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

Abstract

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.

Sex Differences in Cardiac Rehabilitation Outcomes

“…71 Importantly, females with CVD are more likely to exhibit musculoskeletal issues than males with knee, hip, and back pain as being the most commonly reported concerns. 57,70,72–74 As noted above, females are more likely to withdraw from a CR program compared with males due to musculoskeletal issues. 52 Further, these issues will negatively impact the patient’s ability to perform specific exercise modalities and intensities and as a result, these patients may have lesser increases in VO 2 peak following CR.…”

Resistance Training in Patients With Coronary Artery Disease, Heart Failure, and Valvular Heart Disease

“…31 Lower body muscle weakness is prominent in patients with CAD compared with healthy controls with markedly reduced quadriceps isometric endurance resulting in enhanced skeletal muscle fatigue. 32 Upon entry to CR, elderly patients 14,15 and those with diabetes 16 are likely to have significant reductions in muscle strength and functional capacity, especially when these patients undergo CR after coronary artery bypass grafting surgery. The use of the Short Physical Performance Battery Score (SPPB) in older patients (>75 yr) at entry to CR early after cardiac surgery classified 44% of patients with severe or moderate physical limitations.…”

“…14 Comorbidities such as arthritis, osteoporosis and age-related sarcopenia, low exercise and functional capacity, and overall reduced physical performance are more frequently diagnosed in elderly individuals. 3,14,15 These conditions are the main causes of limitations and disability in daily living. Deconditioning of the skeletal muscle is more prevalent in patients with diabetes mellitus, 16 heart failure (HF), 17,18 and/or valvular heart diseases (VHDs).…”

“…12 The prevalence of reduced muscle mass and muscle strength at beginning of CR is high 13 and musculoskeletal comorbidities are common. 14 Comorbidities such as arthritis, osteoporosis and age-related sarcopenia, low exercise and functional capacity, and overall reduced physical performance are more frequently diagnosed in elderly individuals. 3,14,15 These conditions are the main causes of limitations and disability in daily living.…”

SCAI Expert Consensus Statement on Sex-Specific Considerations in Myocardial Revascularization

“…While compliance with optimal medical therapy and regular participation in cardiac rehabilitation programs may be able to improve residual angina, studies have shown that depression, pain, caregiving demands, and poorer socioeconomic status all impact the ability of patients to engage in recommended medical care. [172][173][174][175] The development of targeted programs to address limitations affecting female participation in cardiac rehab and medical follow-up as well as early identification of women with poorer HRQoL at baseline may be useful to improve the health status of women with CAD after revascularization.…”