BACKGROUND: Children spend a lot of time in school, and there are many ergonomic hazards and postural malalignments that put children at greater risk of developing musculoskeletal disorders (MSDs). This study aimed to investigate the effect of exercise therapy on preventing and treating musculoskeletal disorders among school-aged children. METHOD: This randomised controlled trial included 212 (121 boys and 91 girls) school-aged children aged 13 to 15 years assigned to treatment (n = 106) and prevention (n = 106) groups, where the treatment group contained individuals with MSDs and prevention group contained individuals without MSDs. In each group, half of the individuals received exercise therapy (50 min per session, four times per week, for an 8-week), and others continued their daily lives. MSDs and physical activity were assessed by the Teen Nordic Musculoskeletal Screening Questionnaire and the International Physical Activity Questionnaire-Short Form, respectively, at baseline and after the experimental protocol. RESULTS: There was a statistically significant reduction in the frequency of MSDs in the treatment group and occurring MSDs in the prevention group (p <= 0.05). Also, there was significant improvement in all variables of walking, moderate physical activity, vigorous physical activity, and total in intervention groups spatially in students who received exercise therapy (p <= 0.05). CONCLUSIONS: This study demonstrated the effectiveness of exercise therapy in reducing and preventing MSDs and improving physical activity levels among school-aged children aged 13 to 15 years. TRIAL REGISTRATIONS: Ethical Committee of Shahrekord University (IR.SKU.REC.1401.022) (registration date: 31/05/2022).

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