Physical activity levels and musculoskeletal disease risk in adults aged 45 and above: a cross-sectional study.
CHARLS
Metabolic equivalents
Middle-aged and older adults
Musculoskeletal disease
Physical activity
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
25 Oct 2024
25 Oct 2024
Historique:
received:
30
06
2024
accepted:
10
10
2024
medline:
26
10
2024
pubmed:
26
10
2024
entrez:
25
10
2024
Statut:
epublish
Résumé
Musculoskeletal disease (MSD) is a major cause of disability among older adults, and understanding the role of physical activity (PA) in preventing these conditions is crucial. This study aimed to explore the association between PA levels and MSD risk among adults aged 45 and above, clarify the dose‒response relationship, and provide tailored guidelines. Using data from the China Health and Retirement Longitudinal Study (CHARLS), a cross-sectional analysis was conducted on 15,909 adults aged 45 and over. The study population was divided into MSD (n = 7014) and nMSD (n = 8895) groups based on musculoskeletal health status. PA levels were assessed using the International Physical Activity Questionnaire and categorized into low intensity physical activity (LIPA), moderate vigorous physical activity (MVPA), and vigorous physical activity (VPA). Multivariable logistic regression models and restricted cubic spline regression were used to examine the relationship between PA levels and MSD risk in middle-aged and older adults. Sensitivity analyses and stratified analyses were also performed. The main outcome measures were musculoskeletal diseases prevalence and PA levels. MVPA and VPA reduced MSD risk by 19% [OR = 0.81, 95% CI (0.72, 0.90), P < 0.001] and 12% [OR = 0.88, 95% CI (0.79, 0.98), P < 0.05], respectively. What's more, after adjusting for confounding factors, VPA increased risk by 32% [OR = 1.32, 95% CI (1.04, 1.66), P < 0.05]. The relationship was nonlinear, showing a U-shaped pattern with age and hypertension status as significant moderators. The optimal PA energy expenditure was identified as approximately 1500 metabolic equivalents of tasks (METs) per week for adults aged 45-74, 1400 METs per week for those aged 75 and above, and 1600 METs per week for hypertensive adults aged 45 and older. For adults aged 45 years and older, VPA significantly increases the risk of MSD. Adults aged 45 years and older should adjust their weekly METs based on their age. Additionally, those with hypertension should moderately increase their weekly METs to promote optimal musculoskeletal health.
Sections du résumé
BACKGROUND
BACKGROUND
Musculoskeletal disease (MSD) is a major cause of disability among older adults, and understanding the role of physical activity (PA) in preventing these conditions is crucial. This study aimed to explore the association between PA levels and MSD risk among adults aged 45 and above, clarify the dose‒response relationship, and provide tailored guidelines.
METHODS
METHODS
Using data from the China Health and Retirement Longitudinal Study (CHARLS), a cross-sectional analysis was conducted on 15,909 adults aged 45 and over. The study population was divided into MSD (n = 7014) and nMSD (n = 8895) groups based on musculoskeletal health status. PA levels were assessed using the International Physical Activity Questionnaire and categorized into low intensity physical activity (LIPA), moderate vigorous physical activity (MVPA), and vigorous physical activity (VPA). Multivariable logistic regression models and restricted cubic spline regression were used to examine the relationship between PA levels and MSD risk in middle-aged and older adults. Sensitivity analyses and stratified analyses were also performed.
RESULTS
RESULTS
The main outcome measures were musculoskeletal diseases prevalence and PA levels. MVPA and VPA reduced MSD risk by 19% [OR = 0.81, 95% CI (0.72, 0.90), P < 0.001] and 12% [OR = 0.88, 95% CI (0.79, 0.98), P < 0.05], respectively. What's more, after adjusting for confounding factors, VPA increased risk by 32% [OR = 1.32, 95% CI (1.04, 1.66), P < 0.05]. The relationship was nonlinear, showing a U-shaped pattern with age and hypertension status as significant moderators. The optimal PA energy expenditure was identified as approximately 1500 metabolic equivalents of tasks (METs) per week for adults aged 45-74, 1400 METs per week for those aged 75 and above, and 1600 METs per week for hypertensive adults aged 45 and older.
