Kinesiophobia in AMI patients exhibited significant heterogeneity with three distinct trajectories, and individuals with high initial kinesiophobia levels often experienced limited alleviation during rehabilitation, making timely interventions critical.
Key Findings
Results
Three distinct trajectories of kinesiophobia were identified in AMI patients over the follow-up period.
The three trajectories were: persistently high (N = 49, 24.9% of the sample), persistently low (N = 50, 24.5% of the sample), and high-to-critical (N = 108, 50.6% of the sample)
Latent Class Growth Modeling was employed to identify these distinct trajectories
207 patients who completed at least 2 of 4 follow-up assessments were included in the analysis, from an initial recruitment of 239 patients
The study period ran from November 2023 to July 2024
Results
Overall kinesiophobia scores as measured by the Tampa Scale for Kinesiophobia-Heart demonstrated a statistically significant decreasing trend over time.
The total scores of the Tampa Scale for Kinesiophobia-Heart generally demonstrated a decreasing trend (p < .05)
Despite the overall decline, trajectories demonstrated relative stability over time within subgroups
Individuals with high initial kinesiophobia levels often experienced limited alleviation during rehabilitation
Results
Exercise self-efficacy, age, gender, length of hospitalization, and number of stents implanted were predictive factors distinguishing the persistently high kinesiophobia group from the persistently low group.
Multivariate logistic regression analysis was performed to identify predictors associated with different kinesiophobia trajectory categories
Five factors distinguished the persistently high from the persistently low group: exercise self-efficacy, age, gender, length of hospitalization, and number of stents implanted
Data on depression, exercise self-efficacy, and exercise social support were collected alongside demographic and clinical characteristics
Results
Exercise self-efficacy, age, and number of stents implanted were predictors for membership in the high-to-critical kinesiophobia trajectory group.
The high-to-critical group comprised the largest proportion of the sample at 50.6% (N = 108)
Fewer predictors distinguished the high-to-critical group compared to the persistently high group, with gender and length of hospitalization not emerging as significant predictors for this trajectory
Exercise self-efficacy appeared as a significant predictor in both the persistently high and high-to-critical trajectory comparisons
Results
Kinesiophobia in AMI patients exhibited significant heterogeneity, with the majority of patients falling into a high or high-to-critical trajectory rather than a persistently low one.
Combined, 75.5% of patients were in either the persistently high (24.9%) or high-to-critical (50.6%) trajectory groups
Only 24.5% of patients demonstrated persistently low kinesiophobia
The authors concluded that trajectories demonstrated relative stability over time, meaning early classification may predict long-term kinesiophobia burden
What This Means
This research suggests that fear of physical movement (kinesiophobia) is common after a heart attack and does not follow a single, uniform path during recovery. By following 207 heart attack patients over multiple time points, researchers identified three distinct groups: about a quarter of patients maintained persistently high fear of movement, about a quarter maintained persistently low fear, and the largest group (roughly half of patients) started with high fear and only partially improved to a borderline level. While overall fear of movement tended to decrease somewhat over time, patients who started with high levels rarely reduced their fear to low levels on their own.
This research also suggests that certain patient characteristics help predict who will struggle most with fear of movement. Lower confidence in one's ability to exercise (exercise self-efficacy), older age, being male, longer hospital stays, and having more stents implanted during treatment were all linked to belonging to the higher kinesiophobia trajectory groups. These factors could help healthcare providers identify patients who need more targeted support early in their recovery.
The practical implication of these findings is that because fear of movement tends to remain relatively stable once established, waiting to address it may mean patients miss a critical window for improvement. Nearly three-quarters of patients in this study were in a high or only partially improving trajectory, suggesting that early screening and intervention programs designed to reduce fear of physical activity could be important for improving recovery outcomes after a heart attack.
Wang Y, Fan J, Qian H, Shi X. (2026). Trajectories of Kinesiophobia and Influencing Factors in Patients With Acute Myocardial Infarction.. Clinical nursing research. https://doi.org/10.1177/10547738261476790