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Kinesiophobia in patients with angina pectoris of coronary artery disease: A cross-sectional survey

      Highlights

      • As the first study to investigate kinesiophobia in patients with AP of CAD, we have refocused on the effect of "fear of pain" on kinesiophobia in individuals with CAD.
      • This study provides new insights into the application of kinesiophobia in patients with CAD, which can improve the attention of kinesiophobia in patients with AP of CAD.
      • We also reviewed the status quo, identified factors related to kinesiophobia and provided guidance for reducing kinesiophobia in patients with AP of CAD.

      Abstract

      Background

      In the field of chronic pain research, kinesiophobia is defined as avoidance behavior due to fear of pain, but this perspective seems to be neglected in the field of coronary artery disease (CAD).

      Objective

      To investigate the status quo of angina pectoris (AP) and kinesiophobia and factors associated with kinesiophobia in patients with AP of CAD.

      Methods

      This was a cross-sectional study. Participants were recruited by convenience sampling, and patients with AP of CAD in four wards of the Cardiology Department of a hospital were enrolled in this study. Participants completed questionnaires and scales face-to-face with researchers.

      Results

      Most patients with AP of CAD suffered from at least moderate pain episodes (60.2%) of at least 5 minutes per episode (53.8%), but less than 1/3 of patients reached 5 instances of pain per week (29.1%). The total score of kinesiophobia in patients was 40.80±6.65, and the vast majority of patients had moderate to high levels of kinesiophobia (75.7%). The results of multiple linear stepwise regression analysis showed that personal monthly income, New York Heart Function Assessment (NYHA) classification, pain intensity, and pain resilience were independent factors associated with kinesiophobia, and these factors explained 30.2% of the variation in total scores of kinesiophobia.

      Conclusion

      The symptoms of AP were prominent in terms of pain intensity and duration of pain. The level of kinesiophobia was moderate, and this was affected by multiple factors. Health care providers and researchers seldom pay attention to the kinesiophobia of patients with AP of CAD. This study refocused on the effect of "fear of pain" in kinesiophobia in patients with CAD. It opens up new horizons for the application of fear-avoidance models in CAD patients and helps to raise awareness of kinesiophobia in AP patients with CAD and provides guidance for reducing the level of kinesiophobia in the future.

