Comparison of self-reported physical activity between survivors of out-of-hospital cardiac arrest and patients with myocardial infarction without cardiac arrest: a case-control study

Abstract

Aims: To investigate whether out-of-hospital cardiac arrest (OHCA) survivors had lower levels of self-reported physical activity compared to a non-cardiac arrest control group with myocardial infarction (MI), and to explore if symptoms of anxiety, depression, kinesiophobia (fear of movement), and fatigue were associated with a low level of physical activity.

Methods and results: Pre-defined case-control sub-study within the international Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial. Out-of-hospital cardiac arrest survivors at 8 of 61 TTM2 sites in Sweden, Denmark, and the UK were invited. Participants were matched 1:1 to MI controls. Both OHCA survivors and MI controls answered two questions on self-reported physical activity, categorized as a low, moderate, or high level of physical activity, and questionnaires on anxiety and depression symptoms, kinesiophobia, and fatigue 7 months after the cardiac event. Overall, 106 of 184 (58%) eligible OHCA survivors were included and matched to 91 MI controls. In total, 25% of OHCA survivors and 20% of MI controls reported a low level of physical activity, with no significant difference (P = 0.13). Symptoms of kinesiophobia and fatigue were significantly associated with a low level of physical activity in both groups. Out-of-hospital cardiac arrest survivors had significantly more kinesiophobia compared to MI controls (18% vs. 9%, P = 0.04), while levels of anxiety and depression symptoms and fatigue were similar.

Conclusion: Out-of-hospital cardiac arrest survivors had similar levels of physical activity compared to matched MI controls. High level of kinesiophobia and fatigue were associated with a low level of physical activity in both groups.

Registration: ClinicalTrials.gov: NCT03543332.

Keywords: Anxiety; Cardiac arrest; Depression; Fatigue; Kinesiophobia; Myocardial infarction; Physical activity.