Prevalence of Musculoskeletal Conditions in Heart Patients Undergoing Cardiovascular Rehabilitation Programs: A...

Exercise-based cardiovascular rehabilitation is an essential strategy for managing cardiovascular diseases. However, some factors, such as musculoskeletal conditions, may limit exercise capacity and adherence. Although musculoskeletal conditions can lead to activity limitations and influence the strategies used in cardiovascular rehabilitation programs, their management and evaluation are often under-recognized. Knowledge of these conditions is important for interprofessional providers to adapt therapeutic care for this population. This study aimed to verify, through a systematic review and meta-analysis, the prevalence of musculoskeletal conditions in patients enrolled in cardiovascular rehabilitation programs. The search strategy was updated and last executed in May 2024 in the following electronic databases: MEDLINE, EMBASE, CINAHL, Web of Science, and SCOPUS. Observational studies that showed the prevalence of musculoskeletal conditions in patients with heart disease undergoing cardiovascular rehabilitation programs were eligible. To assess the risk of bias in the studies, we used the Newcastle-Ottawa Scale, and to check the overall quality of the evidence, we used the GRADE system. A total of 2,638 studies were screened, of which eight met the inclusion criteria and were rated as having moderate to high methodological quality. The prevalence of musculoskeletal conditions in patients enrolled in a cardiac rehabilitation program was 57.5%, CI 95%: 40.1-73.3; I²: 98%. Common musculoskeletal conditions were arthritis with a prevalence of 49.0%, CI 95%: 35.7-62.4; I²: 98%, musculoskeletal pain with a prevalence of 40.0%, CI 95%: 23.0-60.0; I²: 98%, and osteoporosis with a prevalence of 10.3%, CI 95%: 8.3-12.7; I²: 1%. In the studies included in this review, we found a high prevalence of musculoskeletal conditions. Future studies will be necessary to scrutinize and analyze whether the type, intensity, frequency, and duration of physical exercises proposed in cardiovascular rehabilitation programs can improve or worsen musculoskeletal conditions. These findings highlight the need to integrate musculoskeletal assessment and management into cardiac rehabilitation practice.