Intervention to improve kinesiophobia in patients with coronary artery disease: a systematic review and meta-analysis of randomized controlled trials

To describe interventions aimed at improving kinesiophobia in patients with coronary artery disease and provide an estimate of their effectiveness. A systematic review was conducted from 10 databases including PubMed, Web of Science, Cochrane Library, CINAHL, Embase, APA-PsycInfo, CNKI, VIP, Sinomed, and WangFang to identify all randomized controlled trials that were published from the time of database creation through August 2024. Quality assessment and data extraction were performed independently by two researchers. Using the Cochrane Risk of Bias Assessment Tool for quality assessment and RevMan 5.4 and Stata 15.0 for data syntheses. Subgroup analysis, sensitivity analysis, and publication bias were also conducted. A systematic review and meta-analysis of randomized controlled trials. A total of 16 randomized controlled trials (N = 1408) were included. Interventions to improve kinesiophobia in patients with coronary artery disease include cognitive behavioral interventions, psychological interventions, exercise interventions, multi-modal combined interventions, online and offline of home rehabilitation, and Preoperative Physical Therapy, and all interventions were effective(P < 0.01).These interventions were statistically significant at 1–2 months(SMD=-1.75; 95% CI=-2.16, -1.34), 3 months(SMD=-2.04; 95% CI=-2.66, -1.42), and 6 months(SMD = -4.90; 95% CI = -7.59, -2.20), there was no difference in kinesiophobia between 1 and 3 months after the intervention. These Interventions to reduce patients’ kinesiophobia can also promote the overall improvement of psychological status, cardiac function, exercise capacity, and quality of life(P < 0.01). Although publication bias was detected, sensitivity analyses confirmed the robustness of pooled results. Six intervention modalities identified across 16 included studies were effective in reducing kinesiophobia and demonstrated beneficial short- to mid-term effects. Early identification and intervention targeting kinesiophobia may improve psychological well-being and functional recovery. Further reduction may require individualized approaches and hybrid rehabilitation models combining tele- and center-based strategies. Future standardized, high-quality randomized controlled trials with extended follow-up are needed to clarify long-term effectiveness and support personalized rehabilitation strategies.