CONCLUSIONS
CONCLUSIONS
For adults aged 45 years and older, VPA significantly increases the risk of MSD. Adults aged 45 years and older should adjust their weekly METs based on their age. Additionally, those with hypertension should moderately increase their weekly METs to promote optimal musculoskeletal health.
Identifiants
pubmed: 39455997
doi: 10.1186/s12889-024-20357-4
pii: 10.1186/s12889-024-20357-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2964Informations de copyright
© 2024. The Author(s).
Références
Collaborators GBDM. Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the global burden of Disease Study 2017. Lancet. 2018;392(10159):1684–735.
doi: 10.1016/S0140-6736(18)31891-9
Disease GBD, Injury I, Prevalence C. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the global burden of Disease Study 2017. Lancet. 2018;392(10159):1789–858.
doi: 10.1016/S0140-6736(18)32279-7
Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the global burden of Disease Study 2019. Lancet. 2021;396(10267):2006–17.
pubmed: 33275908
doi: 10.1016/S0140-6736(20)32340-0
Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356–67.
pubmed: 29573870
doi: 10.1016/S0140-6736(18)30480-X
Chen N, Fong DYT, Wong JYH. Secular trends in Musculoskeletal Rehabilitation needs in 191 countries and territories from 1990 to 2019. JAMA Netw Open. 2022;5(1):e2144198.
pubmed: 35044468
pmcid: 8771302
doi: 10.1001/jamanetworkopen.2021.44198
Zhou M, Wang H, Zeng X, Yin P, Zhu J, Chen W, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: a systematic analysis for the global burden of Disease Study 2017. Lancet. 2019;394(10204):1145–58.
pubmed: 31248666
pmcid: 6891889
doi: 10.1016/S0140-6736(19)30427-1
Gebreyesus T, Nigussie K, Gashaw M, Janakiraman B. The prevalence and risk factors of work-related musculoskeletal disorders among adults in Ethiopia: a study protocol for extending a systematic review with meta-analysis of observational studies. Syst Rev. 2020;9(1):136.
pubmed: 32513297
pmcid: 7282038
doi: 10.1186/s13643-020-01403-9
Williams A, Kamper SJ, Wiggers JH, O’Brien KM, Lee H, Wolfenden L, et al. Musculoskeletal conditions may increase the risk of chronic disease: a systematic review and meta-analysis of cohort studies. BMC Med. 2018;16(1):167.
pubmed: 30249247
pmcid: 6154805
doi: 10.1186/s12916-018-1151-2
Yang F, Di N, Guo WW, Ding WB, Jia N, Zhang H, et al. The prevalence and risk factors of work related musculoskeletal disorders among electronics manufacturing workers: a cross-sectional analytical study in China. BMC Public Health. 2023;23(1):10.
pubmed: 36597111
pmcid: 9809125
doi: 10.1186/s12889-022-14952-6
Zohair HMA, Girish S, Hazari A. Work-related musculoskeletal disorders among United Arab Emirates schoolteachers: an examination of physical activity. BMC Musculoskelet Disord. 2024;25(1):134.
pubmed: 38347534
pmcid: 10860240
doi: 10.1186/s12891-024-07256-w
Putsa B, Jalayondeja W, Mekhora K, Bhuanantanondh P, Jalayondeja C. Factors associated with reduced risk of musculoskeletal disorders among office workers: a cross-sectional study 2017 to 2020. BMC Public Health. 2022;22(1):1503.
pubmed: 35932005
pmcid: 9356480
doi: 10.1186/s12889-022-13940-0
Luo Y, Su B, Zheng X. Trends and challenges for Population and Health during Population Aging - China, 2015–2050. China CDC Wkly. 2021;3(28):593–8.
pubmed: 34594944
pmcid: 8393078
doi: 10.46234/ccdcw2021.158
Niederstrasser NG, Attridge N. Associations between pain and physical activity among older adults. PLoS ONE. 2022;17(1):e0263356.
pubmed: 35089966
pmcid: 8797193
doi: 10.1371/journal.pone.0263356
Stamatakis E, Straker L, Hamer M, Gebel K. The 2018 physical activity guidelines for americans: what’s new? Implications for clinicians and the public. J Orthop Sports Phys Therapy. 2019;49(7):487–90.
doi: 10.2519/jospt.2019.0609
Services USDHH. 2008 physical activity guidelines for americans. Volume 2008. Hyattsville, MD: Author, Washington, DC.; 2008. pp. 1–40.
