The interplay between physical activity, chronic musculoskeletal disorders, and related comorbidities in 87,648 Brazilian adults: a cross-sectional, population-based study

Aim To perform a subanalysis of the Brazilian National Health Survey 2019 focusing on estimating the prevalence of chronic musculoskeletal disorders (MSKDs) and to assess the impact of leisure-time physical activity (LTPA) on the associations of depression, sleep disorders, and obesity with chronic MSKDs. Subject and Methods This cross-sectional, nationwide study included 87,648 adults, with prevalence ratios estimated from weighted sample strata. Poisson regression models with robust variance estimated the prevalence ratio (PR) with 95% confidence interval (CI) of chronic MSKDs according to depression, sleep disorders, BMI, and LTPA. Interaction models of marginal effects evaluated the influence of LTPA on the predicted probability of chronic MSKDs considering the presence of other comorbidities. Results The weighted prevalence of chronic MSKDs was 26.1% (95%CI 25.5-26.8%), and it was associated with depression [PR: 2.55 (95% CI: 2.35-2.77), p < 0.001], sleep disorders [PR: 2.32 (95% CI: 2.17-2.48), p < 0.001], and obesity [PR: 1.39 (95% CI: 1.29-1.39), p < 0.001], while it inversely associated with LTPA [PR: 0.92 (95% CI: 0.86-0.99), p = 0.020]. Although depression, sleep disorders and obesity increased the chances for having chronic MSKDs, adherence to international physical activity guidelines was associated with a lower predicted probability of chronic MSKDs, regardless of the associated comorbidities. Conclusions In Brazil, chronic MSKDs were highly prevalent and associated with other disabling comorbidities. Yet the associations were attenuated by meeting current physical activity recommendations. Highlights center dot Chronic musculoskeletal disorders (MSKDs) afflict over 40 million Brazilian adults. center dot MSKDs are associated with high BMI, depression, and unhealthy lifestyle factors. center dot MSKDs are inversely associated with leisure-time physical activity (LTPA) levels. center dot LTPA attenuates the associations of MSKDs with BMI, depression and sleep disorders.