Kinesiophobia in cardiac rehabilitation

Kinesiophobia during cardiac rehabilitation

Cardiac rehabilitation is the cornerstone of secondary prevention in patients with cardiovascular disease. Previous research has shown that participation in cardiac rehabilitation reduces the risk of re-hospitalisation and premature death. Increasing daily levels of physical activity is one of the main goals of cardiac rehabilitation. Nevertheless, the percentage of cardiac patients performing the recommended amount of physical activity has been reported to be as low as 17%. An important factor related to low physical activity is kinesiophobia (fear of movement). It is estimated that kinesiophobia is present in up till 45% of patients with cardiovascular disease. The setting of cardiac rehabilitation might be suitable to not only identify patients with kinesiophobia, but also to target patients with high levels of kinesiophobia. Nevertheless, the impact of current cardiac rehabilitation programs on kinesiophobia is unclear due to the absence of well-validated instruments to measure kinesiophobia in cardiac patients

TSK-NL heart questionnaire to measure kinesiophobia

Kinesiophobia can be measured with the Tampa Scale for Kinesiophia (TSK). The TSK was originally developed for patients with musculoskeletal pain and has been shown to have good reliability and validity in this population.

We validated the Dutch version of the TSK to assess kinesiophobia in cardiac patients (TSK-NL Heart) in a group of 152 patients that participated in a cardiac rehabilitation program. Outcomes of this study showed that the TSK-NL Heart has good test-retest reliability and construct validity. Bases on these results, a license agreement to use this questionnaire was signed by three large electronic health record suppliers. In addition, 12 hospitals in the Netherlands and Belgium applied for this licence. Currently, we are investigating if the TSK-NL Heart is also able to measure changes in kinesiophobia during cardiac rehabilitation (responsiveness). This study is performed in a collaboration with Capri Cardiac Rehabilitation, Amsterdam University of Applied Sciences Amsterdam, Amsterdam University Medical Centre and Cardiovitaal Cardiac Rehabilitation