Fear of Activity and Functional Capacity in Patients With Coronary Artery Disease
Condition: Coronary Artery Disease
MeSH terms: Coronary Artery Disease; Myocardial Ischemia; Coronary Disease
Study type: Observational

Summary: 
      To identify whether coronary artery disease (CAD) patients have fear of activity, and to
      assess the relationship between fear of activity and exercise capacity in CAD patients.
    

Detailed description: 
      Cardiac rehabilitation (CR) is a well-known way of secondary prevention in heart diseases. CR
      is shown to be effective in reducing cardiovascular morbidity and mortality. CR also enhances
      exercise capacity and quality of life, promotes healthy and active lifestyle and reduces
      psychosocial stress and depressive symptoms in coronary artery disease (CAD). Exercise is one
      of the most important component of CR. The positive prognostic effect of the exercise on
      cardiovascular disease is mediated by mechanisms such as reducing numerous risk factors,
      enhancing endothelial function, declining arterial inflammation and stiffness, improving
      diastolic function, remodeling of left ventricle, and stabilization of electrical activity.
      Each 1 MET increase in functional capacity is known to improve survival by 12 %. Exercise
      capacity is a more powerful predictor of mortality among men than other established risk
      factors for cardiovascular disease.

      The prevalence of fear of activity in CAD, heart failure and female patients have been
      studied by several researchers reporting variable results. It ranges from 70% in acute
      hospitalized CAD patients to 20% in chronic patients in community. Muscle endurance, steps
      per day measured by pedometer, IPAQ were found to be lower in patients with high level of
      fear of activity.They did not measure exercise capacity objectively. Research investigating
      the effect of fear of activity on exercise capacity in patients with CAD is lacking.

      The aim of this study is to identify whether coronary artery disease (CAD) patients have fear
      of activity, and to assess the relationship between fear of activity and exercise capacity in
      CAD patients. The hypothesis of this study were that CAD patients would have lower exercise
      capacity than healthy subjects and CAD patients with higher fear of activity would have lower
      exercise capacity.
    

Intervention name(s): Modified Bruce protocol on treadmill
Intervention type(s): Combination Product
Intervention description(s): Fear of activity scale in CAD (FactCAD) was used to assess fear of activity and exercise in subjects with CAD. FactCAD is a novel scale developed specifically for patients with heart disease. Mean time to complete this self-administered scale is 4-7 minutes. The final score of the questionnaire ranges between 0 and 84. High scores indicate higher levels of fear regarding activity or exercise.
Functional capacity was assessed by 6MWT and exercise test. The 6MWT was performed to all participants according to the American Thoracic Society guidelines in a 30-m corridor10. The subjects were asked to walk as long distance as they could within 6 minutes. The 6MWT distance was recorded in meters.
Exercise test was performed using modified Bruce protocol on treadmill in institutions where technical equipment and experience was available.
Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        Study population consisted of 196 patients with CAD (144 men, 52 women) and 113 healthy
        subjects (73 men, 40 women).