Comparison of Kinesiophobia, Upper Limb Function, and Grip Strength in Patients with Pacemakers and Coronary Artery...

To compare kinesiophobia, shoulder range of motion (ROM), functional disability, and handgrip strength (HGS) between patients with cardiac pacemakers and those with stable coronary artery disease (CAD).

This cross-sectional study enrolled 60 individuals aged ≥50 years with preserved left ventricular systolic function, including 30 patients with standard left-sided cardiac pacemakers and 30 individuals with CAD. Kinesiophobia was assessed using the validated Turkish version of the Tampa Scale for Kinesiophobia-Heart (TSK-Heart). Shoulder ROM, HGS, and upper limb function [quick disabilities of the arm, shoulder, and hand (QuickDASH)] were evaluated using standardized clinical protocols. Analysis of covariance was used for between-group comparisons.

The TSK-Heart scores were similar between the pacemaker and CAD groups, with no statistically significant difference (P = .061). Internal rotation of the left shoulder was significantly more limited in the pacemaker group (P = .031, Cohen's d = 0.58). No significant differences were observed in other shoulder ROM parameters, QuickDASH scores, or HGS between the groups.

Kinesiophobia levels were similarly elevated in patients with pacemakers and those with CAD, suggesting that fear of movement is a generalized phenomenon across chronic cardiac populations rather than a device-specific issue. The selective internal rotation limitation observed exclusively in pacemaker recipients highlights the importance of targeted musculoskeletal assessment during clinical follow-up. Recognition of such functional impairments, alongside awareness of elevated kinesiophobia, is critical for comprehensive patient management.