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  1. Marzolini, Susan BPHE, MSc
  2. Candelaria, Henry BPHE, DC
  3. Oh, Paul MD, MSc


BACKGROUND: With the demographic of patients entering cardiac rehabilitation (CR) indicating an older and more obese population, musculoskeletal comorbidities (MSKCS) may be escalating.


METHODS: Musculoskeletal comorbidities affecting exercise were ascertained in 322 patients (233 men and 89 women) by a questionnaire and then an interview before and after 3 months of CR. Outcome variables were measured at baseline and 6 months.


RESULTS: Musculoskeletal comorbidities perceived to affect exercise were reported by 50% of subjects at CR entry (48.1% of males, 55.1% of females; P = .26); most commonly occurring in the knee(s) (25%) and back (19%) due predominantly to arthritis (36.6%) and strains/sprains (28.6%). Multivariate regression revealed that greater body mass, older age, and lower peak oxygen uptake (



) were predictors of baseline MSKCs. At entry, patients with MSKCs were less likely to be exercising 30 minutes or more, 5 times per week than those without MSKCs (17.4% vs 28%, respectively, P = .03). Exercise modifications were required for 33.5% of patients with MSKC. By 3 months, 15.2% of patients developed 62 new MSKCs (26.5% strains/sprains). Six months of CR yielded significant (P < .001) and similar improvements in



for patients with and without baseline MSKCs (16.3% and 18.8%, respectively, P = .28). The improvement was mitigated in those with arthritic conditions compared with others (7.8% vs 20%, respectively, P = .01). By 6 months, 31.1% and 29.8% of patients with and without baseline MSKCs respectively, discontinued CR (P = .81).


CONCLUSIONS: At entry to CR, patients reporting MSKCs had a poorer health profile than those without mskcs, including lower levels of physical activity and cardiovascular fitness, and unfavorable anthropometric measures. With exercise modifications, significant benefits were achievable without affecting compliance.