Why the study?
Kinesiophobia is a significant barrier to effective cardiac rehabilitation and recovery after CABG, motivating efforts to identify its risk factors and develop a nomogram prediction model for individual risk estimation.
This study identifies six clinical and psychological risk factors for kinesiophobia following CABG and provides an internally validated nomogram (AUC 0.939) to help clinicians identify high-risk patients early for targeted cardiac rehabilitation support.
Supports kinesiophobia screening in older post-CABG patients; leaves open whether interventions improve rehabilitation adherence.
Background Kinesiophobia, or the irrational fear of movement, is a significant barrier to effective cardiac rehabilitation and recovery in patients after coronary artery bypass grafting (CABG). This study sought to identify the risk factors for kinesiophobia in post-CABG patients and to develop and validate a nomogram prediction model to estimate individual risk. Methods A retrospective case-control study was conducted on 138 patients who underwent CABG in the Cardiovascular ICU between February 2023 and November 2024. Using the Tampa Scale for Kinesiophobia-Heart (TSK-Heart), patients were categorized into a kinesiophobia group (TSK-Heart >37, n = 95) and a non-kinesiophobia group ( n = 43). Risk Factors were identified with multivariable logistic regression. The resulting coefficients furnished a nomogram for individual risk estimation. Calibration was evaluated with the Hosmer-Lemeshow test and a bootstrap-corrected calibration plot; discrimination was quantified by the receiver operating characteristic (ROC) curve and calibration curve. Results The incidence of kinesiophobia in this cohort was 68.84%. The logistic regression analysis identified six risk factors: advanced age ( OR = 1.127, P = 0.003), lower educational level ( OR = 0.246, P = 0.001), higher degree of disability in activities of daily living (ADL) ( OR = 3.880, P = 0.007), lower self-efficacy in cardiac rehabilitation exercise ( OR = 0.898, P = 0.024), pain catastrophizing ( OR = 4.513, P = 0.023), and fear of falling ( OR = 1.212, P = 0.004). The constructed nomogram demonstrated excellent discrimination, with an AUC of 0.939 (95% CI : 0.898–0.981), and high sensitivity (93.7%) and specificity (83.7%). Calibration was confirmed by the Hosmer-Lemeshow test ( χ 2 = 5.97, P = 0.65) and a bootstrap-corrected calibration plot showing close agreement between predicted and observed probabilities. Conclusions Advanced age, low educational attainment, ADL dependency, poor cardiac rehabilitation self-efficacy, pain catastrophizing, and fear of falling were significant risk factors for kinesiophobia after CABG. The developed nomogram was a reliable and accurate tool for early identification of high-risk patients, enabling clinicians to implement individualized preventative strategies and optimize postoperative recovery.
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Guo et al. (2026) studied this question.
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