{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:34:59Z","timestamp":1787027699583,"version":"build-2736575974"},"reference-count":46,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T00:00:00Z","timestamp":1630886400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004329","name":"Javna Agencija za Raziskovalno Dejavnost RS","doi-asserted-by":"publisher","award":["630-72\/2019-1"],"award-info":[{"award-number":["630-72\/2019-1"]}],"id":[{"id":"10.13039\/501100004329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004329","name":"Javna Agencija za Raziskovalno Dejavnost RS","doi-asserted-by":"publisher","award":["J3-9292"],"award-info":[{"award-number":["J3-9292"]}],"id":[{"id":"10.13039\/501100004329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004329","name":"Javna Agencija za Raziskovalno Dejavnost RS","doi-asserted-by":"publisher","award":["J3-9284"],"award-info":[{"award-number":["J3-9284"]}],"id":[{"id":"10.13039\/501100004329","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biosensors"],"abstract":"<jats:p>Physical activity (PA) and sedentary behavior (SB) levels in healthy adults are predominately based on self-reporting measures, which generally overestimate PA but underestimate SB. Patients with coronary artery disease (CAD) eligible for cardiac rehabilitation (CR) follow an individualized program; thus, objective assessment of physical performance and regular daily activity is required. This study aimed to compare self-reported and objectively measured PA and SB in patients with CAD prior to out-patient CR. We included 91 patients with CAD and assessed their PA with an accelerometer for 8 days prior to CR, along with the short form of the international physical activity questionnaire. We found that most patients were sedentary (61%, ~8 h\/day), and on average performed 63 min\/day of moderate-to-vigorous-intensity physical activity (MVPA). Males performed less daily light-intensity physical activity (\u22125%, p = 0.011) and performed more MVPA (+2%, p = 0.002) compared to females. Maximal aerobic capacity was significantly associated with MVPA (Spearman rho = 0.483, p &lt; 0.001) and MVPA &gt; 10 min bouts (Spearman rho = 0.391, p &lt; 0.001). Self-reported measures overestimated MVPA (total MVPA, +108 min\/day, p &lt; 0.001; MVPA &gt; 10 min bouts, +152 min, p &lt; 0.001) and underestimated SB (\u2212174 min\/day, p &lt; 0.001) compared to objective measures. There was no significant correlation between methods in MVPA (Spearman rho = 0.147, p = 0.165)), MVPA &gt; 10 min bouts (Spearman rho = \u22120.059, p = 576), and SB (Spearman rho = 0.139, p = 0.187). Quantitative analysis demonstrated the huge proportional bias for MVPA, MVPA &gt; 10 min bouts, and SB. Our findings demonstrate that self-reported physical activity provides inaccurate estimates of MVPA and SB in patients with CAD entering the ambulatory CR. This strongly supports the more objective assessments of daily PA, preferably using an accelerometer.<\/jats:p>","DOI":"10.3390\/bios11090318","type":"journal-article","created":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T10:59:12Z","timestamp":1630925952000},"page":"318","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Objectively Measured Physical Activity in Patients with Coronary Artery Disease: A Cross-Validation Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3571-7928","authenticated-orcid":false,"given":"Tim","family":"Kambic","sequence":"first","affiliation":[{"name":"Cardiac Rehabilitation Unit, Department of Research and Education, General Hospital Murska Sobota, 9000 Murska Sobota, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0747-3735","authenticated-orcid":false,"given":"Nejc","family":"\u0160arabon","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, University of Primorska, Polje 42, 6310 Izola, Slovenia"},{"name":"InnoRenew CoE, Human Health Department, Livade 6, 6310 Izola, Slovenia"},{"name":"Laboratory for Motor Control and Motor Behavior, S2P, Science to Practice, Ltd., Tehnolo\u0161ki Park 19, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6918-9994","authenticated-orcid":false,"given":"Vedran","family":"Had\u017ei\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Sport, University of Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5922-4098","authenticated-orcid":false,"given":"Mitja","family":"Lainscak","sequence":"additional","affiliation":[{"name":"Division of Cardiology, General Hospital Murska Sobota, 9000 Murska Sobota, Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia"},{"name":"Faculty of Natural Sciences and Mathematics, University of Maribor, 2000 Maribor, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1177\/2047487320913379","article-title":"Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology","volume":"28","author":"Ambrosetti","year":"2021","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.ijcard.2020.11.014","article-title":"Sedentary behaviour in cardiovascular disease patients: Risk group identification and the impact of cardiac rehabilitation","volume":"326","author":"Bakker","year":"2021","journal-title":"Int. J. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1093\/ije\/dyz148","article-title":"Physical activity of UK adults with chronic disease: Cross-sectional analysis of accelerometer-measured physical activity in 96 706 UK Biobank participants","volume":"48","author":"Barker","year":"2019","journal-title":"Int. J. Epidemiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1136\/bjsports-2020-103270","article-title":"Joint associations of accelerometer-measured physical activity and sedentary time with all-cause mortality: A harmonised meta-analysis in more than 44 000 middle-aged and older individuals","volume":"54","author":"Ekelund","year":"2020","journal-title":"Br. J. Sports Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"123","DOI":"10.7326\/M14-1651","article-title":"Sedentary Time and Its Association With Risk for Disease Incidence, Mortality, and Hospitalization in Adults","volume":"162","author":"Biswas","year":"2015","journal-title":"Ann. Intern. