title: Age, physical inactivity, obesity, health conditions, and health-related quality of life among patients receiving conservative management for musculoskeletal disorders.
abstract: BACKGROUND
  Musculoskeletal conditions and insufficient physical activity have substantial personal and economic costs among contemporary aging societies. This study examined the age distribution, comorbid health conditions, body mass index (BMI), self-reported physical activity levels, and health-related quality of life of patients accessing ambulatory hospital clinics for musculoskeletal disorders. The study also investigated whether comorbidity, BMI, and self-reported physical activity were associated with patients' health-related quality of life after adjusting for age as a potential confounder.
  
  
  METHODS
  A cross-sectional survey was undertaken in three ambulatory hospital clinics for musculoskeletal disorders. Participants (n=224) reported their reason for referral, age, comorbid health conditions, BMI, physical activity levels (Active Australia Survey), and health-related quality of life (EQ-5D). Descriptive statistics and linear modeling were used to examine the associations between age, comorbidity, BMI, intensity and duration of physical activity, and health-related quality of life.
  
  
  RESULTS
  The majority of patients (n=115, 51.3%) reported two or more comorbidities. In addition to other musculoskeletal conditions, common comorbidities included depression (n=41, 18.3%), hypertension (n=40, 17.9%), and diabetes (n=39, 17.4%). Approximately one-half of participants (n=110, 49.1%) self-reported insufficient physical activity to meet minimum recommended guidelines and 150 (67.0%) were overweight (n=56, 23.2%), obese (n=64, 28.6%), severely obese (n=16, 7.1%), or very severely obese (n=14, 6.3%), with a higher proportion of older patients affected. A generalized linear model indicated that, after adjusting for age, self-reported physical activity was positively associated (z=4.22, P<0.001), and comorbidities were negatively associated (z=-2.67, P<0.01) with patients' health-related quality of life.
  
  
  CONCLUSIONS
  Older patients were more frequently affected by undesirable clinical attributes of comorbidity, obesity, and physical inactivity. However, findings from this investigation are compelling for the care of patients of all ages. Potential integration of physical activity behavior change or other effective lifestyle interventions into models of care for patients with musculoskeletal disorders is worthy of further investigation.
authors.affiliation: Centre for Functioning and Health Research, Metro South Health, Brisbane, QLD, Australia ; Institute of Health and Biomedical Innovation, and School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.
authors.forename: Steven M
authors.initials: SM
authors.lastname: McPhail
authors.affiliation: Centre for Functioning and Health Research, Metro South Health, Brisbane, QLD, Australia ; Institute of Health and Biomedical Innovation, and School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.
authors.forename: Mandy
authors.initials: M
authors.lastname: Schippers
authors.affiliation: Institute of Health and Biomedical Innovation, and School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.
authors.forename: Alison L
authors.initials: AL
authors.lastname: Marshall
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015992:Body Mass Index; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009140:Musculoskeletal Diseases / Q000453:epidemiology* / Q000628:therapy*; D011788:Quality of Life; D057185:Sedentary Behavior; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: aging; comorbidity; orthopedic; overweight; physical activity; sedentary