Impact Of Musculoskeletal Conditions Research Articles

Impact of musculoskeletal conditions on the perioperative period in patients with stable coronary artery disease

Abstract Background The aging of the population increases the number of elderly patients undergoing cardiac surgery. Despite the proven effectiveness of coronary bypass graft (CABG) surgery, it can lead to postoperative complications, similar to any other medical intervention. The early postoperative complications are associated directly with the clinical status of the patient. Most recent studies have focused on the effect of patient's musculoskeletal conditions on quality of life, disability and mortality. However, there are few studies devoted to assessment of the impact of musculoskeletal conditions on the course of the postoperative period in patients treated with CABG. Aim To evaluate the impact of musculoskeletal conditions on the early postoperative period in CABG patients with stable coronary artery disease (CAD). Materials and methods 387 patients aged 65 (59; 69) years with stable CAD, scheduled for CABG were enrolled in the study. Before enrollment all patients signed an informed consent form. For the assessment of the musculoskeletal function, sarcopenia was defined in accordance with the European Working Group on Sarcopenia in Older People (EWGSOP, 2019) and osteopenic syndrome (osteopenia/osteoporosis) was defined in accordance with the World Health Organization (WHO,2008). Osteosarcopenia was diagnosed in cases of co-existent sarcopenia and osteopenia/osteoporosis. The patients were divided into two groups according to the presence of musculoskeletal disorders. The 1st group included 105 (27.1%) patients: 52 (49.5%) with sarcopenia; 28 (26.7%) with osteopenic syndrome (osteopenia/osteoporosis) and 25 (23.8%) with osteosarcopenia. The 2nd group included 282 (72.9%) patients without musculoskeletal conditions. The analyzed groups were comparable in age, gender and comorbidities. CABG was performed via a midline sternotomy incision with the cardiopulmonary bypass. In the postoperative period, the total number of developed complications (cardiovascular, surgical, pulmonary) in patients with CAD was taken into account. Statistical analysis was performed using the Statistica software. Results In the early postoperative period, the total number of complications was statistically higher among patients who initially had musculoskeletal disorder. The prevalence of complications was higher in the 1st group of patients - 80 out of 105 (76.2%), while patients without musculoskeletal conditions demonstrated a 1.17 times lower prevalence - 183 out of 282 (64.99%), p=0.034. The incidence and the strength of association was estimated by the odds ratio (OR) and 95% confidence interval (CI). The presence of the initial musculoskeletal disorder was found associated with the 1.7 times increased risk of complications after CABG (OR =1.73, 95% CI: 1.03–2.89, p=0.035). Conclusions The presence of the musculoskeletal condition in CABG patients with CAD is a predictor of early adverse effects in the postoperative period. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The study was supported by Federal State Budgetary Institution of Higher Education “Kemerovo State University” (Contract No. 1327/2020/223, under the Agreement No. 075-15-2020-766 made as of 14th of December, 2020, entitled “Patient-centered care for patients with coronary artery disease and osteosarcopenia who underwent coronary artery bypass graft surgery”).

Impact of musculoskeletal conditions among those in residential aged care in Australia.

To determine the prevalence of musculoskeletal conditions, co-morbidity and functional limitations in older people in residential aged care in Australia and the association of musculoskeletal conditions with mortality. A retrospective cohort study using data from 490325 people in the Registry of Senior Australians was conducted between 2004 and 2014. The association of co-morbidity, health risk factors and functional limitations with musculoskeletal conditions was evaluated using logistic regression. Cox regression was used to examine the association with mortality. Overall, 40.2% [95% CI 40.1-40.4]) of residents had a musculoskeletal condition, which was associated with limited social (OR 1.16 [95% CI 1.14-1.19]) and domestic activities (OR 1.44 [95% CI 1.39-1.49]). Residents with musculoskeletal conditions had a 15% lower risk of mortality (aHR 0.85 [95% CI 0.85-0.86], P<0.001) compared to residents without. The presence of musculoskeletal conditions in older people in residential aged care negatively impacts activities of daily living and quality of life rather than mortality.

