Fear of movement in patients with cardiovascular disease

Cardiovascular diseases are the leading cause of death globally. Physical activity improves functional capacity and quality of life, and is a cornerstone of secondary prevention of cardiovascular disease and a core component of cardiac rehabilitation. After cardiac hospitalization, only 17% of patients perform the recommended amount of physical activity. Self-reported avoidance of physical activity, after cardiac hospitalization, is related to major adverse cardiac events such as readmission to the hospital for ischemic cardiac disease and should thus be targeted. An explanation for these low physical activity levels is anxiety related to physical activity which is frequently reported after cardiac events. Specifically, fear of movement (kinesiophobia) is an important barrier for patients to achieve adequate levels of physical activity, but is not well investigated in patients with cardiovascular disease. The overall aim of the work, described in this thesis, is to explore kinesiophobia in patients with cardiovascular disease. First by investigating the psychometric properties of a measurement tool to objectify kinesiophobia. Second, by studying the perspectives and needs of patients with high levels of kinesiophobia. Third, by assessing which biological, psychological and social factors are associated with kinesiophobia. Fourth, by assessing the relationship between kinesiophobia, cardiac rehabilitation and objectively measured physical activity. And fifth, by developing an intervention to target kinesiophobia in the early phase after hospital discharge.