Anxiety and Fear of Exercise in Cardiopulmonary Rehabilitation: PATIENT AND PRACTITIONER PERSPECTIVES. Issue 2 (March 2019)

• Record Type: Journal Article
• Authors: Farris, Samantha G.; Abrantes, Ana M.; Bond, Dale S.; Stabile, Loren M.; Wu, Wen-Chih
• Is Part Of: Journal of cardiopulmonary rehabilitation and prevention. Volume 39:Issue 2(2019)
• Publication Date: 2019-03
• Subjects: anxiety -- avoidance -- cognitive behavior therapy -- exercise; Cardiopulmonary system -- Diseases -- Patients -- Rehabilitation -- Periodicals; Cardiopulmonary system -- Diseases -- Prevention -- Periodicals; 616.103
• DOI: 10.1097/HCR.0000000000000401
• Languages: English
• ISSNs: 1932-7501

Abstract

Abstract : Purpose: One unexplored mechanism for poor outcomes in cardiovascular and pulmonary rehabilitation (CVPR) is fear about aerobic exercise. Patients in CVPR may tend to avoid aerobic exercise because of the fear of physical sensations associated with exertion. This study examined fear about exercise in patients enrolled in outpatient CVPR and practitioner beliefs and behaviors related to fear associated with exercise. Methods: Survey data were collected from patients (n = 117) enrolled in cardiac rehabilitation (n = 69) and pulmonary rehabilitation (n = 48) and practitioners (n = 16) who were exercise physiologists and nurses working in CVPR. Results: Fears about exercise and avoidance behaviors were common among patients. In pulmonary rehabilitation, fears and avoidance of exercise were correlated with higher levels of anxiety and depression ( r values = 0.27-0.54), lower forced expiratory volume in the first second of expiration/forced vital capacity ( r values = −0.13 to −0.39), lower health-related quality of life ( r values = −0.13 to −0.62), and stronger beliefs about utility of anxiety treatment ( r values = 0.21-0.36). In cardiac rehabilitation, fears about exercise were correlated with higher levels of anxiety ( r values = 0.19-0.38), lower mental health quality of life ( r values = −0.25 to −0.27), and stronger beliefs about utility of anxiety treatment ( r values = 0.30-0.40), and avoidance of exercise was correlated with lower exercise tolerance and poorer physical health quality of life ( r values = −0.22 to −0.24). Practitioners estimated that an average of 47 ± 20% of patients experience fear associated with exercise and reported low feelings of preparedness to address patient anxiety and fear. Conclusions: It may be beneficial to provide practitioners with skills to recognize and address anxiety and fear in their patients as it relates to exercise. Abstract : Supplemental Digital Content is Available in the Text.Fear and avoidance of exercise were common among patients attending cardiovascular and pulmonary rehabilitation (CVPR) and were associated with poor clinical features at CVPR admission. Practitioners working in CVPR reported low feelings of preparedness to address patients' fear of exercise. Practitioners and patients could benefit from skills to recognize and address fear associated with exercise.