      Keywords

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      References

        • Fanaroff AC
        • Kaltenbach LA
        • Peterson ED
        • et al.
        Management of persistent angina after myocardial infarction treated with percutaneous coronary intervention: insights from the TRANSLATE-ACS study.
        J Am Heart Assoc. 2017; 6e007007https://doi.org/10.1161/JAHA.117.007007
        • De Luca L
        • Temporelli PL
        • Lucci D
        • et al.
        Characteristics, treatment and quality of life of stable coronary artery disease patients with or without angina: Insights from the START study.
        PLoS One. 2018; 13e0199770https://doi.org/10.1371/journal.pone.0199770
        • Peri-Okonny PA
        • Patel KK
        • Jones PG
        • et al.
        Low diastolic blood pressure is associated with angina in patients with chronic coronary artery disease.
        J Am Coll Cardiol. 2018; 72: 1227-1232https://doi.org/10.1016/j.jacc.2018.05.075
        • Dehmer GJ.
        Angina pectoris: diagnosis, treatment, and prognosis.
        Curr Probl Cardiol. 1987; 12: 213-281https://doi.org/10.1016/0146-2806(87)90008-9
        • Wittbrodt MT
        • Moazzami K
        • Shah AJ
        • et al.
        Neural responses during acute mental stress are associated with angina pectoris.
        J Psychosom Res. 2020; 134110110https://doi.org/10.1016/j.jpsychores.2020.110110
        • Tsai CC
        • Chuang SY
        • Hsieh IC
        • et al.
        The association between psychological distress and angina pectoris: a population-based study.
        PLoS One. 2019; 14e0224451https://doi.org/10.1371/journal.pone.0224451
        • Keessen P
        • Latour CHM
        • van Duijvenbode ICD
        • et al.
        Factors related to fear of movement after acute cardiac hospitalization.
        BMC Cardiovasc Disord. 2020; 20: 495https://doi.org/10.1186/s12872-020-01783-9
        • Knapik A
        • Dąbek J
        • Brzęk A.
        Kinesiophobia as a problem in adherence to physical activity recommendations in elderly Polish patients with coronary artery disease.
        Patient Prefer Adherence. 2019; 13: 2129-2135https://doi.org/10.2147/PPA.S216196
        • Baykal Şahin H
        • Kalaycıoğlu E
        • Şahin M.
        The effect of cardiac rehabilitation on kinesiophobia in patients with coronary artery disease.
        Turk J Phys Med Rehabil. 2021; 67: 203-210https://doi.org/10.5606/tftrd.2021.5164
        • Dąbek J
        • Knapik A
        • Gallert-Kopyto W
        • et al.
        Fear of movement (kinesiophobia) - an underestimated problem in Polish patients at various stages of coronary artery disease.
        Ann Agric Environ Med. 2020; 27: 56-60https://doi.org/10.26444/aaem/106143
        • Lethem J
        • Slade PD
        • Troup JD
        • et al.
        Outline of a Fear-Avoidance Model of exaggerated pain perception–I.
        Behav Res Ther. 1983; 21: 401-408https://doi.org/10.1016/0005-7967(83)90009-8
        • Bäck M
        • Jansson B
        • Cider A
        • et al.
        Validation of a questionnaire to detect kinesiophobia (fear of movement) in patients with coronary artery disease.
        J Rehabil Med. 2012; 44: 363-369https://doi.org/10.2340/16501977-0942
        • Keessen P
        • den Uijl I
        • Visser B
        • et al.
        Fear of movement in patients attending cardiac rehabilitation: A validation study.
        J Rehabil Med. 2020; 52: jrm00021https://doi.org/10.2340/16501977-2653
        • Slepian PM
        • Ankawi B
        • France CR.
        Longitudinal analysis supports a fear-avoidance model that incorporates pain resilience alongside pain catastrophizing.
        Ann Behav Med. 2020; 54: 335-345https://doi.org/10.1093/abm/kaz051
        • Sturgeon JA
        • Zautra AJ.
        Resilience: a new paradigm for adaptation to chronic pain.
        Curr Pain Headache Rep. 2010; 14: 105-112https://doi.org/10.1007/s11916-010-0095-9
        • Ni P
        • Chen JL
        • Liu N.
        The sample size estimation in quantitative nursing research.
        Chin J Nurs. 2010; 45: 378-380
        • Thong ISK
        • Jensen MP
        • Miró J
        • et al.
        The validity of pain intensity measures: what do the NRS, VAS,VRS,and FPS-R measure?.
        Scand J Pain. 2018; 18: 99-107https://doi.org/10.1515/sjpain-2018-0012
        • Huang R
        • He Y
        • Huang HH
        • et al.
        Research progress on kinesiophobia in patients with coronary heart disease.
        Chinese General Practice Nursing. 2021; 19: 4779-4784
        • Slepian PM
        • Ankawi B
        • Himawan LK
        • et al.
        Development and initial validation of the Pain Resilience Scale.
        J Pain. 2016; 17: 462-472https://doi.org/10.1016/j.jpain.2015.12.010
        • Dong WJ
        • Lin M.
        Psychometric evaluation of the Chinese version of the Pain Resilience Scale in patients with coronary heart disease.
        Chin J Prac Nurs. 2018; 34: 2486-2490https://doi.org/10.3760/cma.j.issn.1672-7088.2018.32.002
        • Ren PN
        • Zhang Y
        • Ding L
        • et al.
        The mediating effect of kinesophobia on self-efficacy and exercise adherence in patients with acute myocardial infarction after PCI.
        Nurs J Chin PLA. 2022; 39: 21-24
        • Nymark C
        • Mattiasson AC
        • Henriksson P
        • et al.
        Emotions delay care-seeking in patients with an acute myocardial infarction.
        Eur J Cardiovasc Nurs. 2014; 13: 41-47https://doi.org/10.1177/1474515113475953
        • Gheorghe A
        • Griffiths U
        • Murphy A
        • et al.
        The economic burden of cardiovascular disease and hypertension in low- and middle-income countries: a systematic review.
        BMC Public Health. 2018; 18: 975https://doi.org/10.1186/s12889-018-5806-x
        • Gołba A
        • Soral T
        • Młynarska A
        • et al.
        [Kinesiophobia in patients with cardiovascular disease].
        Wiad Lek. 2018; 71: 1653-1660
        • Luque-Suarez A
        • Martinez-Calderon J
        • Falla D.
        Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review.
        Br J Sports Med. 2019; 53: 554-559https://doi.org/10.1136/bjsports-2017-098673
        • Luque-Suarez A
        • Martinez-Calderon J
        • Navarro-Ledesma S
        • et al.
        Kinesiophobia is associated with pain intensity and disability in chronic shoulder pain: A cross-sectional study.
        J Manipulative Physiol Ther. 2020; 43791–798https://doi.org/10.1016/j.jmpt.2019.12.009
        • Ling Y
        • Chen H
        • Todd J
        The effect of pain resilience on pain-related self-efficacy, coping and pain adaptation.
        Chin J Pain Med. 2021; 27: 449-454
        • Baykal Şahin H
        • Kalaycıoğlu E
        • Şahin M.
        The effect of cardiac rehabilitation on kinesiophobia in patients with coronary artery disease.
        Turk J Phys Med Rehabil. 2021; 67: 203-210https://doi.org/10.5606/tftrd.2021.5164
        • Jafri SH
        • Imran TF
        • Medbury E
        • et al.
        Cardiovascular outcomes of patients referred to home based cardiac rehabilitation.
        Heart Lung. 2022; 52: 1-7https://doi.org/10.1016/j.hrtlng.2021.11.005
      1. Letter on Reply to Proposal No.2373 (No.249 for Medical and Sports) at the Second Session of the Thirteenth National Committee of the Chinese People’s Political Consultative Conference. National Health Commission of the People’s Republic of China, 2020 (Accessed March 21, 2022)
        • Bäck M
        • Cider Å
        • Herlitz J
        • et al.
        Kinesiophobia mediates the influences on attendance at exercise-based cardiac rehabilitation in patients with coronary artery disease.
        Physiother Theory Pract. 2016; 32: 571-580https://doi.org/10.1080/09593985.2016.1229828