Movement Behaviors and Quality of Life in Cardiac Rehabilitation Programs: A Study Based on the Canadian 24‐Hour Movement Guidelines

Q: What are the key findings of this study?

Only 2.9% of cardiac rehabilitation program participants simultaneously met all three recommendations of the Canadian 24-Hour Movement Guidelines, while higher physical activity and lower sedentary behavior were associated with better quality of life.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Cardiovascular disease and/or risk factors (n=105). Intervention: Canadian 24-Hour Movement Guidelines adherence vs. Non-adherence. Primary outcome: Simultaneous adherence to all three recommendations of the Canadian 24-Hour Movement Guidelines (physical activity, sedentary behavior, and sleep).

Q: What does this research mean for the field?

Only 2.9% of cardiac rehabilitation participants meet all three Canadian 24-Hour Movement Guidelines, with higher physical activity and lower sedentary behavior associating with improved quality of life. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Júlio César de Ávila Soares; Maria Eduarda Martins Vigilato; Heloísa Balotari Valente; Alice Haniuda Moliterno; João Pedro Lucas Neves Silva; Diego Giulliano Destro Christófaro; Luiz Carlos Marques Vanderlei

doi:10.1002/pri.70281

August 2, 2026Physiotherapy Research InternationalOpen Access

Movement Behaviors and Quality of Life in Cardiac Rehabilitation Programs: A Study Based on the Canadian 24‐Hour Movement Guidelines

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Key result

Only ~3% of cardiac rehab participants meet 24-hour movement guidelines, with compliance linked to better QoL.

n=105

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Why the study?

Cardiac rehabilitation participants have specific characteristics that may influence adherence to the Canadian 24-Hour Movement Guidelines and their relationship with quality of life.

Does adherence to 24-hour movement guidelines improve quality of life in cardiac rehabilitation participants?

Key Points

Investigate adherence to the Canadian 24-Hour Movement Guidelines and evaluate associations among physical activity, sedentary behavior, sleep duration, and quality of life in cardiac rehabilitation participants.
Cross-sectional observational study of N=105 cardiac rehabilitation participants (mean age 68.46 ± 10.15 years; 58.1% coronary artery disease; 53.3% men).
Assessed movement behaviors (moderate-to-vigorous physical activity, sedentary behavior, and sleep) via accelerometers and quality of life using the 36-Item Short-Form Health Survey (SF-36).
Evaluated associations between movement behaviors and SF-36 domains using simple and multivariable quantile regression models adjusted for demographic and clinical covariates.
Only 2.9% of participants met all three guidelines simultaneously, whereas 41.9% met none, 45.7% met one, and individual adherence was 29.5% for physical activity, 9.5% for sedentary behavior, and 34.3% for sleep.
Sedentary behavior was negatively associated with physical functioning (β = -0.070, p = 0.019 for min/day; β = -0.877, p = 0.002 for percentage of time).
Moderate-to-vigorous physical activity was positively associated with physical functioning, vitality, and social functioning (p < 0.05), whereas sleep duration showed no significant association with quality-of-life domains.

Study Design

Type

Cross-Sectional (n=105)

Multicenter

Yes

Structured PICO

Does adherence to 24-hour movement guidelines improve quality of life in cardiac rehabilitation participants?

P

Population

105 adults (mean age 68.5 years, 46.7% female) with cardiovascular disease or risk factors enrolled in cardiac rehabilitation programs, monitored for 7 days to assess movement behaviors and quality of life.

E

Exposure

Movement behaviors (physical activity, sedentary behavior, and sleep) measured by accelerometers over 7 days to assess adherence to the Canadian 24-Hour Movement Guidelines.

O

Outcome

Proportion of participants meeting the recommendations of the Canadian 24-Hour Movement Guidelines and the association between levels of physical activity, sedentary behavior, and sleep duration with quality-of-life domains (assessed by SF-36).patient reported

Very few cardiac rehabilitation participants meet all 24-hour movement guidelines, but higher physical activity and lower sedentary time are associated with better quality of life, highlighting the need to target these behaviors outside supervised sessions.

Limitations

Cross-sectional design prevents causal inference regarding the relationship between movement behaviors and quality of life.
Convenience sampling from a single urban municipality limits external validity and generalizability.
Accelerometry may have underestimated certain activities such as cycling, resistance training, and water-based movements.
A single cutoff for moderate-to-vigorous physical activity may not fully capture moderate-intensity effort in older or deconditioned adults.
Sleep assessment focused solely on duration without subjective measures of sleep quality or other dimensions like fragmentation.
Unmeasured confounding variables such as educational level, socioeconomic status, and other medications were not included in the adjusted models.
Centers represent local CRP structure rather than broader Brazilian or international CRPs
No subjective measure of sleep quality was applied, restricting sleep analyses to duration

Implication

Low adherence suggests intervention targets in cardiac rehab; leaves open causal effects on quality of life.

Abstract

BACKGROUND AND PURPOSE: The Canadian 24-Hour Movement Guidelines integrate recommendations on physical activity (PA), sedentary behavior (SB), and sleep. Individuals in cardiac rehabilitation programs (CRPs) have specific characteristics that may influence adherence to these 24-Hour Movement Guidelines and their relationship with quality of life. This study aimed to investigate the proportion of CRP participants who meet the recommendations of the Canadian 24-Hour Movement Guidelines and to evaluate the association between levels of PA, SB, and sleep duration with the quality-of-life domains of these individuals. METHODS: This was a cross-sectional observational study including CRP participants (mean age: 68.46 ± 10.15 years; 58.1% with coronary artery disease). Quality of life was assessed using the 36-Item Short-Form Health Survey (SF-36). Movement behaviors (PA, SB, and sleep) were measured by accelerometers. Compliance with the guidelines was described using percentage values. Associations between PA, SB, and sleep with quality-of-life domains were analyzed using quantile regression. The significance level was set at 5%. RESULTS: Among the 105 participants analyzed, only 2.9% simultaneously met all three recommendations. Individual adherence was 29.5% (PA), 9.5% (SB), and 34.3% (sleep). A negative association was identified between SB and functional capacity, and positive associations were found between PA and the domains of functional capacity, vitality, and social aspects. Sleep duration was not associated with quality-of-life domains. DISCUSSION: Few CRP participants simultaneously meet all three recommendations of the Canadian 24-Hour Movement Guidelines, with partial adherence being more frequent. Higher levels of PA and lower time spent in SB were associated with better quality of life, whereas sleep duration showed no significant association.

Discussion

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Cite This Study

Soares et al. (2026) conducted a cross-sectional in Cardiovascular disease and/or risk factors (n=105). Canadian 24-Hour Movement Guidelines adherence vs. Non-adherence was evaluated on Simultaneous adherence to all three recommendations of the Canadian 24-Hour Movement Guidelines (physical activity, sedentary behavior, and sleep). Only 2.9% of cardiac rehabilitation program participants simultaneously met all three recommendations of the Canadian 24-Hour Movement Guidelines, while higher physical activity and lower sedentary behavior were associated with better quality of life.

synapsesocial.com/papers/6a72e7f4226790f370657608 https://doi.org/10.1002/pri.70281

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Movement Behaviors and Quality of Life in Cardiac Rehabilitation Programs: A Study Based on the Canadian 24‐Hour Movement Guidelines

Figures

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Movement Behaviors and Quality of Life in Cardiac Rehabilitation Programs: A Study Based on the Canadian 24‐Hour Movement Guidelines

Figures

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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