The relationship between dyspnea-related kinesiophobia and physical activity in people with COPD: Cross-sectional survey and mediated moderation analysis

Background: Changing the behavior of physical activity (PA) in COPD patients remains a challenge, because this population faces the same barriers to PA as the general population, as well as disease-specific barriers, especially dyspnea-related kinesiophobia. Objectives: This study aimed to assess the status of dyspnea-related kinesiophobia in people with COPD, and investigate its impact on PA levels, further examine the mediated moderation effects of exercise perception and social support on this relationship. Methods: A cross-sectional survey was conducted with COPD patients recruited from four tertiary hospitals in Jinan Province, China. We used Breathlessness Beliefs Questionnaire to identify dyspnea-related kinesiopho-bia. International Physical Activity Questionnaire-short-form, Exercise Benefits/Barriers Scale, and Social Support Rating Scale were used to assess PA, exercise perception and social support, respectively. The data were statistically processed using correlation analysis and a test of mediated moderation model. Results: A total of 223 COPD patients were included, and all of them had a symptom of dyspnea-related kine-siophobia. Dyspnea-related kinesiophobia was negatively correlated with exercise perception, subjective social support and PA. Exercise perception partially mediated the impact of dyspnea-related kinesiophobia on PA levels, and subjective social support indirectly influences PA by moderating the relationship between dyspnea-related kinesiophobia and exercise perception. Conclusions: People with COPD commonly have dyspnea-related kinesiophobia and experienced physical inactivity. The mediated moderation model provides a better understanding of how dyspnea-related kinesio-phobia, exercise perception, and subjective social support work together to influence PA. Interventions seek-ing to improve the levels of PA in COPD patients should consider these elements. (c) 2023 Elsevier Inc. All rights reserved.