Objectives The objective of this study was to investigate how kinesiophobia and self-efficacy explain the relationship between fatigue and physical activity (PA) in post-coronary artery bypass grafting (post-CABG) patients over the age of 45. Design A prospective multicentre and cross-sectional study. Setting The study was conducted in four public tertiary hospitals in China. Participants A total of 1278 patients who underwent CABG surgery were selected from the case pool, with their surgeries occurring between 3 and 19 months prior to selection. Out of 1038 patients who met the inclusion criteria and were invited to participate in the study, 759 patients agreed to participate and complete the questionnaire. Ultimately, 376 questionnaires were deemed eligible and included in the analysis. Primary and secondary outcome measures The questionnaire included the following scales: the Chinese version of the Multidimensional Fatigue Inventory (MFI-20), the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), the Cardiac Exercise Self-Efficacy Instrument (CESEI) and the International Physical Activity Questionnaire-Long (IPAQ-L). A serial mediation model was used to test whether the association between fatigue and PA was mediated by kinesiophobia and self-efficacy, in the overall sample and subsamples defined by age. Results The results confirmed that fatigue was directly (95% CI (−5.73 to −3.02)) associated with PA. Higher kinesiophobia (95% CI (−0.16 to −0.05)) or lower PA self-efficacy (95% CI (−0.11 to −0.02)) were parallel pathways through which higher fatigue impediment reduced PA levels. In both subgroups, the street pathways of kinesiophobia and self-efficacy were altered. In the age, 45–60 years group, kinesiophobia (Boot 95% CI (−0.19 to−0.05)) was a mediator of fatigue on PA levels, while in the 61–75 years age group, self-efficacy (Boot 95% CI (−0.17 to −0.04)) was a mediator of fatigue on PA levels. Conclusions A clear relationship between fatigue and PA was mediated by both kinesiophobia and self-efficacy. Furthermore, our findings highlight the importance of adapting the intervention according to the age of the patients, mainly by reducing patients’ kinesiophobia in patients aged 45–60 years and increasing patients’ self-efficacy in patients aged 61–75 years. It may be possible to improve PA levels in post-CABG patients over 45 years of age by eliminating kinesiophobia and increasing self-efficacy.

Objective To investigate the potential classification of kinesiophobia in patients after cardiac surgery under extracorporeal circulation from a psychosocial perspective, and analyse the characteristic differences among different latent levels of patients. Study design This is a cross-sectional study of Chinese adults after cardiac surgery under extracorporeal circulation, aged 18 years and older, recruited from a tertiary hospital in North China. Methods This study uses latent profile analysis to identify potential classifications of kinesiophobia in questionnaires from 348 patients undergoing cardiac surgery under extracorporeal circulation. Multiple logistic regression analysis was used to evaluate the influencing factors at different latent classifications. Results The average performance of each indicator in Model 3 is best suited for analysis, Entropy=0.873 and bootstrap likelihood ratio test (p)＜0.0001. The result of regression equation shows postoperative time (p<0.001), age, self-efficacy, pain and social support level (p<0.05) were the factors influencing the potential profile classification of patients after cardiac surgery under extracorporeal circulation. Conclusion The study identified three distinct classifications of patients: the low kinesiophobia group, the moderate kinesiophobia—high-risk perceived symptoms group and the high kinesiophobia—high exercise avoidance group (HK-HEAG). Addressing kinesiophobia, especially in older male patients during the early postoperative period, is crucial. Enhancing self-efficacy seems effective in reducing kinesiophobia, while increasing social support may not be as beneficial for the HK-HEAG. These findings provide a basis for implementing preventive interventions in cardiac rehabilitation. Trial registration number The research is registered with the Chinese Clinical Trial Registry (ChiCTR2200057895).

Introduction Physical activity (PA) can improve cardiac function, exercise capacity, and quality of life, in addition to reducing mortality by 20%–30% and preventing the recurrence of adverse cardiovascular events in patients following coronary artery bypass graft (CABG). However, PA levels are low in patients after CABG. This study intends to explore the mediating effect of kinesiophobia between self-efficacy and PA levels in patients following CABG. Methods and analysis The proposed study constitutes a prospective, multicentre and cross-sectional study comprising 413 patients. Four teaching hospitals with good reputations in CABG will be included in the study. All of them are located in Beijing, China, and provide medical service to the whole country. This study will assess the following patient-reported outcome measures: demographic information, International Physical Activity Questionnaire-Long, Social Support Rating Scale, Cardiac Exercise Self-Efficacy Instrument, Multidimensional Fatigue Inventory, Hospital Anxiety and Depression Scale, and Tampa Scale for Kinesiophobia Heart. Ethics and dissemination This study conforms to the principles of the Declaration of Helsinki and relevant ethical guidelines. Ethical approval has been obtained from the Ethics Committee of The Sixth Medical Centre of PLA General Hospital (approval number: HZKY-PJ-2022–2). All study participants will provide written informed consent. Findings from this study will be published in Chinese or English for widespread dissemination of the results. Trial registration number Chinese Clinical Trial Register, ChiCTR2100054098.

Introduction: Cardiac rehabilitation (CR) is a critical treatment for patients with coronary heart disease after percutaneous coronary intervention. Unfortunately, participation and adherence of CR are unexpectedly poor. This study aims to test whether low-intensity or medium-intensity brisk walking is more helpful in improving early attendance, adherence and physical results. Methods and analysis: This randomised controlled study will compare the effects of low-intensity and medium-intensity brisk walking to improve adherence and cardiopulmonary endurance. Participants will be randomly allocated to low-intensity or medium-intensity groups and will be followed-up for 8 weeks. Primary and secondary outcome data will be collected at baseline and at 2, 4 and 8 weeks. Primary outcomes measure changes in oxygen consumption (VO ₂ ) peak value (mL/kg/min), as well as adherence. Secondary outcomes include changes in body mass index, oxygen pulse, maximal metabolic equivalent, breathing reserve, vital capacity, ratio of forced expiratory volume in 1 s to forced vital capacity, Δoxygen consumption/Δwork rate (ΔVO ₂ /ΔWR), minute ventilation/carbon dioxide production and self-efficacy. Ethics and dissemination: Ethical approval and informed consent form have been obtained from the Ethics Committee of Hebei General Hospital (approval number: NA-2021–03). The study background and main objective, as well as potential benefits and risks, will be fully explained to the participants and their families. Findings from this study will be published on academic journals in Chinese or in English for widespread dissemination of the results Trial registration number: ChiCTR2100047568.