Analysis of risk factors for kinesiophobia after coronary artery bypass grafting and construction of a nomogram prediction model
- 1Cardiac and Vascular Surgery ICU, The First Affiliated Hospital of Anhui Medical University
- 2Department of Cardiovascular Medicine, The First Affiliated Hospital of Anhui Medical University
Abstract
Background: Kinesiophobia, or the irrational fear of movement, is a significant barrier to effective cardiac rehabilitation and recovery in patients after coronary artery bypass grafting (CABG). This study sought to identify the risk factors for kinesiophobia in post-CABG patients and to develop and validate a nomogram prediction model to estimate individual risk.
Methods: A retrospective case-control study was conducted on 138 patients who underwent CABG in the Cardiovascular ICU between February 2023 and November 2024. Using the Tampa Scale for Kinesiophobia-Heart (TSK-Heart), patients were categorized into a kinesiophobia group (TSK-Heart >37, n = 95) and a non-kinesiophobia group ( n = 43). Risk Factors were identified with multivariable logistic regression. The resulting coefficients furnished a nomogram for individual risk estimation. Calibration was evaluated with the Hosmer-Lemeshow test and a bootstrap-corrected calibration plot; discrimination was quantified by the receiver operating characteristic (ROC) curve and calibration curve.
Results: The incidence of kinesiophobia in this cohort was 68.84%. The logistic regression analysis identified six risk factors: advanced age ( OR = 1.127, P = 0.003), lower educational level ( OR = 0.246, P = 0.001), higher degree of disability in activities of daily living (ADL) ( OR = 3.880, P = 0.007), lower self-efficacy in cardiac rehabilitation exercise ( OR = 0.898, P = 0.024), pain catastrophizing ( OR = 4.513, P = 0.023), and fear of falling ( OR = 1.212, P = 0.004). The constructed nomogram demonstrated excellent discrimination, with an AUC of 0.939 (95% CI : 0.898–0.981), and high sensitivity (93.7%) and specificity (83.7%). Calibration was confirmed by the Hosmer-Lemeshow test ( χ ² = 5.97, P = 0.65) and a bootstrap-corrected calibration plot showing close agreement between predicted and observed probabilities.
Conclusions: Advanced age, low educational attainment, ADL dependency, poor cardiac rehabilitation self-efficacy, pain catastrophizing, and fear of falling were significant risk factors for kinesiophobia after CABG. The developed nomogram was a reliable and accurate tool for early identification of high-risk patients, enabling clinicians to implement individualized preventative strategies and optimize postoperative recovery.
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BibTeX
@article{guo2026analysis,
title = {{Analysis of risk factors for kinesiophobia after coronary artery bypass grafting and construction of a nomogram prediction model}},
author = {Lancai Guo and Jing Li and Wenjuan Ye and Xue Wei and Xia Wu and Xiaocan Wang},
journal = {Frontiers in Cardiovascular Medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1742685},
url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1742685/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Analysis of risk factors for kinesiophobia after coronary artery bypass grafting and construction of a nomogram prediction model
AU - Lancai Guo
AU - Jing Li
AU - Wenjuan Ye
AU - Xue Wei
AU - Xia Wu
AU - Xiaocan Wang
PY - 2026
DA - 2026/10/26
JO - Frontiers in Cardiovascular Medicine
DO - 10.3389/fcvm.2026.1742685
UR - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1742685/full
AB - Background: Kinesiophobia, or the irrational fear of movement, is a significant barrier to effective cardiac rehabilitation and recovery in patients after coronary artery bypass grafting (CABG). This study sought to identify the risk factors for kinesiophobia in post-CABG patients and to develop and validate a nomogram prediction model to estimate individual risk. Methods: A retrospective case-control study was conducted on 138 patients who underwent CABG in the Cardiovascular ICU between February 2023 and November 2024. Using the Tampa Scale for Kinesiophobia-Heart (TSK-Heart), patients were categorized into a kinesiophobia group (TSK-Heart >37, n = 95) and a non-kinesiophobia group ( n = 43). Risk Factors were identified with multivariable logistic regression. The resulting coefficients furnished a nomogram for individual risk estimation. Calibration was evaluated with the Hosmer-Lemeshow test and a bootstrap-corrected calibration plot; discrimination was quantified by the receiver operating characteristic (ROC) curve and calibration curve. Results: The incidence of kinesiophobia in this cohort was 68.84%. The logistic regression analysis identified six risk factors: advanced age ( OR = 1.127, P = 0.003), lower educational level ( OR = 0.246, P = 0.001), higher degree of disability in activities of daily living (ADL) ( OR = 3.880, P = 0.007), lower self-efficacy in cardiac rehabilitation exercise ( OR = 0.898, P = 0.024), pain catastrophizing ( OR = 4.513, P = 0.023), and fear of falling ( OR = 1.212, P = 0.004). The constructed nomogram demonstrated excellent discrimination, with an AUC of 0.939 (95% CI : 0.898–0.981), and high sensitivity (93.7%) and specificity (83.7%). Calibration was confirmed by the Hosmer-Lemeshow test ( χ ² = 5.97, P = 0.65) and a bootstrap-corrected calibration plot showing close agreement between predicted and observed probabilities. Conclusions: Advanced age, low educational attainment, ADL dependency, poor cardiac rehabilitation self-efficacy, pain catastrophizing, and fear of falling were significant risk factors for kinesiophobia after CABG. The developed nomogram was a reliable and accurate tool for early identification of high-risk patients, enabling clinicians to implement individualized preventative strategies and optimize postoperative recovery.
SN - 2297-055X
ER -