Fear of movement affects 20% of patients with coronary artery disease

A doctoral thesis at Sahlgrenska Academy, University of Gothenburg, Sweden, has found that one out of five patients with coronary artery disease experience such a great fear of movement (kinesiophobia) that their health may suffer as a result.

Due to fear that movement will harm them, many patients with coronary artery disease avoid exercise and physical activity. Kinesiophobia, which is a normal psychological reaction in the acute stage after a coronary event, prevents many patients from participating in a cardiac rehabilitation program.

A doctoral thesis by researchers at Sahlgrenska Academy, University of Gothenburg, demonstrates that kinesiophobia is more common than previously believed. Doctoral student Maria Bäck looked at 332 patients with coronary artery disease six months after the acute cardiac event. She found occurrence of kinesiophobia in one out of every five patients.

"The situation is serious," Ms. Bäck says. "Patients with kinesiophobia were less likely to participate in cardiac rehabilitation, performed worse on muscle tests and reported less physical activity, primarily medium and high-frequency activities. They also experienced poorer quality of life, as well as higher degrees of anxiety and depression, than patients without kinesiophobia.

This is the first study exploring kinesiophobia in patients with coronary artery disease. The phenomenon is familiar to clinical practitioners, however, and studies of other patient populations - particular those with chronic pain - have found that kinesiophobia poses an obstacle to successful rehabilitation.

Ms. Bäck's thesis shows that attending exercise-based cardiac rehabilitation decreases the odds for kinesiophobia. The researchers concluded that patients with kinesiophobia must be identified as early as possible after a cardiac event, if they are to follow through on exercise-based cardiac rehabilitation

"Exercise-based cardiac rehabilitation clearly reduces mortality and morbidity and has a salutary psychological impact," Ms. Bäck says. "So designing targeted interventions for rehabilitation of patients with kinesiophobia is extremely important."