Fear of Physical Activity, Anxiety, and Depression

Abstract

Abstract. Background: Physical activity (PA) is recommended by heart failure treatment guidelines. Adherence to exercise prescriptions is low and not much is known about everyday PA in this patient group. Aims: This study describes objectively assessed everyday PA/sedentary behavior in men and women with chronic heart failure and examines associations of potential barriers for engaging in PA, namely fear of physical activity (FoPA), general anxiety, and depression, with indicators of PA and sedentary behavior. Method: In 61 outpatients with heart failure (67.5 ± 10.7 years of age) the impact of FoPA, trait anxiety, and depression on 6-day accelerometer measures was evaluated using linear regression models. Results: Sedentary behavior was prevalent in men and women alike, with lying down and sitting/standing as predominant activity classes during daytime. Men had higher PA energy expenditure (726 vs. 585 kcal/d, Cohen’s effect size d = 0.74) and walked up/down more often (0.21% vs. 0.12% of total PA, d = 0.56) than women. FoPA did not differ between sexes. FoPA, but not anxiety and depression, significantly and consistently predicted less walking up/down independent of covariates (β-values between −0.26 and −0.44, p-values < 0.024). Limitations: The self-selected sample included few women. Medical data were assessed via self-reports. Conclusion: FoPA, but not anxiety and depression, significantly and consistently predicted less walking up/down independent of covariates. These preliminary findings highlight FoPA as a barrier to everyday PA in patients with heart failure.

Mediation analysis of activities of daily living and kinesiophobia in association between cardiac function and health status of patients with chronic heart failure

“…Within the scope of this study, the patient factors encompass two aspects: namely, high kinesiophobia scores and a low socioeconomic status. Fear of movement is a significant barrier to CR attendance and management in HF patients, which has been confirmed in both qualitative and quantitative studies 25,26 . Moreover, Sina Kianoush et al found that the patients with a higher Social Vulnerability Index exhibited a low utilization rate of CR, who is mainly characterized by poverty, unemployment and educational attainment below high school level in terms of social and economic status 27 .…”

Kinesiophobia and physical activity: A systematic review and meta-analysis

“…The 74 articles identified by the systematic review included a total of 13388 participants aged 11 to 85 years, including 7308 women, 4729 men, and 1351 participants whose gender and sex was not reported. The studies investigated populations with pain (n = 37) 62,64–71,73,76–81,83,88,89,111–128 cardiac conditions (n = 6) 86,87,104,129–131 , surgery (n = 8) 63,131–137 , arthritis (n = 10) 75,82,84,85,91,138–142 , neurologic conditions (n = 3) 90,143,144 , pulmonary conditions (n = 3) 145–147 , cancer (n = 1) 74 , women health conditions (n = 2) 72,148 , as well as healthy adults (n = 6) 29,85,107,149–151 (Table 1).…”

A Web-Based Mind-Body Intervention (Mindful Steps) for Promoting Walking in Chronic Cardiopulmonary Disease: Insights From a Qualitative Study

“…Through the Mindful Steps intervention components, participants learned a variety of strategies that were particularly helpful for walking, including breath regulation/ awareness, body awareness, pacing, mind-body exercises, and goal setting. For individuals with COPD and HF, fear of breathlessness or fear of PA (likely due to breathlessness experienced during PA) are barriers to engaging in PA. [59][60][61][62][63] In Mindful Steps, participants practiced breathing exercises (e.g., pursed lip breathing) and learned how to nonjudgmentally attend to their breath. At 6-months, we identified prominent themes regarding the usefulness of the breathing exercises and improvements in breathing.…”