Musculoskeletal complaints in cardiac rehabilitation: Prevalence and impact on cardiovascular risk factor profile and functional and psychosocial status

Objective To assess the prevalence of musculoskeletal complaints and their association with risk factor profile and functional and psychosocial status in patients on a cardiac rehabilitation program. Methods In this cross-sectional study of 449 patients admitted within three months of an acute coronary syndrome, patients were divided into those with (MSC+) and those without (MSC-) musculoskeletal complaints. The Hospital Anxiety and Depression Scale and the Short Form 36 Health Survey were used to assess psychosocial status and quality of life, and the International Physical Activity Questionnaire for physical activity. Functional capacity was estimated from exercise testing. Results Musculoskeletal pain was present in 119 patients (27%), mainly in the lower limbs (56%). MSC+ were older (mean 56.5±9.9 vs. 53.2±9.5 years; p<0.001) and more frequently women (20.2% vs. 9.1%; p<0.001). MSC+ had a higher prevalence of dyslipidemia (68.6% vs. 51.2%; p<0.001), hypertension (51.7% vs. 35.5%; p<0.001), obesity (29.4% vs. 17.9%; p<0.001) and metabolic syndrome (44.5% vs. 31.5%; p<0.001). MSC+ showed higher body mass index and waist circumference, and lower physical activity levels (p<0.05), as well as lower functional capacity (8.6±2.2 vs. 9.6±2.1 MET; p<0.05), higher scores for depression (6 [3-9] vs. 3 [1-7]; p<0.05) and anxiety (7 [3-10] vs. 5 [2-8]; p<0.05), and lower scores for physical (44.1±8.7 vs. 47.6±7.6; p<0.05) and mental (39.2±13.0 vs. 44.0±13.0; p<0.05) quality of life. Conclusions Musculoskeletal complaints are common in cardiac rehabilitation and predict lower levels of physical activity, worse cardiovascular risk factor profile, and poorer functional capacity and psychosocial status, irrespective of age and gender.