Patients attending exercise-based cardiac rehabilitation demonstrated higher baseline fear-avoidance beliefs that significantly decreased over 4 months, resulting in no significant difference compared to controls (20.7% vs 21.4%, p=0.50).
Cohort (n=62)
No
Does exercise-based cardiac rehabilitation led by a registered physiotherapist improve fear-avoidance beliefs and physical activity levels in patients after first-time myocardial infarction compared to self-directed exercise?
Exercise-based cardiac rehabilitation led by a physiotherapist significantly reduces fear-avoidance beliefs and increases physical activity in patients after first-time myocardial infarction.
Absolute Event Rate: 20.7% vs 21.4%
p-value: p=0.50
OBJECTIVE: The aim of this study was to examine fear-avoidance beliefs in patients after first-time myocardial infarction and to determine how such beliefs change over time. A further aim was to analyse fear-avoidance beliefs and physical activity levels in patients attending exercise-based cardiac rehabilitation led by a registered physiotherapist, compared with a control group. DESIGN: Prospective cohort study. PATIENTS: A total of 62 patients after first-time myocardial infarction were consecutively included in the study, mean age 61 years (range 42-73). Thirty-four patients chose exercise-based cardiac rehabilitation and 28 carried out the exercise regime on their own (controls). At follow-up, 57 patients (n = 30 and n = 27, respectively) responded. METHODS: The Fear-Avoidance Beliefs Questionnaire and the Exercise and Physical Activity questionnaires were completed at 1 and 4 months post-infarction. RESULTS: Clinically relevant fear-avoidance beliefs were seen in 48% of all patients at baseline, compared with 21% at follow-up (p = 0.01). Corresponding baseline values were 62% for the cardiac rehabilitation group and 29% for controls (p = 0.02). At follow-up, 4 months post-infarction, the difference between the groups was no longer seen. The total amount of physical activity increased over time for the cardiac rehabilitation group (p = 0.03), and this was also significant compared with the control group (p = 0.02). CONCLUSION: Compared with controls, patients attending exercise-based cardiac rehabilitation led by a registered physiotherapist, demonstrated higher levels of fear-avoidance beliefs at baseline, which decreased over time. Furthermore, attendees increased their level of physical activity and exercise over time. Participation in exercise-based cardiac rehabilitation is therefore strongly recommended for patients with myocardial infarction, especially for those with increased fear of movement.
Åhlund et al. (Tue,) conducted a cohort in First-time myocardial infarction (n=62). Exercise-based cardiac rehabilitation vs. Self-managed exercise (control group) was evaluated on Clinically relevant fear-avoidance beliefs (m-FABQ score ≥ 9) at 4 months (p=0.50). Patients attending exercise-based cardiac rehabilitation demonstrated higher baseline fear-avoidance beliefs that significantly decreased over 4 months, resulting in no significant difference compared to controls (20.7% vs 21.4%, p=0.50).