RT Journal Article
SR Electronic
T1 Impact of kinesiophobia on initiation of cardiac rehabilitation: a prospective cohort path analysis
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e066435
DO 10.1136/bmjopen-2022-066435
VO 12
IS 11
A1 Keessen, Paul
A1 Kan, Kees-Jan
A1 Ter Riet, Gerben
A1 Visser, Bart
A1 Jørstad, Harald
A1 Latour, Corine
A1 van Duijvenbode, Ingrid
A1 Scholte op Reimer, Wilma
YR 2022
UL http://bmjopen.bmj.com/content/12/11/e066435.abstract
AB Objectives To identify factors associated with kinesiophobia (fear of movement) after cardiac hospitalisation and to assess the impact of kinesiophobia on cardiac rehabilitation (CR) initiation.Design Prospective cohort study.Setting Academic Medical Centre, Department of Cardiology.Participants We performed a prospective cohort study in cardiac patients recruited at hospital discharge. In total, 149 patients (78.5% male) with a median age of 65 years were included, of which 82 (59%) were referred for CR.Primary and secondary outcome measures We assessed kinesiophobia with the Tampa Scale for Kinesiophobia (TSK). For this study, the total score was used (range 13–52). We assessed baseline factors (demographics, cardiac disease history, questionnaire data on anxiety, biopsychosocial complexity and self-efficacy) associated with kinesiophobia using linear regression with backward elimination. For linear regression, the standardised beta (β) was reported. Prospectively, the impact of kinesiophobia on probability of CR initiation, in the first 3 months after hospital discharge (subsample referred for CR), was assessed with logistic regression. For logistic regression, the OR was reported.Results Moderate and severe levels of kinesiophobia were found in 22.8%. In the total sample, kinesiophobia was associated with cardiac anxiety (β=0.33, 95% CI: 0.19 to 0.48), social complexity (β=0.23, 95% CI: 0.06 to 0.39) and higher education (β=−0.18, 95% CI: −0.34 to −0.02). In those referred for CR, kinesiophobia was negatively associated with self-efficacy (β=−0.29, 95% CI: −0.47 to −0.12) and positively with cardiac anxiety (β=0.43, 95% CI: 0.24 to 0.62). Kinesiophobia decreased the probability of CR initiation (ORRange13–52 points=0.92, 95% CI: 0.85 to 0.99).Conclusion In patients hospitalised for cardiovascular disease, kinesiophobia is associated with cardiac anxiety, social complexity, educational level and self-efficacy. Kinesiophobia decreased the likelihood of CR initiation with 8% per point on the TSK.Data are available upon reasonable request. Data are available on reasonable request. Requests for analyses of data from this study should be directed to PK (p.keessen@hva.nl).