Trends in Global Musculoskeletal Rehabilitation Needs from 1990 to 2050: A Systematic Analysis of the Global Burden of Disease Study 2021.

Abstract

This study aims to analyze musculoskeletal disorders (MSDs) prevalence trends, gender, age and regional inequalities to improve prevention and treatment strategies. This study analyzed epidemiological trends and health inequities of seven MSDs [rheumatoid arthritis (RA), osteoarthritis (OA), low back pain (LBP), neck pain (NP), amputations, fractures, and other injuries] from 1990 to 2021 using Global burden of diseases (GBD) data. Joinpoint regression and Autoregressive Integrated Moving Average (ARIMA) models assessed historical trends and projected burdens to 2050. Gender, age, and Socio-demographic Index (SDI) differences in MSDs burden were also analyzed. MSDs are a major cause of global disability, affecting life quality and socioeconomic systems. Data from the GBD 2021 on the prevalence and years lived with disability (YLDs) of seven major MSDs across different ages and genders in 204 countries and territories from 1990 to 2021. NOT Applicable. Measures Building upon the data from GBD 2021, our primary outcomes focused on quantifying the epidemiological burden of seven MSDs through age-standardized prevalence rates (ASPR) and years lived with disability rates (ASDR), while examining their temporal trends using Joinpoint regression for historical patterns (1990-2021) and ARIMA modeling for future projections (2022-2050). We further evaluated health inequities by analyzing disparities related to gender and age, along with socioeconomic inequalities measured through the Slope Index of Inequality (SII) and Concentration Index (CI) across five SDI quintiles. These comprehensive assessments were applied to seven MSDs to provide a complete picture of global rehabilitation needs and their evolving patterns. From 1990 to 2021, global MSDs burden increased markedly, with OA exhibiting the most pronounced rise in prevalence (6069.89 per 100,000, 95%UI 5378.74∼6705.20). By 2050, OA will dominate the disease burden, particularly among females, and fractures will exhibit diverging trends. Specifically, declining in high-SDI regions and rising in low-SDI areas. Most MSDs (OA/LBP/NP/RA) exhibited similar gender differences. At the same time, the increase in age leads to a significant increase in the burden of RA. The burden of MSDs among women and the elderly highlights the urgent needs for equitable rehabilitation resources. This study highlights the escalating burden of MSDs, driven by aging populations, lifestyle changes, and unequal access to healthcare. Enhancing the quality and coverage of rehabilitation services particularly in low SDI regions, and addressing gender and age disparities are crucial for mitigating global impact of MSDs.