Fear of movement common among patients with CAD

In a Swedish cohort of patients with CAD, 20% demonstrated a high level of kinesiophobia, or fear of movement, 6 months after experiencing a cardiac event, researchers reported.

“Based on clinical experience, some patients with CAD are afraid to move their body after a coronary event and consequently avoid physical activity and exercise. It has been shown in other patient groups that kinesiophobia has a negative influence on the outcome of rehabilitation. However, the impact on kinesiophobia by clinical variables and rehabilitation outcomes for patients with CAD has not been previously investigated,” study researcher Maria Bäck, PhD, RPT, of Sahlgrenska Academy and University of Gothenburg in Sweden, told Cardiology Today.

Maria Bäck

Bäck and colleagues evaluated 332 patients (mean age, 65 years; 75 women) diagnosed with CAD between 2007 and 2009 at Sahlgrenska University Hospital in Sweden. They measured fear of movement using the Tampa Scale for Kinesiophobia Heart and assessed health-related quality of life, including general health and physical functioning, using the Short-Form 36 health survey questionnaire.

Besides finding that 20% of the cohort had a high level of kinesiophobia, the researchers also identified several variables that appeared to affect a patient’s likelihood of having high or low levels of kinesiophobia.

“Patients with a high level of kinesiophobia had a significantly lower attendance to cardiac rehabilitation, lower degree of physical activity, higher levels of anxiety and depression, and a worse health-related quality of life compared with patients with a low level of kinesiophobia,” Bäck said.

Specifically, results showed that attending cardiac rehabilitation decreased the odds for a high level of kinesiophobia by 56.7%, whereas participating in high vs. medium degrees of physical activity lowered the odds by 80.8%. Additionally, better general health and physical functioning reduced the odds by 4.3% and 1.8%, respectively.

Conversely, experiencing HF as a complication at the hospital and anxiety increased the likelihood for having a high level of kinesiophobia by 418.7% and 19.2%, respectively. Previous HF, however, was associated with a significant 88.3% reduction in kinesiophobia due to suppression.

The researchers noted no significant differences between groups in terms of age or sex, according to Bäck.

“An impact on kinesiophobia was identified by clinical variables with influence on rehabilitation outcomes and prognosis in patients with CAD,” Bäck said. “In light of these findings, kinesiophobia should receive attention in the cardiac rehabilitation of these patients and would benefit from future research.”

For more information:

Bäck M. Int J Cardiol. 2012;doi:10.1016/j.ijcard.2011.12.107.

Maria Bäck, PhD, RPT, can be reached at Institute of Medicine, Shalgrenska Academy, University of Gothenburg, Box 430, S-405 Gothenburg, Sweden; maria.m.back@vregion.se.

Disclosure: Bäck reports no relevant financial disclosures.