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1136\/bjsports-2017-098963","article-title":"Do the associations of sedentary behaviour with cardiovascular disease mortality and cancer mortality differ by physical activity level? A systematic review and harmonised meta-analysis of data from 850 060 participants","volume":"53","author":"Ekelund","year":"2019","journal-title":"Br. J. Sports Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1007\/s10654-018-0380-1","article-title":"Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: A systematic review and dose response meta-analysis","volume":"33","author":"Patterson","year":"2018","journal-title":"Eur. J. Epidemiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"l4570","DOI":"10.1136\/bmj.l4570","article-title":"Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: Systematic review and harmonised meta-analysis","volume":"366","author":"Ekelund","year":"2019","journal-title":"BMJ"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1161\/CIRCULATIONAHA.119.043030","article-title":"Prospective Associations of Accelerometer-Measured Physical Activity and Sedentary Time With Incident Cardiovascular Disease, Cancer, and All-Cause Mortality","volume":"141","author":"Dempsey","year":"2020","journal-title":"Circulation"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/S0140-6736(12)61031-9","article-title":"Effect of physical inactivity on major non-communicable diseases worldwide: An analysis of burden of disease and life expectancy","volume":"380","author":"Lee","year":"2012","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1016\/j.jacc.2017.08.017","article-title":"Physical activity and mortality in patients with stable coronary heart disease","volume":"70","author":"Stewart","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1161\/01.CIR.102.12.1358","article-title":"Physical Activity and Mortality in Older Men With Diagnosed Coronary Heart Disease","volume":"102","author":"Wannamethee","year":"2000","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3547","DOI":"10.1093\/eurheartj\/ehz564","article-title":"Mortality reduction with physical activity in patients with and without cardiovascular disease","volume":"40","author":"Jeong","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1097\/HJR.0b013e3283101671","article-title":"Physical activity and mortality in men and women with coronary heart disease: A prospective population-based cohort study in Norway (the HUNT study)","volume":"15","author":"Moholdt","year":"2008","journal-title":"Eur. J. Cardiovasc. Prev. Rehabil."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/1479-5868-5-56","article-title":"A comparison of direct versus self-report measures for assessing physical activity in adults: A systematic review","volume":"5","author":"Prince","year":"2008","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"E5","DOI":"10.1097\/HCR.0000000000000334","article-title":"Objectively measured changes in physical activity and sedentary behavior in cardiac rehabilitation: A prospective cohort study","volume":"38","author":"Freene","year":"2018","journal-title":"J. Cardiopulm. Rehabil. Prev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1177\/2047487318806357","article-title":"Comparison of self-reported and objectively measured levels of sitting and physical activity and associations with markers of health in cardiac rehabilitation patients","volume":"26","author":"Prince","year":"2019","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1177\/2047487315617101","article-title":"Objectively-measured sedentary time and its association with markers of cardiometabolic health and fitness among cardiac rehabilitation graduates","volume":"23","author":"Prince","year":"2016","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2062","DOI":"10.1016\/j.jacc.2019.02.031","article-title":"Sitting Time, Physical Activity, and Risk of Mortality in Adults","volume":"73","author":"Stamatakis","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1097\/HCR.0000000000000488","article-title":"Validity of the Past-day Adults\u2019 Sedentary Time Questionnaire in a Cardiac Rehabilitation Population","volume":"40","author":"Freene","year":"2020","journal-title":"J. Cardiopulm. Rehabil. Prev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e051325","DOI":"10.1136\/bmjopen-2021-051325","article-title":"Effects of high-load and low-load resistance training in patients with coronary artery disease: Rationale and design of a randomised controlled clinical trial","volume":"11","author":"Kambic","year":"2021","journal-title":"BMJ Open"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Sagelv, E.H., Ekelund, U., Pedersen, S., Brage, S., Hansen, B.H., Johansson, J., Grimsgaard, S., Nordstr\u00f6m, A., Horsch, A., and Hopstock, L.A. (2019). Physical activity levels in adults and elderly from triaxial and uniaxial accelerometry. The Troms\u00f8 Study. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0225670"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1249\/mss.0b013e31815a51b3","article-title":"Physical Activity in the United States Measured by Accelerometer","volume":"40","author":"Troiano","year":"2008","journal-title":"Med. Sci. Sport Exerc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1007\/s40279-017-0716-0","article-title":"Accelerometer Data Collection and Processing Criteria to Assess Physical Activity and Other Outcomes: A Systematic Review and Practical Considerations","volume":"47","author":"Migueles","year":"2017","journal-title":"Sport Med."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Ricardo, L.I., Wendt, A., Galliano, L.M., de Andrade Muller, W., Ni\u00f1o Cruz, G.I., Wehrmeister, F., Brage, S., Ekelund, U., and Crochemore MSilva, I. (2020). Number of days required to estimate physical activity constructs objectively measured in different age groups: Findings from three Brazilian (Pelotas) population-based birth cohorts. