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

Rocha, José Afonso; Allison, Thomas G.; Santoalha, José; Araújo, Vítor; Pereira, Fernando Parada; Maciel, Maria Júlia

doi:10.1016/j.repce.2014.08.021

Cited by 4 publications

(7 citation statements)

References 23 publications

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“…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.…”

Section: Sex Differences In the Core Components Of Crmentioning

confidence: 97%

Sex Differences in Cardiac Rehabilitation Outcomes

Smith

Thomas

Bonikowske

et al. 2022

Circulation Research

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Cardiovascular disease is a leading cause of morbidity and mortality in males and females in the United States and globally. Cardiac rehabilitation (CR) is recommended by the American Heart Association/American College of Cardiology for secondary prevention for patients with cardiovascular disease. CR participation is associated with improved cardiovascular disease risk factor management, quality of life, and exercise capacity as well as reductions in hospital admissions and mortality. Despite these advantageous clinical outcomes, significant sex disparities exist in outpatient phase II CR programming. This article reviews sex differences that are present in the spectrum of care provided by outpatient phase II CR programming (ie, from referral to clinical management). We first review CR participation by detailing the sex disparities in the rates of CR referral, enrollment, and completion. In doing so, we discuss patient, health care provider, and social/environmental level barriers to CR participation with a particular emphasis on those barriers that majorly impact females. We also evaluate sex differences in the core components incorporated into CR programming (eg, patient assessment, exercise training, hypertension management). Next, we review strategies to mitigate these sex differences in CR participation with a focus on automatic CR referral, female-only CR programming, and hybrid CR. Finally, we outline knowledge gaps and areas of future research to minimize and prevent sex differences in CR programming.

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Section: Sex Differences In the Core Components Of Crmentioning

confidence: 97%

Sex Differences in Cardiac Rehabilitation Outcomes

Smith

Thomas

Bonikowske

et al. 2022

Circulation Research

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“…Our study demonstrated that women reported higher levels of pain and discomfort following ACS. Ongoing pain is an issue as this tends to occur in older women, is associated with higher cardiometabolic risk and negatively impacts participation in cardiac rehabilitation 27…”

Section: Discussionmentioning

confidence: 99%

Does sex predict quality of life after acute coronary syndromes: an Australian, state-wide, multicentre prospective cohort study

et al. 2019

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ObjectiveWomen have reported higher mortality and major adverse cardiovascular events (MACE) following acute coronary syndromes (ACSs) compared with men. With this in mind, we aimed to identify predictors of poor quality of life (QoL) post-ACS as our primary outcome. We examined predictors of MACE, major cerebrovascular events and major bleeding as our secondary outcome.DesignProspective cohort study.Setting30 metropolitan centres across the Victorian Cardiac Outcomes Registry network.Participants16 517 patients treated with percutaneous coronary intervention (PCI) for ACS (22.9% females). Selection/inclusion criteria: consecutive patients with successful or attempted PCI for ACS from 2013 to 2016, alive at 30 days post-PCI. Exclusion criteria: patients not fulfilling ACS criteria. At 30 days, 2497 (64.7% females) completed the QoL EQ-5D-3L instrument.Primary and secondary outcome measuresQoL, assessed using the EuroQo-5Dimensions (EQ-5D-3L) instrument by telephone at 30 days. Independent predictors of QoL were identified by univariate and multivariate logistic regression analyses.ResultsWomen were significantly older with more diabetes, cerebrovascular disease and renal failure. Regarding the primary outcome, female sex was independently associated with moderate/severe impairment in all EQ-5D-3L domains including mobility (OR 2.38, 95% CI 2.06 to 2.75, p<0.001), personal care (OR 2.14, 95% CI 1.73 to 2.66, p<0.001), activities of daily living (OR 1.84, 95% CI 1.63 to 2.08, p<0.001), pain/discomfort (OR 1.44, 95% CI 1.24 to 1.67, p<0.001) and anxiety/depression (OR 1.49, 95% CI 1.30 to 1.70, p<0.001). Women had significantly lower self-rated Visual Analogue Scale scores (80.0 for both groups, IQR 60-85 vs 70-90, p<0.001). There was no significant difference between the sexes in secondary outcomes.ConclusionsFemale sex was a predictor of poorer QoL following PCI for ACS including significantly higher pain, anxiety and depression. This was independent of age, comorbidities and ACS presentation. There is a clinical need for a tailored approach in female ACS management, for example, emphasis on management of depressive and anxiety symptoms.

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“…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.…”

mentioning

confidence: 99%

“…The diagnoses of sarcopenia or the presence of components of sarcopenia is associated with higher risk of developing CVD5 and higher CVD and all-cause mortality 12. The prevalence of reduced muscle mass and muscle strength at beginning of CR is high13 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.…”

mentioning

confidence: 99%