Measuring Overall Physical Activity for Cardiac Rehabilitation Participants: A Review of the Literature

Background Assessment of physical activity (PA) for cardiac rehabilitation (CR) participants is critical to monitor changes. However, the validity and reliability of PA measures to assess PA throughout the day, not only during exercise training, is poorly investigated. Aim To establish a reliable and valid measure to assess overall PA in CR participants. Methods A narrative literature review was performed based on a systematic search of Embase, CINAHL, MEDLINE and PubMed databases. Eight studies comparing two or more PA measures with at least one direct measure met the inclusion criteria. Results Methodological designs were heterogeneous. Correlations and levels of agreement between self-reported measures and direct measures were weak to moderate, while the correlations between direct measures were high. Of the direct measures, the SenseWear armband (BodyMedia Inc., Pittsburgh, PA, USA) had the highest validity, and the PA diary and MobilePAL questionnaires performed better than other self-reported PA measures. Conclusion Direct measures were more valid and reliable than self-reported measures. No recommendation for a definitive PA measure was made due to lack of strong evidentiary support for one PA measure over another. There is a need for accurate measures of overall PA in evaluating current and changing PA levels following CR.