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Comparison of Different Physical Activity Measures in a Cardiac Rehabilitation Program: A Prospective Study

Alharbi, Muaddi; Bauman, Adrian; Alabdulaali, Mohammed; Neubeck, Lis; Smith, Sidney; Naismith, Sharon; Jeon, Yun-Hee; Tofler, Geoffrey; Surour, Atef; Gallagher, Robyn


Muaddi Alharbi

Adrian Bauman

Mohammed Alabdulaali

Sidney Smith

Sharon Naismith

Yun-Hee Jeon

Geoffrey Tofler

Atef Surour

Robyn Gallagher


Concordant assessments of physical activity (PA) and related measures in cardiac rehabilitation (CR) is essential for exercise prescription. This study compared exercise measurement from an in-person walk test; wearable activity tracker; and self-report at CR entry, completion (8-weeks) and follow-up (16-weeks). Forty patients beginning CR completed the Six-Minute Walk Test (6MWT), Physical Activity Scale for the Elderly (PASE), and wore Fitbit-Flex for four consecutive days including two weekend days. The sample mean age was 66 years; 67% were male. Increased exercise capacity at CR completion and follow-up was detected by a 6MWT change in mean distance (39 m and 42 m; p = 0.01, respectively). Increased PA participation at CR completion was detected by Fitbit-Flex mean change in step counts (1794; p = 0.01). Relative changes for Fitbit-Flex step counts and a 6MWT were consistent with previous research, demonstrating Fitbit-Flex’s potential as an outcome measure. With four days of data, Fitbit-Flex had acceptable ICC values in measuring step counts and MVPA minutes. Fitbit-Flex steps and 6MWT meters are more responsive to changes in PA patterns following exposure to a cardiac rehabilitation program than Fitbit-Flex or PASE-estimated moderate–vigorous PA (MVPA) minutes. Fitbit-Flex step counts provide a useful additional measure for assessing PA outside of the CR setting and accounts for day-to-day variations. Two weekend days and two weekdays are needed for Fitbit-Flex to estimate PA levels more precisely.


Alharbi, M., Bauman, A., Alabdulaali, M., Neubeck, L., Smith, S., Naismith, S., Jeon, Y., Tofler, G., Surour, A., & Gallagher, R. (2022). Comparison of Different Physical Activity Measures in a Cardiac Rehabilitation Program: A Prospective Study. Sensors, 22(4), Article 1639.

Journal Article Type Article
Acceptance Date Feb 17, 2022
Online Publication Date Feb 19, 2022
Publication Date 2022
Deposit Date Mar 31, 2022
Publicly Available Date Mar 31, 2022
Journal Sensors
Publisher MDPI
Peer Reviewed Peer Reviewed
Volume 22
Issue 4
Article Number 1639
Keywords coronary heart disease; physical activity; Fitbit; 6MWT; PASE; responsiveness; interchangeability; cardiac rehabilitation
Public URL


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