Relevance of Kinesiophobia in Relation to Changes Over Time Among Patients After an Acute Coronary Artery Disease Event

Purpose: To identify levels of kinesiophobia during the first 4 months after an acute episode of coronary artery disease (CAD), while controlling for gender, anxiety, depression, and personality traits. Methods: In all, 106 patients with CAD (25 women), mean age 63.1 ± 11.5 years, were included in the study at the cardiac intensive care unit, Sahlgrenska University Hospital, Sweden. The patients completed questionnaires at 3 time points: in the cardiac intensive care unit (baseline), 2 weeks, and 4 months after baseline. The primary outcome measure was kinesiophobia. Secondary outcome measures were gender, anxiety, depression, harm avoidance, and positive and negative affect. A linear mixed model procedure was used to compare kinesiophobia across time points and gender. Secondary outcome measures were used as covariates. Results: Kinesiophobia decreased over time (P = .005) and there was a significant effect of gender (P = .045; higher values for women). The presence of a high level of kinesiophobia was 25.4% at baseline, 19% after 2 weeks, and 21.1% after 4 months. Inclusion of the covariates showed that positive and negative affect and harm avoidance increased model fit. The effects of time and gender remained significant. Conclusions: This study highlights that kinesiophobia decreased over time after an acute CAD episode. Nonetheless, a substantial part of the patients were identified with a high level of kinesiophobia across time, which emphasizes the need for screening and the design of a treatment intervention.

[1]  U. Kujala,et al.  Finnish version of the Tampa Scale of Kinesiophobia: Reference values in the Finnish general population and associations with leisure-time physical activity. , 2015, Journal of rehabilitation medicine.

[2]  P. Doherty,et al.  Challenges in secondary prevention of cardiovascular diseases: a review of the current practice. , 2015, International journal of cardiology.

[3]  B. Whalley,et al.  Psychological Interventions for Coronary Heart Disease: Cochrane Systematic Review and Meta-analysis , 2014, International Journal of Behavioral Medicine.

[4]  M. Simmonds,et al.  Rethinking the fear avoidance model: Toward a multidimensional framework of pain-related disability , 2013, PAIN®.

[5]  Mellar P. Davis Pain-Related Fear: Exposure-Based Treatment of Chronic Pain , 2013 .

[6]  Å. Cider,et al.  The impact on kinesiophobia (fear of movement) by clinical variables for patients with coronary artery disease. , 2013, International journal of cardiology.

[7]  G. Crombez,et al.  Fear-Avoidance Model of Chronic Pain: The Next Generation , 2012, The Clinical journal of pain.

[8]  J. Vlaeyen,et al.  Fear-avoidance model of chronic musculoskeletal pain: 12 years on , 2012, PAIN.

[9]  Å. Cider,et al.  Validation of a questionnaire to detect kinesiophobia (fear of movement) in patients with coronary artery disease. , 2012, Journal of rehabilitation medicine.

[10]  K. Filion,et al.  Efficacy of exercise-based cardiac rehabilitation post-myocardial infarction: a systematic review and meta-analysis of randomized controlled trials. , 2011, American heart journal.

[11]  Serge Poiraudeau,et al.  Fear-avoidance beliefs and pain avoidance in low back pain--translating research into clinical practice. , 2011, The spine journal : official journal of the North American Spine Society.

[12]  S. Ebrahim,et al.  Exercise-based cardiac rehabilitation for coronary heart disease. , 2011, The Cochrane database of systematic reviews.

[13]  J. Sluiter,et al.  Norming of the Tampa Scale for Kinesiophobia across pain diagnoses and various countries , 2011, PAIN.

[14]  S. George,et al.  Psychologically Informed Interventions for Low Back Pain: An Update for Physical Therapists , 2011, Physical Therapy.

[15]  D. Warburton,et al.  A Meta-analysis of the effects of Exercise Training on Left Ventricular Remodeling Following Myocardial Infarction: Start early and go longer for greatest exercise benefits on remodeling , 2011, Trials.

[16]  M. Berk,et al.  Validity of the Hospital Anxiety and Depression Scale and Patient Health Questionnaire-9 to screen for depression in patients with coronary artery disease. , 2007, General hospital psychiatry.

[17]  D. Moser,et al.  "The rust of life": impact of anxiety on cardiac patients. , 2007, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[18]  S. Wulff SAS for Mixed Models , 2007 .

[19]  D. Carless,et al.  An Alternative View of Psychological Well-Being in Cardiac Rehabilitation: Considering Temperament and Character , 2006, European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology.

[20]  N. Vøllestad,et al.  Clinical Course and Impact of Fear-Avoidance Beliefs in Low Back Pain: Prospective Cohort Study of Acute and Chronic Low Back Pain: II , 2006, Spine.

[21]  L. Clark Temperament as a unifying basis for personality and psychopathology. , 2005, Journal of abnormal psychology.

[22]  G. Ostir,et al.  Reliability of the Positive and Negative Affect Schedule (PANAS) in medical rehabilitation , 2005, Clinical rehabilitation.

[23]  S. Seedat Origins of Phobias and Anxiety Disorders: Why More Women Than Men , 2004 .

[24]  I. Lyoo,et al.  Trait and state aspects of harm avoidance and its implication for treatment in major depressive disorder, dysthymic disorder, and depressive personality disorder , 2004, Psychiatry and clinical neurosciences.

[25]  T. T. Haug,et al.  The validity of the Hospital Anxiety and Depression Scale. An updated literature review. , 2002, Journal of psychosomatic research.

[26]  Geert Crombez,et al.  Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability , 1999, Pain.

[27]  J. Reggers,et al.  Temperament and character inventory (TCI) and depression. , 1999, Journal of psychiatric research.

[28]  T. Przybeck,et al.  Swedish normative data on personality using the Temperament and Character Inventory. , 1998, Comprehensive psychiatry.

[29]  M. Geisser,et al.  The relationship between symptoms of post-traumatic stress disorder and pain, affective disturbance and disability among patients with accident and non-accident related pain , 1996, PAIN®.

[30]  P. Onghena,et al.  Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance , 1995, Pain.

[31]  C. Robert Cloninger,et al.  Temperament predicts clomipramine and desipramine response in major depression. , 1994, Journal of affective disorders.

[32]  D. Watson,et al.  Development and validation of brief measures of positive and negative affect: the PANAS scales. , 1988, Journal of personality and social psychology.

[33]  A. Zigmond,et al.  The Hospital Anxiety and Depression Scale , 1983, Acta psychiatrica Scandinavica.

[34]  M. Lundberg,et al.  Kinesiophobia among patients with musculoskeletal pain in primary healthcare. , 2006, Journal of rehabilitation medicine.

[35]  K. Power,et al.  The relationship between trait vulnerability and anxiety and depressive diagnoses at long-term follow-up of Generalized Anxiety Disorder. , 2004, Journal of anxiety disorders.

[36]  C. R. Cloninger,et al.  The temperament and character inventory (TCI) : a guide to its development and use , 1994 .

[37]  H. Philips Avoidance behaviour and its role in sustaining chronic pain. , 1987, Behaviour research and therapy.