Study finds fear of exercise common in heart failure patients

Cardiovascular disease, including heart failure, is the most common cause of death in Germany. Older people with pre-existing conditions are particularly affected by heart failure. The heart is no longer able to pump enough blood into the body.

Thirty years ago, it was commonly thought that patients with this condition should take enough rest. However, as well as in addition to treatment with medication, the benefit of exercise has been scientifically shown.

Together with their clinical partners, scientists at Trier University have now investigated why many people with heart failure still shy away from physical activity. For the first time, it has been shown that it is in connection to their disease that patients are afraid of exercise. This fear contributes to avoidance of exercise regardless of the heart's pumping capacity.

"When people with heart failure go for a walk or climb stairs and realize that they are getting out of breath, they often have the feeling that their heart cannot cope. As a result, they avoid exercise," explains Heike Spaderna, Professor for Health Psychology at Trier University.

"But even healthy people can get out of breath when climbing stairs. It is important to explain to patients that not all symptoms of fatigue are due to heart disease."

For their study, which was published in PLOS One, the researchers in Nursing Science from Trier surveyed 185 patients with heart failure from various clinics in Germany. They were able to show that fear of exercise is associated with heart failure and that avoidance of physical activity is not due to a fundamentally greater tendency towards anxiety among patients.

The authors of the study conducted foundational research in this area. "Now that a connection has been established, the next step is to consider how we can take away patients' fear of exercise," says Spaderna. The Professor from Trier has had good experiences with virtual reality to mobilize people. Exercises could be designed in a playful way. A special exercise-app would also be conceivable.

"One problem is that it is not standard practice to discuss with heart failure patients how they can integrate exercise into their everyday lives despite their condition. Only some have an exercise plan or physiotherapy," explains Spaderna.

With their research, the health psychologists would also like to provide medical professionals with the knowledge to address patients' fear of exercise. This could give people with heart failure a better quality of life and, ideally, increase their lifespan.