Morrow JR Jr., Defina LF, Leonard D, Trudelle-Jackson E, Custodio MA. Meeting physical activity guidelines and musculoskeletal injury: the WIN study. Med Sci Sports Exerc. 2012;44(10):1986–92.
pubmed: 22525778
pmcid: 3445731
doi: 10.1249/MSS.0b013e31825a36c6
Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451–62.
pubmed: 33239350
doi: 10.1136/bjsports-2020-102955
Zhao Y, Strauss J, Yang G, Giles J, Hu P, Hu Y et al. China health and retirement longitudinal study–2011–2012 national baseline users’ guide. Beijing: National School of Development, Peking University. 2013;2:1–56.
Ekelund U, Tarp J, Steene-Johannessen J, Hansen BH, Jefferis B, Fagerland MW, et al. Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis. BMJ. 2019;366:l4570.
pubmed: 31434697
pmcid: 6699591
doi: 10.1136/bmj.l4570
Macfarlane DJ, Lee CC, Ho EY, Chan KL, Chan DT. Reliability and validity of the Chinese version of IPAQ (short, last 7 days). J Sci Med Sport. 2007;10(1):45–51.
pubmed: 16807105
doi: 10.1016/j.jsams.2006.05.003
Zeng Z, Bian Y, Cui Y, Yang D, Wang Y, Yu C. Physical activity dimensions and its association with risk of diabetes in Middle and older aged Chinese people. Int J Environ Res Public Health. 2020;17:21.
doi: 10.3390/ijerph17010021
Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett DR Jr, Tudor-Locke C, et al. 2011 Compendium of Physical activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011;43(8):1575–81.
pubmed: 21681120
doi: 10.1249/MSS.0b013e31821ece12
Bai A, Tao L, Huang J, Tao J, Liu J. Effects of physical activity on cognitive function among patients with diabetes in China: a nationally longitudinal study. BMC Public Health. 2021;21(1):481.
pubmed: 33706749
pmcid: 7948339
doi: 10.1186/s12889-021-10537-x
Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95.
pubmed: 12900694
doi: 10.1249/01.MSS.0000078924.61453.FB
Chu AH, Ng SH, Koh D, Müller-Riemenschneider F. Reliability and validity of the self-and interviewer-administered versions of the global physical activity questionnaire (GPAQ). PLoS ONE. 2015;10(9):e0136944.
pubmed: 26327457
pmcid: 4556683
doi: 10.1371/journal.pone.0136944
Cruz-Jentoft AJ, Sayer AA, Sarcopenia. Lancet. 2019;393(10191):2636–46.
pubmed: 31171417
doi: 10.1016/S0140-6736(19)31138-9
Petermann-Rocha F, Balntzi V, Gray SR, Lara J, Ho FK, Pell JP, et al. Global prevalence of Sarcopenia and severe Sarcopenia: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2022;13(1):86–99.
pubmed: 34816624
doi: 10.1002/jcsm.12783
Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020;21(3):300–7. e2.
pubmed: 32033882
doi: 10.1016/j.jamda.2019.12.012
Wang H, Men P, Xiao Y, Gao P, Lv M, Yuan Q, et al. Hepatitis B infection in the general population of China: a systematic review and meta-analysis. BMC Infect Dis. 2019;19(1):811.
pubmed: 31533643
pmcid: 6751646
doi: 10.1186/s12879-019-4428-y
Strain T, Wijndaele K, Dempsey PC, Sharp SJ, Pearce M, Jeon J, et al. Wearable-device-measured physical activity and future health risk. Nat Med. 2020;26(9):1385–91.
