Abstract
This is a conference abstract from the "Psychosomatic Medicine Of The XXI Century: Realities And Perspectives" II Congress. It is dedicated to the role of kinesiophobia in heart rhythm disorders and cardiorehabilitation.
Background
Cardiorehabilitation (CR) consists of three main components: exercise (EX), lifestyle modification, and psychological interventions. Exercise has been shown to reduce overall and cardiovascular mortality [0.87 (95% CI 0.75, 0.99) and 0.74 (95% CI 0.63, 0.87), respectively], and frequency of hospitalizations (0.69 (95% CI) 0.51, 0.93)] [B. Bellmann, 2020]. CR with adequate exercise prevents arrhythmias, reduces episodes of atrial fibrillation without a serious risk of side effects [Benoit Robaye, 2019]. However, it is necessary to start CR as early as possible, applying an individual and comprehensive approach with strict dosing and phasing, continuity, and regularity with a gradual increase in the volume and intensity of EX [Shumakov VO, 2020]. However, it has been established that one of the important reasons for refusing to use physical activity, especially at the outpatient stage, is the fear of movement - kinesiophobia (KP), which is associated with possible destabilization of the disease.
Aim
The aim of the study was to assess the presence and causes of kinesiophobia in patients with arrhythmias and cardiac conduction disease.
Materials and methods
To achieve this goal, 46 patients were examined, whose mean age was 42.48 ± 2.88. The analysis of clinical and instrumental (electrocardiography (ECG)) methods of research taking into account age, sex, body mass index (BMI) is carried out. The level of KP was assessed according to the Tampa Scale of Kinesiophobia Heart (TSK-Heart) questionnaire, which includes 17 questions that assess the relationship between destabilization and movement. A low score (17) indicates the absence of KP, an increase in the rate confirms the presence of fear associated with movement. Among the examined ventricular extrasystoles (ES) - 19, paroxysms of atrial fibrillation (AF) - 27 cases.
Results
Analyzing the results of TSK-Heart, we confirmed the presence of KP in the examined patients, however, the severity of phobia was not affected by the sex of patients - TSK-Heart index in men was 40.14 ± 2.28, in women - 39.25 ± 4.59. There was a significant difference in the value of TSK-Heart depending on clinical nosology: in patients with ES, the level of KP was 34.83 ± 1.75, in AF - 45.86 ± 2.67 (p <0.05). A positive correlation was found between BMI and the degree of KP (rs = 0.61, p <0.05), which confirms the low level of physical activity of patients. The presence of KP in patients did not correlate with age, disease duration, or concomitant pathology. Analyzing the results, it should be noted that the use of exercise by patients with arrhythmias is limited to the existing negative symptoms during destabilization of the disease, the use of active interventions is wrongly considered as a trigger for destabilization of the disease. This requires the development and implementation of individual programs of CR with the inclusion of adequate physical activity, which would, if systematically performed, create a positive motivation for the patient to constantly perform exercises, which reduces the progression and prevents destabilization of the disease.
Conclusion
The presence of kinesiophobia has a nosological cause and is associated with the initial level of physical activity of patients with arrhythmias and cardiac conduction disease.