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June 12, 2026European Journal of Preventive Cardiology0 citationsOpen Access

Physical activity and sedentary behaviour in a phase III cardiac rehabilitation program: identifying vulnerable subgroups

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MBM BorgesKWK WagnerMPM Lemos Pires

Key Result

Among patients entering phase III cardiac rehabilitation, men were over 5 times more likely to meet physical activity guidelines than women (OR 5.50; 95% CI 1.7-17.7).

Key Points

  • To assess physical activity and sedentary behaviour levels in patients entering a phase III cardiac rehabilitation program and identify at-risk subgroups.
  • Cross-sectional analysis of patients with cardiovascular disease (CVD) completing baseline assessments and wearing accelerometers for 7 days.
  • Patients engaged in supervised exercise sessions 2-3 times per week.
  • Group differences were analyzed using t-tests, correlations, and multivariable regression models.
  • Patients averaged 45.89 minutes/day of moderate-to-vigorous physical activity (MVPA) and 11.06 hours/day of sedentary behaviour (SB).
  • Women had lower MVPA compared to men, performing 31.1 min/day vs 45.1 min/day (p=.041).
  • Those with diabetes accumulated less MVPA (43.7 vs 45.9 min/day; p=.011) and completion of phase II CR was associated with lower SB percentage (p=.032).

Study Design

Type

Cross-Sectional (n=190)

Structured PICO

P
Population
190 cardiovascular disease patients (mean age 62, 17.9% women) entering a phase III cardiac rehabilitation program, assessed with 7-day accelerometry.
E
Exposure
Phase III cardiac rehabilitation program (supervised 60-min exercise sessions, 2-3x/week) with 7-day accelerometer monitoring
O
Outcome
Physical activity (moderate-to-vigorous and light) and sedentary behaviour levels measured by 7-day accelerometer

In patients entering phase III cardiac rehabilitation, sedentary behavior remains high despite meeting physical activity guidelines, with women, diabetics, and those with lower fitness or no prior phase II rehab identified as vulnerable subgroups requiring tailored support.

Main Result

Odds Ratio: 5.5 (95% CI 1.7–17.7)

Abstract

Abstract Introduction Patients entering a phase III cardiac rehabilitation (CR) program often attend exercise sessions regularly and many meet WHO physical activity (PA) guidelines. However, both PA and sedentary behaviour (SB) are independent cardiovascular risk factors, and meeting PA guidelines does not necessarily protect individuals who accumulate high levels of SB. Additionally, within CR populations, specific subgroups may present less favourable behavioural profiles and require tailored support. Purpose To characterise PA and SB levels in patients entering a phase III CR program and identify subgroups at greater risk for suboptimal activity patterns. Methods In this cross-sectional analysis, patients completed the following baseline assessments: sociodemographic and clinical measures; a symptom-limited ramp cardiopulmonary exercise test; and wore an accelerometer for 7 days. Patients attended supervised 60-min CR exercise sessions, 2-3x/week. Group differences were examined using t-tests or non-parametric alternatives, correlations with pearson coefficient, and multivariable analyses were done with logistic and linear regression models. Results 190 CVD patients were included (62±10 y/o, 17.9% women, 85.8% coronary artery disease, 84.2% completed phase II CR). Patients accumulated on average 45.89±24.81 min/day of moderate-to-vigorous PA (MVPA) and 11.06±1.28 hours/day of SB. Women performed more light PA (LPA), while men accumulated more MVPA (LPA women: 185.7 min/day, IQR = 142.0–210.6 vs men 157.1 min/day, IQR = 128.9–189.6, p=.038; MVPA women 31.1 min/day, IQR=17.9–56.1 vs men 45.1 min/day, IQR = 30.2–61.3, p=.041). Average MVPA was negatively correlated with age (r=–0.19, p=.008) and positively correlated with cardiorespiratory fitness (VO2peak) (r=0.34, p.001). Patients with diabetes accumulated less MVPA (43.7 min/day, IQR = 28.3–61.2 vs 45.9 min/day, IQR=29.9–69.9, p=.011) and patients who completed a phase II CR program had lower SB percentage (76.6%, IQR = 71.1–80.2 vs 78.8%, IQR=74.1–81.9, p=.028). In multivariable models, sex, VO2peak, and accelerometer wear time independently predicted meeting PA guidelines. Men were over 5x more likely to meet PA guidelines than women (OR=5.50, 95% CI 1.7–17.7), and each 1 ml/kg/min increase in VO2peak was associated with 14% higher odds of compliance (OR=1.14, 95% CI 1.01–1.29). Accelerometer wear time was also a significant predictor (p=.004). Completion of phase II CR was the only independent predictor of lower %SB/day, with participants who had completed phase II spending on average 2.9% less of their day in SB (p =.032). Conclusion Although most patients entering phase III CR achieved recommended MVPA levels, SB remained high. Women, individuals with lower VO2peak, those with diabetes, and participants who had not completed Phase II CR showed less favourable activity profiles. These findings highlight the need for tailored strategies within long-term CR to support these vulnerable subgroups.

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Cite This Study

Borges et al. (2026) conducted a cross-sectional in Cardiovascular disease (n=190). Male sex vs. Female sex was evaluated on Meeting physical activity guidelines (OR 5.50, 95% CI 1.7-17.7). Among patients entering phase III cardiac rehabilitation, men were over 5 times more likely to meet physical activity guidelines than women (OR 5.50; 95% CI 1.7-17.7).

synapsesocial.com/papers/6a2bd1386550ea4541ffe99dhttps://doi.org/10.1093/eurjpc/zwag249.138
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