pubmed: 32807930
pmcid: 7116559
doi: 10.1038/s41591-020-1012-3
Schmid D, Ricci C, Baumeister SE, Leitzmann MF. Replacing sedentary time with physical activity in relation to Mortality. Med Sci Sports Exerc. 2016;48(7):1312–9.
pubmed: 26918559
doi: 10.1249/MSS.0000000000000913
Chastin SFM, De Craemer M, De Cocker K, Powell L, Van Cauwenberg J, Dall P, et al. How does light-intensity physical activity associate with adult cardiometabolic health and mortality? Systematic review with meta-analysis of experimental and observational studies. Br J Sports Med. 2019;53(6):370–6.
pubmed: 29695511
doi: 10.1136/bjsports-2017-097563
Kim W, Jin YS, Lee CS, Hwang CJ, Lee SY, Chung SG, et al. Relationship between the type and amount of physical activity and low back pain in koreans aged 50 years and older. PM R. 2014;6(10):893–9.
pubmed: 24780849
doi: 10.1016/j.pmrj.2014.04.009
Alzahrani H, Mackey M, Stamatakis E, Zadro JR, Shirley D. The association between physical activity and low back pain: a systematic review and meta-analysis of observational studies. Sci Rep. 2019;9(1):8244.
pubmed: 31160632
pmcid: 6547713
doi: 10.1038/s41598-019-44664-8
Lee JH, Yun I, Nam CM, Jang SY, Park EC. Association between physical activity and health-related quality of life in middle-aged and elderly individuals with musculoskeletal disorders: findings from a national cross-sectional study in Korea. PLoS ONE. 2023;18(11):e0294602.
pubmed: 37972082
pmcid: 10653435
doi: 10.1371/journal.pone.0294602
Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31.
pubmed: 30312372
doi: 10.1093/ageing/afy169
Sherrington C, Fairhall NJ, Wallbank GK, Tiedemann A, Michaleff ZA, Howard K et al. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Reviews. 2019;(1).
Brosseau L, Taki J, Desjardins B, Thevenot O, Fransen M, Wells GA, et al. The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part two: strengthening exercise programs. Clin Rehabil. 2017;31(5):596–611.
pubmed: 28183213
doi: 10.1177/0269215517691084
McPhee JS, French DP, Jackson D, Nazroo J, Pendleton N, Degens H. Physical activity in older age: perspectives for healthy ageing and frailty. Biogerontology. 2016;17:567–80.
pubmed: 26936444
pmcid: 4889622
doi: 10.1007/s10522-016-9641-0
Adams M, Gordt-Oesterwind K, Bongartz M, Zimmermann S, Seide S, Braun V, et al. Effects of Physical Activity interventions on Strength, Balance and Falls in Middle-aged adults: a systematic review and Meta-analysis. Sports Med Open. 2023;9(1):61.
pubmed: 37466877
pmcid: 10356733
doi: 10.1186/s40798-023-00606-3
Barrow DR, Abbate LM, Paquette MR, Driban JB, Vincent HK, Newman C, et al. Exercise prescription for weight management in obese adults at risk for osteoarthritis: synthesis from a systematic review. BMC Musculoskelet Disord. 2019;20(1):610.
pubmed: 31861990
pmcid: 6925458
doi: 10.1186/s12891-019-3004-3
Sanchez-Lastra MA, Ding D, Del Pozo Cruz B, Dalene KE, Ayan C, Ekelund U, et al. Joint associations of device-measured physical activity and abdominal obesity with incident cardiovascular disease: a prospective cohort study. Br J Sports Med. 2024;58(4):196–203.
pubmed: 37940366
doi: 10.1136/bjsports-2023-107252
Myers J, Kokkinos P, Nyelin E. Physical activity, Cardiorespiratory Fitness, and the metabolic syndrome. Nutrients. 2019;11(7).