The Impact of Musculoskeletal Conditions on Assessed Levels of Care Required by Older Australians

IntroductionMusculoskeletal problems, including conditions such as back pain, neck pain, rheumatoid arthritis, gout and osteoarthritis are common in the population and significant contributors to global disease burden. Age is one of the most common risk factors for musculoskeletal conditions and over 40% of older people accessing residential aged care have a musculoskeletal condition. It is not known whether individuals living in the community with musculoskeletal conditions have similar needs to those in permanent care and this is important to know in order to provide appropriate care.&#x0D; Objectives and ApproachThe objective of this study was to profile individuals with musculoskeletal conditions in different aged care service settings (i.e. permanent care, community care only, transition/ respite care, or no services). Specifically, we examined the concurrent chronic conditions, health risk factors and functional limitations of individuals by service setting. A cross-sectional evaluation of individuals in the National Historical Cohort of the Registry of Senior Australians (ROSA) between 2004 and 2014 was conducted. Multivariable logistic regression models estimated the factors associated with being in different aged care settings. Odds ratios (OR) and 95% confidence intervals (CI) were determined.&#x0D; Results401,026 (42.5%) individuals with musculoskeletal conditions were assessed for aged care service eligibility during the study period. Of these 197,181 (49.2%) accessed permanent care, 37,003 (9.2%) accessed home care, 54,826 (13.7%) transition/respite, and 112,016 (27.9%) - no care. Individuals accessing community care compared to residential care were more likely to be female, have pain and have difficulty maintaining their home, as were individuals accessing no services compared to residential care.&#x0D; Conclusion / ImplicationsCompared to those in residential care, individuals with musculoskeletal conditions in the community with or without assistance had few differences related to other chronic conditions and functional limitations. But the reasons why some had support, while others did not, are unclear.

Models of care for musculoskeletal health: a cross-sectional qualitative study of Australian stakeholders' perspectives on relevance and standardised evaluation.

BackgroundThe prevalence and impact of musculoskeletal conditions are predicted to rapidly escalate in the coming decades. Effective strategies are required to minimise ‘evidence-practice’, ‘burden-policy’ and ‘burden-service’ gaps and optimise health system responsiveness for sustainable, best-practice healthcare. One mechanism by which evidence can be translated into practice and policy is through Models of Care (MoCs), which provide a blueprint for health services planning and delivery. While evidence supports the effectiveness of musculoskeletal MoCs for improving health outcomes and system efficiencies, no standardised national approach to evaluation in terms of their ‘readiness’ for implementation and ‘success’ after implementation, is yet available. Further, the value assigned to MoCs by end users is uncertain. This qualitative study aimed to explore end users’ views on the relevance of musculoskeletal MoCs to their work and value of a standardised evaluation approach.MethodsA cross-sectional qualitative study was undertaken. Subject matter experts (SMEs) with health, policy and administration and consumer backgrounds were drawn from three Australian states. A semi-structured interview schedule was developed and piloted to explore perceptions about musculoskeletal MoCs including: i) aspects important to their work (or life, for consumers) ii) usefulness of standardised evaluation frameworks to judge ‘readiness’ and ‘success’ and iii) challenges associated with standardised evaluation. Verbatim transcripts were analysed by two researchers using a grounded theory approach to derive key themes.ResultsTwenty-seven SMEs (n = 19; 70.4 % female) including five (18.5 %) consumers participated in the study. MoCs were perceived as critical for influencing and initiating changes to best-practice healthcare planning and delivery and providing practical guidance on how to implement and evaluate services. A ‘readiness’ evaluation framework assessing whether critical components across the health system had been considered prior to implementation was strongly supported, while ‘success’ was perceived as an already familiar evaluation concept. Perceived challenges associated with standardised evaluation included identifying, defining and measuring key ‘readiness’ and ‘success’ indicators; impacts of systems and context changes; cost; meaningful stakeholder consultation and developing a widely applicable framework.ConclusionsA standardised evaluation framework that includes a strong focus on ‘readiness’ is important to ensure successful and sustainable implementation of musculoskeletal MoCs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-1173-9) contains supplementary material, which is available to authorized users.

