Fear of movement in cardiac care: how patients and professionals define cardiac kinesiophobia
H Hermans, O Wintoniak, W H M EmonsAbstract
Background
Regular physical activity is vital for cardiac patients, yet many struggle to stay active or join rehabilitation programs. Kinesiophobia, an irrational fear of movement and its potential harm, may be a key psychological barrier. Although research on cardiac kinesiophobia in cardiac patients is growing, the concept still lacks a clear definition.
Purpose
The aim of this study was to explore the key components that define kinesiophobia as understood by cardiac patients and healthcare professionals in order to develop an inductively derived conceptualization that is both meaningful to patients and applicable in clinical practice.
Methods
A qualitative study with a phenomenologically informed design was conducted using semi-structured interviews and an inductive analytic approach. In total, 24 participants were interviewed. The patient group comprised 10 cardiac patients (50% female), aged 22–74 years (M = 57.00, SD = 15.00). The professional group included 14 specialists, such as (sports) cardiologists, clinical health psychologists, and physiotherapists, of whom 50% were female, aged 30–56 years (M = 41.64, SD = 10.86).
Results
The interviews yielded 646 quotations, which were organised into 128 codes. These codes were then grouped into 15 subthemes reflecting recurring patterns in participants’ experiences. Through iterative comparison and refinement, the subthemes were integrated into three overarching themes representing core dimensions of cardiac kinesiophobia, along with a fourth theme that emerged only from the professional interviews. The overarching themes were: the nature of fear (e.g., fear of exertion, reduced bodily trust), triggers of fear (e.g., bodily sensations, lack of knowledge), and coping with fear of physical activity (e.g., professional reassurance, partner involvement, avoidance, control). The fourth theme concerned the overestimation of physical capacity.
Conclusion
This study shows that kinesiophobia in cardiac patients is a multidimensional phenomenon involving cognitive–emotional reactions, heightened bodily vigilance, avoidance and control-seeking behaviours, and contextual influences such as knowledge, social factors, and professional support. By integrating patient and professional perspectives, it clarifies how fear of movement manifests in cardiac care. These findings support more accurate assessment and more tailored interventions to enhance physical activity and rehabilitation outcomes.