A Positive Impact of Sport-Related Musculo-Skeletal Pain on the Quality of Life and Pain Attitudes in Adolescents with Lower Limb Disability

Background/Objectives: Sport participation provides important physical and psycholog-ical benefits but carries a risk of musculoskeletal injury and associated pain. In adoles-cents with lower limb disabilities, sport-related pain may uniquely influence quality of life, coping strategies, and ongoing engagement in physical activity. This study investi-gates these effects in sitwake participants, comparing adolescents who experienced tran-sient injuries during training with those who did not, and evaluates subsequent changes in pain attitudes, quality of life, and return-to-sport rates. Method: A prospective case-control study was conducted over three months, with baseline and follow-up as-sessments. Adolescents with lower limb disabilities engaged in sitwake were assigned to a pain group (PG; with transient injuries with moderate pain during observation period) or no-pain group (no-PG). Health-related quality of life and pain attitudes were measured using the 37-item DISABKIDS Chronic Generic Module and 27-item Pain Attitudes Ques-tionnaire. Injuries in PG were managed with physiotherapy. Return-to-training rates were recorded the following season. Results: At baseline, PG and no-PG showed comparable scores in the two scales. By follow-up, PG demonstrated significantly greater improve-ments in independence, physical limitations, emotions, social inclusion, stoicism, and cautiousness subscales. No differences were observed for social exclusion or treatment impact subscales. Return to training rates were higher in PG (65%) than no-PG (29%). Conclusions: Sitwake participation with transient, moderate pain promotes positive psy-chosocial outcomes in adolescents with lower limb disabilities. The PG showed greater improvements in quality of life and adaptive pain attitudes, with higher return-to-training rates. Structured, manageable sport-related pain may foster resilience, coping, and sus-tained engagement in sport.