Musculoskeletal disorders among spousal caregivers of individuals with chronic motor disabilities: a cross-sectional study in Tunisia.

OBJECTIVES: To determine the prevalence and identify the independent factors associated with musculoskeletal disorders (MSDs) among spousal caregivers of individuals with chronic motor disabilities. DESIGN: A cross-sectional study. SETTING: The sole tertiary-level Physical Medicine and Rehabilitation Department serving its region in Tunisia. PARTICIPANTS: A consecutive sample of 142 spousal caregivers (response rate 85%) was recruited between January and June 2024. Inclusion criteria were being the primary spouse caregiver for an individual with a chronic motor disability (>6 months). Exclusion criteria included caregivers with pre-existing chronic musculoskeletal or rheumatic diseases or an inability to complete the questionnaire. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the prevalence of MSDs, assessed by the Nordic Musculoskeletal Questionnaire.Secondary outcomes included pain intensity (visual analogue scale (VAS)) and the identification of factors independently associated with MSDs. Associated factors (eg, caregiver burden by Zarit Burden Scale, fatigue by Checklist Individual Strength) were analysed using multivariate logistic regression. RESULTS: The prevalence of at least one MSD was 72.5% (103/142). Chronic low back pain (LBP) was the most common MSD (54.2%). Among affected caregivers, the mean pain intensity was 56.9±18.2 mm on the VAS, with 28.2% reporting severe pain (VAS≥70 mm). Multivariate regression analysis identified four independent predictors of MSDs: providing care for≥8 hours per day (adjusted OR (AOR)=10.06, 95% CI 1.24 to 81.38), a high caregiver burden (AOR=4.15, 95% CI 1.07 to 16.06), severe caregiver fatigue (AOR=3.10, 95% CI 1.24 to 7.72) and caring for an obese partner (AOR=3.07, 95% CI 1.00 to 9.40). CONCLUSIONS: The high prevalence of MSDs, particularly chronic LBP, among spousal caregivers highlights the significant physical strain associated with this role. The strong association with prolonged daily caregiving, high burden and fatigue identifies key modifiable risk factors. These findings suggest that the health of spousal caregivers is often overlooked, which could impact their long-term well-being and the quality of care they provide. Implementing targeted support interventions, such as ergonomic training and respite care, should be considered.