The Investigation of Kinesiophobia, Pain Catastrophizing, Physical Activity, Anxiety, and Depression in Patients with Myocardial Infarction

Abstract

Purpose: The aim of the study was to compare the kinesiophobia, pain catastrophizing, physical activity, anxiety, and depression in patients with or without MI. Methods: A cross-sectional prospective case-control study was conducted with a total of 100 participants (50 myocardial infarction, 50 age-sex matched controls). Participants were evaluated with the Tampa Scale of Kinesiophobia for Heart (TSK Heart), Pain Catastrophizing Scale (PCS), International Physical Activity Questionnaire-Short Form (IPAQ-SF), Hospital Anxiety And Depression Scale (HADS). Results: There was significant difference between two groups in all subscales of IPAQ-SF (except sitting time) (p<0.01). Control group were significantly more physically active. PCS score was higher in MI patients (p<0.01). HAD-A and HAD-D scores were significantly higher in MI group. PCS was not significantly correlated with any parameters (p>0.05). Second, TSK Heart was correlated with Sitting PA, Walking PA, Moderate PA, HAD-A and HAD-D (r=0.425-0.827,p<0.01). There was relationship between HAD-A with Sitting PA, Walking PA and Moderate PA (r1=0.445,r2=-0.485,r3=-0.378,p<0.01). Lastly, HAD-D was correlated with Sitting PA, Walking PA and Moderate PA (r1=0.475,r2=-0.520,r3=-0.578,p<0.01). Conclusion: The study results showed that the decreased physical activity, increased kinesiophobia, pain catastrophizing, depression and anxiety in patients with MI. In addition, kinesiophobia was demonstrated to be related with mild-moderate physical activity and depression-anxiety.

Keywords

• Aerobic exercise
• fear of movement
• MI
• pain perception
• psychosocial status

References

1. 1. Timmis A, Townsend N, Gale CP, Torbica A, Lettino M, Petersen SE, et al. European Society of Cardiology: Cardiovascular Disease Statistics 2019. European Heart Journal. 2019;41(1):12-85.
2. 2. WHO Cardiovasculer diseases Fact sheets [Available from: http://www.who.int/media centre/factsheets/fs317/en/.
3. 3. Bäck M, Öberg B, Krevers B. Important aspects in relation to patients’ attendance at exercise-based cardiac rehabilitation – facilitators, barriers and physiotherapist’s role: a qualitative study. BMC Cardiovascular Disorders. 2017;17(1):77.
4. 4. Simonÿ CP, Pedersen BD, Dreyer P, Birkelund R. Dealing with existential anxiety in exercise-based cardiac rehabilitation: a phenomenological-hermeneutic study of patients' lived experiences. Journal of Clinical Nursing. 2015;24(17-18):2581-90.
5. 5. Janszky I, Ahlbom A, Hallqvist J, Ahnve S. Hospitalization for Depression Is Associated with an Increased Risk for Myocardial Infarction Not Explained By Lifestyle, Lipids, Coagulation, and Inflammation: The SHEEP Study. Biological Psychiatry. 2007;62(1):25-32.
6. 6. Janszky I, Ahnve S, Lundberg I, Hemmingsson T. Early-Onset Depression, Anxiety, and Risk of Subsequent Coronary Heart Disease. Journal of the American College of Cardiology. 2010;56(1):31-7.
7. 7. Lichtman JH, Froelicher ES, Blumenthal JA, Carney RM, Doering LV, Frasure-Smith N, et al. Depression as a Risk Factor for Poor Prognosis Among Patients With Acute Coronary Syndrome: Systematic Review and Recommendations. Circulation. 2014;129(12):1350-69.
8. 8. Korri S, Miller R, Todd DD. Kinesiophobia: a new view of chronic pain behaviour. Pain Manag. 1990;3:35-43.

