with other healthcare professionals. About 53% had specific training in pediatric pain, while 40% had training in CRPS. Only 13% had received training in cognitive-behavioral therapy (CBT). The use of the Budapest criteria was limited, primarily applied during the diagnostic suspicion phase. The most common therapeutic strategies included mirror therapy (40%) and relaxation techniques (80%). The main reported challenges were the lack of specific clinical guidelines (60%) and insufficient professional training (47%).
CONCLUSION
Physical therapists are key contributors to multidisciplinary diagnosis and play a central role in managing pediatric CRPS in most cases, adopting a collaborative and largely non-pharmacological approach. However, the absence of standardized clinical guidelines limits treatment consistency. The development of pediatric-specific protocols and enhanced training in psychological therapies such as CBT is recommended.
Core Tip: Pediatric complex regional pain syndrome is a complex condition that significantly impacts children’s well-being, yet diagnostic and treatment challenges remain due to the lack of pediatric-specific criteria. This study surveyed physiotherapists to assess current practices and knowledge gaps. Limited use of diagnostic tools and the absence of standardized guidelines were major barriers identified. The findings highlight the need for tailored protocols and improved training in psychological therapies.