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0216017"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/j.jsams.2011.04.003","article-title":"Validation and comparison of ActiGraph activity monitors","volume":"14","author":"Sasaki","year":"2011","journal-title":"J. Sci. Med. Sport"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1002\/nur.21694","article-title":"Validation of accelerometer thresholds and inclinometry for measurement of sedentary behavior in young adult university students","volume":"38","author":"Peterson","year":"2015","journal-title":"Res. Nurs. Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/HCR.0b013e3181fc0970","article-title":"Characteristics of Patients Entering Cardiac Rehabilitation in the United Kingdom 1993-2006: Implications for the future","volume":"31","author":"Evans","year":"2011","journal-title":"J. Cardiopulm. Rehabil. Prev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1249\/01.MSS.0000078924.61453.FB","article-title":"International physical activity questionnaire: 12-country reliability and validity","volume":"35","author":"Craig","year":"2003","journal-title":"Med. Sci. Sport Exerc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1161\/CIR.0b013e31829b5b44","article-title":"Exercise standards for testing and training: A scientific statement from the American heart association","volume":"128","author":"Fletcher","year":"2013","journal-title":"Circulation"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1213\/ANE.0000000000002864","article-title":"Correlation coefficients: Appropriate use and interpretation","volume":"126","author":"Schober","year":"2018","journal-title":"Anesth. Analg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s12966-020-00938-3","article-title":"A comparison of self-reported and device measured sedentary behaviour in adults: A systematic review and meta-analysis","volume":"17","author":"Prince","year":"2020","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1136\/bmj.313.7048.41","article-title":"Statistics Notes: Measurement error and correlation coefficients","volume":"313","author":"Bland","year":"1996","journal-title":"BMJ"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research","volume":"15","author":"Koo","year":"2016","journal-title":"J. Chiropr. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S0140-6736(86)90837-8","article-title":"Statistical methods for assessing agreement between two methods of clinical measurement","volume":"327","author":"Bland","year":"1986","journal-title":"Lancet"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.hrtlng.2018.09.008","article-title":"Sedentary behavior and physical activity in cardiac rehabilitation participants","volume":"48","author":"Ramadi","year":"2019","journal-title":"Heart Lung"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.rehab.2017.06.003","article-title":"A prospective study examining the influence of cardiac rehabilitation on the sedentary time of highly sedentary, physically inactive patients","volume":"61","author":"Biswas","year":"2018","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/1479-5868-11-28","article-title":"Exploring patterns of accelerometry-assessed physical activity in elderly people","volume":"11","author":"Ortlieb","year":"2014","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/0735-1097(94)90420-0","article-title":"Prognostic significance of peak exercise capacity in patients with coronary artery disease","volume":"23","author":"Luc","year":"1994","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1177\/2047487313514018","article-title":"Increasing the medium-term clinical benefits of hospital-based cardiac rehabilitation by physical activity telemonitoring in coronary artery disease patients","volume":"22","author":"Frederix","year":"2015","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1016\/S0140-6736(16)30370-1","article-title":"Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women","volume":"388","author":"Ekelund","year":"2016","journal-title":"Lancet"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"104238","DOI":"10.1016\/j.archger.2020.104238","article-title":"Association between different cutoff points for objectively measured moderate-to-vigorous physical activity and cardiometabolic markers in older adults","volume":"91","author":"Rech","year":"2020","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1249\/MSS.0000000000001933","article-title":"Association between Bout Duration of Physical Activity and Health: Systematic Review","volume":"51","author":"Jakicic","year":"2019","journal-title":"Med. Sci. Sport Exerc."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health Organization 2020 guidelines on physical activity and sedentary behaviour","volume":"54","author":"Bull","year":"2020","journal-title":"Br. J. Sports Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1186\/1479-5868-8-115","article-title":"Validity of the international physical activity questionnaire short form (IPAQ-SF): A systematic review","volume":"8","author":"Lee","year":"2011","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2057","DOI":"10.1177\/2047487319864180","article-title":"Exercise training in cardiovascular disease: Are we closing the gender gap?","volume":"27","author":"Kambic","year":"2020","journal-title":"Eur. J. Prev. Cardiol."}],"container-title":["Biosensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6374\/11\/9\/318\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:57:26Z","timestamp":1760165846000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6374\/11\/9\/318"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,6]]},"references-count":46,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["bios11090318"],"URL":"https:\/\/doi.org\/10.3390\/bios11090318","relation":{},"ISSN":["2079-6374"],"issn-type":[{"value":"2079-6374","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,6]]}}}