How does kinesiophobia change over time in patients with acute coronary artery disease?

• The occurrence of kinesiophobia and the impact on kinesiophobia by clinical variables with influence on rehabilitation outcomes in exercise-based cardiac rehabilitation (CR) has by us been identified six months after acute coronary artery disease (CAD). However, the occurrence of kinesiophobia in the acute phase of CAD and how it changes over time has not previously been studied. Moreover, the gender perspective has not been highlighted. The primary purpose was to identify levels of kinesiophobia in the acute phase of CAD and to study changes over time and in relation to gender. Participants: In total, 105 patients with CAD (25 women), mean age 63.1±11.5 were included in the study at the cardiac intensive care, Sahlgrenska University Hospital, Sweden between October 2013 and June 2014. Design and statistics: The patients were asked to fill in a set of questionnaires including the Tampascale for Kinesiophobia Heart (TSK-SV Heart), the Hospital Anxiety and Depression Scale (HADS), Harm Avoidance (HA) and the Positive and Negative Affect Schedule (PANAS). The patients filled in the questionnaires at three different time points: At the cardiac intensive care (T1), after 2 weeks (T2) and after 4 months (T3). A linear mixed model (LMM) procedure was used to compare kinesiophobia across time points. The within-subjects-design factor was data collection time (T1-T3), and the between-subjects-design factor was gender. The dependent variable was kinesiophobia. The questionnaires reflecting personality traits and affective states (HADS, PANAS, HA) were used as covariates in order to discover any effects these might have on differences across groupings. Covariates were included in two steps: first all five, then only those that contributed significantly at p-level < 0.05. Thirty-five patients were excluded due to loss of follow-up or missing data. The mean value on the TSK-SV Heart was 32.1 at T1, 30.3 at T2 and 29.2 at T3. The presence of a high level of kinesiophobia was 24% at T1 and 19% at T2 and T3. Without covariates, there was an effect of gender (p=0.011), with a higher TSK-SV Heart mean score for women, and over time points (p=0.013), with lower TSK-SV Heart mean score at T3. No interaction effect was found. Inclusion of the covariates showed that the HADS variables had no impact on kinesiophobia. Although negative affect (p=0.016), positive affect (p=0.002), and HA (p=0.057) had impact on kinesiophobia, this did not influence the significane of gender (p=0.042) and over time points (p=0.004). Kinesiophobia decreased over time after acute CAD, independent of patients´ personality traits and affective states. Female gender had a significant influence on kinesiohobia. Still 19% of the patients were identified with a high level of kinesiophobia at T3. The further establishment of the impact of kinesiophobia in CR and the design of a treatment intervention should be prioritized in future studies. The results of this study suggest that it is desirable to screen for kinesiophobia in the acute phase of CAD, as recognition may facilitate the appropriate treatment for these patients with the overall target of enhancing attendance at CR.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Sjukgymnastik (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Physiotherapy (hsv//eng)

Keyword

coronary artery disease

exercise-based cardiac rehabilitation

kinesiophobia

Publication and Content Type

vet (subject category)

kon (subject category)