Burmehl, Lola and Hasenbring, Monika and Kananian, Schahryar and Kleinschmidt, Judit and Kupferschmitt, Alexa Alica and Koellner, Volker (2025) Relationship between Anxiety, Depression and Physical Performance in the 6-Minute Walk Test: Avoidance and Endurance Behavior as Moderators in Patients with Post-COVID Syndrome. VERHALTENSTHERAPIE, 35 (4). pp. 130-144. ISSN 1016-6262, 1423-0402
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Background: Post-COVID syndrome (PCS) includes persistent symptoms such as fatigue, shortness of breath and mental disorders. There is evidence that dysfunctional behavioral patterns can negatively influence the process of symptoms. The present study investigates the influence of anxiety, depression and coping styles according to the avoidance/endurance concept on the performance of patients in the 6minute walk test (6MWT). Patients and Methods: A total of 156 post-COVID patients (& Oslash; 51 years, 78% female) underwent an interdisciplinary, multimodal rehabilitation program. The survey was conducted using standardized questionnaires (GAD-7, PHQ-9, AEQ) and the 6-minute walk test (6MWT) at the beginning (t0) and end (t1) of rehabilitation. Results: Psychological symptoms (Cohen's d = -0.42, p < 0.001) and physical performance in the 6MWT (Cohen's d = 0.69, p < 0.001) showed significant differences over the course of rehabilitation. Avoidance behavior negatively moderated depression as independent variable, while eustress-endurance reactions positively influenced the correlation in depressive and anxiety symptoms. Distress-endurance reactions had a negative effect on GAD-7 and 6MWT. Discussion and Conclusion: Avoidance behavior has a negative effect on physical performance in the context of depression while persistent eustress coping strategies appear to be more beneficial in PCS. Moderated along anxiety symptoms, distress-endurance reactions are found to be an inhibiting factor for physical performance. Due to the relevance of the avoidance-endurance concept, this should be used to adapt individual rehabilitation concepts.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | REHABILITATION; PAIN; VALIDATION; DISORDERS; FEAR; Coping; Depression; Anxiety; Avoidance/Endurance; Post-COVID syndrome; Anxiety; Avoidance/Endurance; Post-COVID syndrome |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Psychosomatische Medizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 29 Sep 2026 04:57 |
| Last Modified: | 29 Sep 2026 04:57 |
| URI: | https://pred.uni-regensburg.de/id/eprint/67072 |
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