{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:25:26Z","timestamp":1793132726074,"version":"4.5.0"},"reference-count":29,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T00:00:00Z","timestamp":1669334400000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003246","name":"Dutch Research Council","doi-asserted-by":"crossref","award":["023.010.064"],"award-info":[{"award-number":["023.010.064"]}],"id":[{"id":"10.13039\/501100003246","id-type":"DOI","asserted-by":"crossref"}]},{"name":"RAAK-PRO","award":["RAAK.PRO02.083"],"award-info":[{"award-number":["RAAK.PRO02.083"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,11,3]]},"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify factors associated with kinesiophobia (fear of movement) after cardiac hospitalisation and to assess the impact of kinesiophobia on cardiac rehabilitation (CR) initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Academic Medical Centre, Department of Cardiology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>We performed a prospective cohort study in cardiac patients recruited at hospital discharge. In total, 149 patients (78.5% male) with a median age of 65 years were included, of which 82 (59%) were referred for CR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>We assessed kinesiophobia with the Tampa Scale for Kinesiophobia (TSK). For this study, the total score was used (range 13\u201352). We assessed baseline factors (demographics, cardiac disease history, questionnaire data on anxiety, biopsychosocial complexity and self-efficacy) associated with kinesiophobia using linear regression with backward elimination. For linear regression, the standardised beta (\u03b2) was reported. Prospectively, the impact of kinesiophobia on probability of CR initiation, in the first 3 months after hospital discharge (subsample referred for CR), was assessed with logistic regression. For logistic regression, the OR was reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Moderate and severe levels of kinesiophobia were found in 22.8%. In the total sample, kinesiophobia was associated with cardiac anxiety (\u03b2=0.33, 95%\u2009CI: 0.19 to 0.48), social complexity (\u03b2=0.23, 95%\u2009CI: 0.06 to 0.39) and higher education (\u03b2=\u22120.18, 95%\u2009CI: \u22120.34 to \u22120.02). In those referred for CR, kinesiophobia was negatively associated with self-efficacy (\u03b2=\u22120.29, 95%\u2009CI: \u22120.47 to \u22120.12) and positively with cardiac anxiety (\u03b2=0.43, 95%\u2009CI: 0.24 to 0.62). Kinesiophobia decreased the probability of CR initiation (OR\n                      <jats:sup>\n                        <jats:italic>Range13\u201352 points<\/jats:italic>\n                      <\/jats:sup>\n                      =0.92, 95%\u2009CI: 0.85 to 0.99).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients hospitalised for cardiovascular disease, kinesiophobia is associated with cardiac anxiety, social complexity, educational level and self-efficacy. Kinesiophobia decreased the likelihood of CR initiation with 8% per point on the TSK.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-066435","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T09:33:21Z","timestamp":1669368801000},"page":"e066435","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Impact of kinesiophobia on initiation of cardiac rehabilitation: a prospective cohort path analysis"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9165-4987","authenticated-orcid":false,"given":"Paul","family":"Keessen","sequence":"first","affiliation":[{"name":"Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands"},{"name":"Department of Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kees-Jan","family":"Kan","sequence":"additional","affiliation":[{"name":"Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerben","family":"Ter Riet","sequence":"additional","affiliation":[{"name":"Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart","family":"Visser","sequence":"additional","affiliation":[{"name":"Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3617-3256","authenticated-orcid":false,"given":"Harald","family":"J\u00f8rstad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corine","family":"Latour","sequence":"additional","affiliation":[{"name":"Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"van Duijvenbode","sequence":"additional","affiliation":[{"name":"Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilma","family":"Scholte op Reimer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Research Group Chronic Diseases, Utrecht University of Applied Sciences, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,11,25]]},"reference":[{"key":"2025121400101080000_12.11.e066435.1","doi-asserted-by":"crossref","DOI":"10.2340\/16501977-2749","article-title":"Corrigendum to fear of movement in patients attending cardiac rehabilitation: a validation study","volume":"52","author":"Keessen","year":"2020","journal-title":"J Rehabil Med"},{"key":"2025121400101080000_12.11.e066435.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2011.12.107"},{"key":"2025121400101080000_12.11.e066435.3","doi-asserted-by":"crossref","DOI":"10.1186\/s12872-020-01783-9","article-title":"Factors related to fear of movement after acute cardiac hospitalization","volume":"20","author":"Keessen","year":"2020","journal-title":"BMC Cardiovasc Disord"},{"key":"2025121400101080000_12.11.e066435.4","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1080\/09593985.2016.1229828","article-title":"Kinesiophobia mediates the influences on attendance at exercise-based cardiac rehabilitation in patients with coronary artery disease","volume":"32","author":"B\u00e4ck","year":"2016","journal-title":"Physiother Theory Pract"},{"key":"2025121400101080000_12.11.e066435.5","doi-asserted-by":"crossref","DOI":"10.1016\/j.jacc.2015.10.044","article-title":"Exercise-Based cardiac rehabilitation for coronary heart disease: cochrane systematic review an meta-analysis","volume":"6712","author":"Anderson","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"2025121400101080000_12.11.e066435.6","first-page":"S365","article-title":"Impact of cardiac rehabilitation and exercise training on psychological risk factors and subsequent prognosis in patients with cardiovascular disease","volume":"32","author":"Lavie","year":"2016","journal-title":"Can J Cardiol"},{"key":"2025121400101080000_12.11.e066435.7","unstructured":"Kline RB . 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