Marriott CFS, Petrella AFM, Marriott ECS, Boa Sorte Silva NC, Petrella RJ. High-intensity interval training in older adults: a scoping review. Sports Med Open. 2021;7(1):49.
pubmed: 34279765
pmcid: 8289951
doi: 10.1186/s40798-021-00344-4
Atakan MM, Li Y, Kosar SN, Turnagol HH, Yan X. Evidence-based effects of High-Intensity Interval Training on Exercise Capacity and Health: a review with historical perspective. Int J Environ Res Public Health. 2021;18(13).
Juopperi S, Sund R, Rikkonen T, Kröger H, Sirola J. Cardiovascular and musculoskeletal health disorders associate with greater decreases in physical capability in older women. BMC Med. 2021;22:1–9.
Heneweer H, Vanhees L, Picavet HS. Physical activity and low back pain: a U-shaped relation? Pain. 2009;143(1–2):21–5.
pubmed: 19217208
doi: 10.1016/j.pain.2008.12.033
Hagen KB, Dagfinrud H, Moe RH, Østerås N, Kjeken I, Grotle M, et al. Exercise therapy for bone and muscle health: an overview of systematic reviews. BMC Med. 2012;10:1–11.
doi: 10.1186/1741-7015-10-167
Weyh C, Pilat C, Krüger K. Musculoskeletal disorders and level of physical activity in welders. Occup Med. 2020;70(8):586–92.
doi: 10.1093/occmed/kqaa169
Atakan MM, Li Y, Kosar SN, Turnagol HH, Yan X. Evidence-based effects of High-Intensity Interval Training on Exercise Capacity and Health: a review with historical perspective. Int J Environ Res Public Health. 2021;18(13):7201.
pubmed: 34281138
pmcid: 8294064
doi: 10.3390/ijerph18137201
Rhim HC, Tenforde A, Mohr L, Hollander K, Vogt L, Groneberg DA, et al. Association between physical activity and musculoskeletal pain: an analysis of international data from the ASAP survey. BMJ open. 2022;12(9):e059525.
pubmed: 36123076
pmcid: 9486184
doi: 10.1136/bmjopen-2021-059525
Alzahrani H, Shirley D, Cheng SWM, Mackey M, Stamatakis E. Physical activity and chronic back conditions: a population-based pooled study of 60,134 adults. J Sport Health Sci. 2019;8(4):386–93.
pubmed: 31333893
pmcid: 6620421
doi: 10.1016/j.jshs.2019.01.003
van der Molen HF, Visser S, Alfonso JH, Curti S, Mattioli S, Rempel D, et al. Diagnostic criteria for musculoskeletal disorders for use in occupational healthcare or research: a scoping review of consensus- and synthesised-based case definitions. BMC Musculoskelet Disord. 2021;22(1):169.
pubmed: 33573616
pmcid: 7879660
doi: 10.1186/s12891-021-04031-z
Armstrong T, Bull F. Development of the World Health Organization Global Physical Activity Questionnaire (GPAQ). J Public Health. 2006;14(2):66–70.
doi: 10.1007/s10389-006-0024-x
Tomioka K, Iwamoto J, Saeki K, Okamoto N. Reliability and validity of the International Physical Activity Questionnaire (IPAQ) in elderly adults: the Fujiwara-Kyo Study. J Epidemiol. 2011;21(6):459–65.
pubmed: 21946625
pmcid: 3899462
doi: 10.2188/jea.JE20110003
Hagstromer M, Oja P, Sjostrom M. The International Physical Activity Questionnaire (IPAQ): a study of concurrent and construct validity. Public Health Nutr. 2006;9(6):755–62.
pubmed: 16925881
doi: 10.1079/PHN2005898
Sember V, Meh K, Soric M, Starc G, Rocha P, Jurak G. Validity and reliability of International Physical Activity questionnaires for adults across EU countries: systematic review and Meta Analysis. Int J Environ Res Public Health. 2020;17:19.
doi: 10.3390/ijerph17197161
Alentorn-Geli E, Samuelsson K, Musahl V, Green CL, Bhandari M, Karlsson J. The Association of Recreational and competitive running with hip and knee osteoarthritis: a systematic review and Meta-analysis. J Orthop Sports Phys Ther. 2017;47(6):373–90.
pubmed: 28504066
doi: 10.2519/jospt.2017.7137