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Kinesiophobia mediates the influences on attendance at exercise-based cardiac rehabilitation in patients with coronary artery disease.

Journal article
Authors Maria Bäck
Åsa Cider
Johan Herlitz
Mari Lundberg
Bengt Jansson
Published in Physiotherapy theory and practice
Volume 32
Issue 8
Pages 571-580
ISSN 1532-5040
Publication year 2016
Published at Institute of Neuroscience and Physiology
Department of Psychology
Institute of Medicine, Department of Molecular and Clinical Medicine
Institute of Clinical Sciences, Department of Orthopaedics
Pages 571-580
Language en
Subject categories Physiotherapy, Cardiovascular medicine


To identify predictors of attendance at exercise-based cardiac rehabilitation (CR) and to test the hypothesis that kinesiophobia mediates the influence on attendance at CR in patients with coronary artery disease (CAD).In total, 332 patients (75 women; mean age 65 ± 9.1 years) with a diagnosis of CAD were recruited at Sahlgrenska University Hospital, Sweden.The patients were tested in terms of objective measurements, self-rated psychological measurements, and level of physical activity. A path model with direct and indirect effects via kinesiophobia was used to predict participation in CR. An exploratory selection of significant predictors was made.A current incidence of coronary bypass grafting (p < 0.001) and a diagnosis of ST-elevation myocardial infarction (p = 0.004) increased the probability of attendance at CR, while kinesiophobia (p = 0.001) reduced attendance. As a mediator, kinesiophobia was influenced by four predictors and the following indirect effects were found. General health and muscle endurance increased the probability of attendance at CR, while self-rated anxiety and current incidence of heart failure had the opposite effect.This study suggests that kinesiophobia has an influence on and a mediating role in attendance at CR. The results need to be further investigated in relation to clinical practice.

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