Physical therapy in the prevention of musculoskeletal sequelae in patients undergoing chronic psychotropic drug use: A literature review

Abstract

Introduction: Chronic use of psychotropic drugs is associated with significant musculoskeletal repercussions, including reduced strength, postural changes, loss of bone density, increased risk of falls, and functional impairment. These changes result from the interaction between pharmacological effects, biopsychosocial factors, and secondary sedentary lifestyle, requiring an interdisciplinary approach that integrates physical therapy, medicine, and educational strategies to prevent and minimize sequelae. Objective: We analyzed the impact of the integration of physical therapy and medicine in the prevention and management of musculoskeletal sequelae in patients undergoing prolonged use of psychotropic drugs, identifying effective rehabilitation strategies, functional protocols, and collaborative care mechanisms. Methods: This is a descriptive and analytical literature review based on national and international publications obtained from the Virtual Health Library (VHL), Latin American and Caribbean Health Sciences Literature (LILACS), PubMed, and Scopus databases. Eleven studies published between 2016 and 2025 were included, selected for their relevance to the musculoskeletal effects of psychotropic drugs, risk of falls, bone loss, motor changes, and interdisciplinary approaches aimed at preventing these outcomes. Results:  Evidence suggests that structured programs involving resistance exercises, balance training, lower limb strengthening, motor reeducation, and health education significantly reduce the functional impact of psychotropic drugs. Interventions associated with medical follow-up, including monitoring of side effects, pharmacological adjustment, and metabolic and bone risk assessment, have been shown to prevent falls, minimize bone mineral density loss, and improve mobility. Multidisciplinary models, educational support, and continuity of care strategies, including telerehabilitation, have proven to be decisive for adherence, engagement, and maintenance of results. Conclusion: An interdisciplinary approach between physical therapy and medicine is essential to prevent musculoskeletal sequelae in chronic users of psychotropic drugs. Individualized, evidence-based protocols combining therapeutic exercises, continuous clinical monitoring, and biopsychosocial strategies promote the preservation of functionality, postural stability, and autonomy. This collaborative model reaffirms the importance of professional integration and patient-centered care as essential pillars of contemporary musculoskeletal rehabilitation.