9. 9. Tungare N, Nagarwala R, Shyam A, Sancheti P. Factors affecting kinesiophobia in coronary artery disease patients. Physiotherapy - The Journal of Indian Association of Physiotherapists. 2020;14(1):32-6.
10. 10. Bäck M, Lundberg M, Cider Å, Herlitz J, Jansson B. Relevance of kinesiophobia in relation to changes over time among patients after an acute coronary artery disease event. Journal of cardiopulmonary rehabilitation and prevention. 2018;38(4):224-30.
11. 11. Vlaeyen JWS, Kole-Snijders AMJ, Boeren RGB, van Eek H. Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain. 1995;62(3):363-72.
12. 12. Crombez G, Eccleston C, Van Damme S, Vlaeyen JWS, Karoly P. Fear-Avoidance Model of Chronic Pain: The Next Generation. The Clinical Journal of Pain. 2012;28(6):475-83.
13. 13. Bäck M, Cider Å, Herlitz J, Lundberg M, Jansson B. The impact on kinesiophobia (fear of movement) by clinical variables for patients with coronary artery disease. International journal of cardiology. 2013;167(2):391-7.
14. 14. Bäck M, Cider Å, Herlitz J, Lundberg M, Jansson B. Kinesiophobia mediates the influences on attendance at exercise-based cardiac rehabilitation in patients with coronary artery disease. Physiotherapy theory and practice. 2016;32(8):571-80.
15. 15. Dwyer MJ, Pasini M, De Dominicis S, Righi E. Physical activity: Benefits and challenges during the COVID-19 pandemic. Scand J Med Sci Sports. 2020;30(7):1291-4.
16. 16. Kocjan J, Knapik A. Barriers of physical activity (kinesiophobia) in patients subjected to cardiac rehabilitation. Baltic journal of health and physical activity. 2014;6(4):291.
17. 17. Association NYH. New York Heart Association Functional Classification. 2012.
18. 18. Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior research methods. 2009;41(4):1149-60.
19. 19. Gignac GE, Szodorai ET. Effect size guidelines for individual differences researchers. Personality and individual differences. 2016;102:74-8.
20. 20. Acar S, Savci S, Keskinoğlu P, Akdeniz B, Özpelit E, Kahraman BÖ, et al. Tampa Scale of Kinesiophobia for Heart Turkish Version Study: cross-cultural adaptation, exploratory factor analysis, and reliability. Journal of pain research. 2016;9:445.
21. 21. Saglam M, Arikan H, Savci S, Inal-Ince D, Bosnak-Guclu M, Karabulut E, et al. International physical activity questionnaire: reliability and validity of the Turkish version. Perceptual and motor skills. 2010;111(1):278-84.
22. 22. Aydemir Ö, Guvenir T, Kuey L, Kultur S. Validity and reliability of Turkish version of hospital anxiety and depression scale. Turk Psikiyatri Derg. 1997;8(4):280-7.
23. 23. Süren M, Okan I, Gökbakan AM, Kaya Z, Erkorkmaz Ü, Arici S, et al. Factors associated with the pain catastrophizing scale and validation in a sample of the Turkish population. Turkish journal of medical sciences. 2014;44(1):104-8.
24. 24. Ammar A, Brach M, Trabelsi K, Chtourou H, Boukhris O, Masmoudi L, et al. Effects of COVID-19 home confinement on eating behaviour and physical activity: results of the ECLB-COVID19 international online survey. Nutrients. 2020;12(6):1583.
25. 25. Kayikcioglu M, Tuncel OK, Tokgozoglu L. Impact of the COVID-19 pandemic in patients with a previous history of premature myocardial infarction. American journal of preventive cardiology. 2020;4:100128.
26. 26. Roshanaei-Moghaddam B, Katon WJ, Russo J. The longitudinal effects of depression on physical activity. General hospital psychiatry. 2009;31(4):306-15.
27. 27. 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 preference and adherence. 2019;13:2129.
28. 28. Dabek J, Knapik A, Gallert-Kopyto W, Brzek A, Piotrkowicz J, Gasior Z. Fear of movement (kinesiophobia)–an underestimated problem in Polish patients at various stages of coronary artery disease. Annals of agricultural and environmental medicine. 2020;27(1).
29. 29. Yümin ET, Alp Ö, Saltan A, Sertel M, ANKARALI H, Şimşek TT. Effects of Pain, Dyspnea, and Kinesiophobia on Life Quality in Patients with Coronary Artery Disease. Anatolian Clinic the Journal of Medical Sciences. 2017;22(2):75-84.
30. 30. Şahin HB, Kalaycıoğlu E, Şahin M. The effect of cardiac rehabilitation on kinesiophobia in patients with coronary artery disease. Turkish Journal of Physical Medicine & Rehabilitation (2587-1250). 2021;67(2).
31. 31. Bäck M, Caldenius V, Svensson L, Lundberg M. Perceptions of Kinesiophobia in Relation to Physical Activity and Exercise After Myocardial Infarction: A Qualitative Study. Physical therapy. 2020;100(12):2110-9.
32. 32. Tsouna-Hadjis E, Kallergis G, Agrios N, Zakopoulos N, Lyropoulos S, Liakos A, et al. Pain intensity in nondiabetic patients with myocardial infarction or unstable angina: Its association with clinical and psychological features. International journal of cardiology. 1998;67(2):165-9.
33. 33. Ernstsen L, Rangul V, Nauman J, Nes BM, Dalen H, Krokstad S, et al. Protective effect of regular physical activity on depression after myocardial infarction: the HUNT study. The American journal of medicine. 2016;129(1):82-8. e1.
34. 34. Price KJ, Gordon BA, Bird SR, Benson AC. A review of guidelines for cardiac rehabilitation exercise programmes: Is there an international consensus? European journal of preventive cardiology. 2016;23(16):1715-33.
35. 35. Rothenbacher D, Jaensch A, Mons U, Hahmann H, Becker T, Koenig W, et al. Prognostic value of one-year course of symptoms of anxiety and depression in patients with coronary heart disease: Role of physical activity and unmet medical need. European journal of preventive cardiology. 2015;22(9):1129-38.
36. 36. Kluszczyńska M, Młynarska A, Mikulakova W, editors. Influence of Frailty Syndrome on Kinesiophobia According to the Gender of Patients after Coronary Artery Bypass Surgery. Healthcare; 2021: Multidisciplinary Digital Publishing Institute.