How can we assess the burden of muscle, bone and joint conditions in rural Botswana: context and methods for the MuBoJo focused ethnography

BackgroundMusculoskeletal diseases are the most common causes of long-term pain and disability worldwide and a growing international public health concern. However, the everyday burden and impact of musculoskeletal conditions are not well understood, especially among people living in low- and middle-income countries in Africa. Since 2011, World Spine Care, a nongovernmental organisation, has collaborated with the Botswana Ministry of Health to open spine care centres and to conduct research. The broad aim of the Muscle, Bone and Joint (MuBoJo) research project is to examine the sociocultural, organisational and clinical characteristics for the burden of living with and caring for people living with musculoskeletal conditions in rural Botswana. In this paper, we describe the community context, theoretical framework, and research methods to address the project aim with a qualitative study.Methods/DesignThis focused ethnography is based on eight months (November 2011, April 2013, October 2013-March 2014) of fieldwork in Botswana. The project was theoretically informed by the concepts of explanatory models of illness, social suffering, and biographical disruption. Data collection included fieldnotes, non-participant and participant observations, and informal and in-depth interviews with villagers and healthcare providers. Villager interviews were typically conducted in Setswana with an interpreter. Audio recordings were transcribed verbatim in the language spoken with Setswana contextually translated into English. Computer software supported qualitative data management. Analysis is ongoing using constant comparison and a template organising style to facilitate pattern-finding and reveal insights for the burden and care of musculoskeletal conditions.DiscussionFindings from the MuBoJo Project will document the context of musculoskeletal burden, illness beliefs, self-care behaviours, and healthcare options in a Botswana rural village. These data will inform ongoing efforts to establish spine care clinics for underserved populations in low-middle income countries and sustain these healthcare services through local providers and volunteer health professionals. This study also will generate new knowledge about the burden and impact of muscle, bone and joint disorders for cross-cultural comparisons and patient-centred interventions.ConclusionsOur systematic and transparent methodology to conduct musculoskeletal research in more than one language and in a cross-cultural setting may be useful for investigators and NGO healthcare personnel.Electronic supplementary materialThe online version of this article (doi:10.1186/s12998-015-0056-9) contains supplementary material, which is available to authorized users.

SP0026 How to use the new data from eumusc.net to support national political campaigning

The Musculoskeletal Surveillance and Information network (EUMUSC.NET) is a project supported by the European Commission, EULAR and 23 centres across Europe. It intends to raise and harmonise quality of care...

What is the prevalence of musculoskeletal problems in the elderly population in developed countries? A systematic critical literature review.

BackgroundThe proportion of older people will be tripled by the year 2050. In addition, the incidence of chronic musculoskeletal (MSK) conditions will also increase among the elderly people. Thus, in order to prepare for future health care demands, the magnitude and impact of MSK conditions from this growing population is needed. The objective of this literature review is to determine the current prevalence of MSK disorders in the elderly population.MethodsA systematic literature search was conducted in Pubmed on articles in English, published between January 2000 and July 2011. Studies from developed countries with prevalence estimates on elderly people (60+) on the following MSK conditions were included: Non-specific extremity pain, rheumatoid arthritis, osteoarthritis, osteoporosis, and back pain. The included articles were extracted for information and assessed for risk of bias.ResultsA total of 85 articles were included with 173 different prevalence estimates. Musculoskeletal disorders are common in the elderly population, but due to heterogeneity of the studies, no general estimate on the prevalence of MSK can be determined. Women report more often MSK pain than men. Overall, prevalence estimates either remain fairly constant or increase slightly with increasing age, but with a tendency to decrease in the oldest (80+) people.ConclusionsMusculoskeletal disorders remain prevalent in the elderly population. Given the increasing proportion of elderly population in the world population and the burden of MSK diseases among the elderly people, efforts must be made to maintain their functional capacity for as long as possible through optimal primary and secondary health care.