Physical activity and disability in patients with noncardiac chest pain: a longitudinal cohort study

Abstract

Background: Noncardiac chest pain (NCCP) is one of the leading reasons for emergency department visits and significantly limits patients' daily functioning. The protective effect of physical activity has been established in a number of pain problems, but its role in the course of NCCP is unknown. This study aimed to document the level of physical activity in patients with NCCP and its association with NCCP-related disability in the 6 months following an emergency department visit. Methods: In this prospective, longitudinal, cohort study, participants with NCCP were recruited in two emergency departments. They were contacted by telephone for the purpose of conducting a medical and sociodemographic interview, after which a set of questionnaires was sent to them. Participants were contacted again 6 months later for an interview aimed to assess their NCCP-related disability. Results: The final sample consisted of 279 participants (57.0% females), whose mean age was 54.6 (standard deviation = 15.3) years. Overall, the proportion of participants who were physically active in their leisure time, based on the Actimètre questionnaire criteria, was 22.0%. Being physically active at the first measurement time point was associated with a 38% reduction in the risk of reporting NCCP-related disability in the following 6 months (ρ = .047). This association remained significant after controlling for confounding variables. Conclusions: Being physically active seems to have a protective effect on the occurrence of NCCP-related disability in the 6 months following an emergency department visit with NCCP. These results point to the importance of further exploring the benefits of physical activity in this population.

The Effect of Internet-Delivered Cognitive Behavioral Therapy Versus Psychoeducation Only on Psychological Distress in Patients With Noncardiac Chest Pain: Randomized Controlled Trial

“…Physical activity has been shown to be associated with a lower risk of experiencing NCCP. Therefore, avoidance of such activities has negative effects on these patients [ 14 ]. This situation seems to cause functional impairment, psychological distress, and impaired quality of life in these patients [ 4 , 15 - 18 ].…”

Determinants of depression in non-cardiac chest pain patients: a cross sectional study

“…A longitudinal cohort study in 2020 demonstrated that patients with NCCP are less active than the normal population. Inactivity in these patients may interfere with the maintenance of NCCP and also reduce the threshold of pain tolerance [ 4 ]. On the other hand, studies represented a bidirectional relationship between depression and physical activity which means depression reduces the level of exercise, and inactivity is a risk factor for depression.…”

“…The annual financial burden of NCCP is more than double that of acute myocardial infarction and angina pectoris [ 3 ]. In the United States, the costs associated with these medical services are estimated between $8 and $13 billion each year [ 4 ].…”

How is type D personality associated with the major psychological outcomes in noncardiac chest pain patients?

“…Noncardiac chest pain (NCCP) is defined as recurrent angina-like chest pain with no evidence of underlying heart problems after medical examinations, which leads to further medical consultations and imposes a lot of costs on both patients and the health-care system (Castonguay et al, 2020;Fass & Achem, 2011;Mourad et al, 2013). The main underlying causes of NCCP include psychological disorders, gastroesophageal reflux, esophageal dysmotility, and esophageal hypersensitivity.…”

“…The annual financial burden of NCCP is more than double the amount of myocardial infarction and angina pectoris (Fass & Achem, 2011;Mourad et al, 2013). In the United States, for instance, the cost associated with these medical services is estimated to be between 8 and 13 billion dollars each year (Castonguay et al, 2020). In addition to NCCP's financial burden and its comparability to that of cardiac diseases, NCCP also negatively influences the quality of everyday life in those suffering from it, by different means, including interruption of daily activities and occupational disability (Israel et al, 2015;Mourad et al, 2020).…”