Physical Activity Levels

Cardiac rehabilitation exercise professionals are unlikely to argue with the importance of assessing and documenting baseline physical activity levels or changes in physical activity levels over time. However, despite 40 years of using questionnaires to measure physical activity there are still questions over the best method to achieve it (Shephard, 2003). There are practical uses of gathering these data:

• as an auditable outcome of physical activity behaviour at key time points, e.g. event/diagnosis, pre- and post-rehabilitation and at one year;

• to educate patients about the definitions and differences between physical activity for general health benefit and exercise for fitness gain and associated benefits (see Chapter 4).

The challenge is to collect meaningful, standardised data. Although many programmes collect a measure of physical activity, there is often wide variation in the tools used, making comparisons between programmes extremely difficult. Self-report measures, although inexpensive and easy to administer (Pepin, et al., 2004), can provide inaccurate information, due to recall bias. Definitions of physical activity, such as those adopted by Health Education Board for Scotland (HEBS) (2001) relate to either moderate or vigorous activity and do not take into account mild activity, such as bowling, slow walking, dancing or golfing, the activities often reported by the CR patient population. A questionnaire being piloted by the British Heart Foundation (BHF), as part of their proposed minimum data set for CR, aims to address this problem (Lewin, et al., 2004).

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