Prevalência de condições musculoesqueléticas em pacientes cardíacos submetidos aos programas de reabilitação cardiovascular: revisão sistemática e metanálise

Abstract

Introduction: Cardiovascular rehabilitation based on physical exercises is one of the treatment strategies for cardiovascular diseases, but some factors may restrict the performance of exercises, such as musculoskeletal conditions. Although musculoskeletal conditions cause activity restrictions and have implications for the strategies used in the cardiovascular rehabilitation program, the management and evaluation of these musculoskeletal conditions are not usually seen as a priority in these programs. Notably, knowledge of musculoskeletal conditions would be important information for interprofessional providers to adapt therapeutic care to this population. Objective: To verify, through a systematic review and meta-analysis, the prevalence of musculoskeletal conditions in patients enrolled in a cardiovascular rehabilitation program. Methods: A comprehensive bibliographic search was carried out in may and june 2022 in five electronic databases. Observational studies that showed the prevalence of musculoskeletal conditions in patients with heart disease undergoing cardiovascular rehabilitation programs were eligible. The risk of study bias was assessed using the NewCastle-Ottawa Scale and the overall quality of evidence using the GRADE system. Results: Eight studies were included in this review, and rated from moderate to high methodological quality. The prevalence of musculoskeletal conditions in patients enrolled in a cardiac rehabilitation program was 57,5%, IC95%: 40,1-73,3; I2:98%. Common musculoskeletal conditions were arthritis with a prevalence of 49,0%, IC95%: 35,7-62,4; I2:98%, musculoskeletal pain with prevalence of 40,0% IC95%: 23,0- 60,0; I2: 98%, osteoporosis with a prevalence of 10,3%, IC95%: 8,3-12,7; I2:1%. Regarding the affected regions mentioned by the included studies, it was possible to find the prevalence of 14,7%, IC95%: 5,8 – 32,5; I2:95%, for the knee region and 9,4%, IC95%: 5,2-16,4; I2: 95%,for the spine. Conclusion: We found a high prevalence of musculoskeletal conditions and low to very low quality of evidence in the studies included in this review. Future studies are needed to scrutinize and standardize assessment instruments in this heart disease population with musculoskeletal conditions.