Diagnostic Criteria

AWGS2 uses slightly higher grip strength cut-offs and a different chair stand threshold than EWGSOP2. Fifteen unique growing-pains criteria sets were found, with substantial inconsistency and occasional direct conflict among criteria components. The Polish-language RLS criteria adaptation uniquely includes pain in RLS sensation descriptions, unlike NIH and IRLSSG criteria. No universally accepted definition or criteria set for growing pains has been adopted by researchers or clinicians. Operational definitions vary, especially between EWGSOP2 and AWGS2. The protocol separates analyses by diagnostic framework to avoid an ambiguous combined prevalence estimate. Separate meta-analyses will be performed for EWGSOP2 and AWGS2 when quantitative synthesis is appropriate.