Exercise & Training

Instrumental activities of daily living and objective physical activity in people with cardiovascular disease.

TL;DR

Greater IADL frequency was associated with higher objectively measured PA in stable participants with CVD, and leisure-related activities were associated with increased MVPA, suggesting that encouraging these activities may help promote meaningful PA engagement in this population.

Key Findings

Higher Frenchay Activities Index (FAI) total scores were significantly associated with greater physical activity across all objective PA measures in stable CVD patients.

  • Association with daily steps: unstandardized coefficient (B) = 78.1
  • Association with low-intensity PA (LPA) per day: B = 0.7
  • Association with moderate-to-vigorous-intensity PA (MVPA) per day: B = 0.2
  • Associations were significant after adjusting for clinical confounding factors in a multivariate linear regression model
  • Study included 1126 stable CVD participants (median age 74.0 years; 278 females)

Four housework-related FAI sub-items were positively associated with daily average step count and low-intensity physical activity.

  • Housework sub-items from the FAI were analyzed separately alongside leisure activity sub-items
  • Associations were found with both number of steps per day and LPA per day
  • Housework sub-items were not significantly associated with MVPA
  • Analysis was performed using multivariate linear regression adjusting for clinical confounders

Six leisure-related FAI sub-items were positively associated with daily average step count and LPA, and two leisure-related sub-items were positively associated with daily MVPA.

  • Leisure activities showed the broadest associations across PA outcomes including steps, LPA, and MVPA
  • Two leisure sub-items specifically were associated with MVPA, unlike housework items
  • This pattern suggests leisure activities contribute more to higher-intensity physical activity than housework activities
  • The authors suggest encouraging leisure activities may help promote meaningful PA engagement in CVD populations

The study used accelerometers over 2 weeks to objectively measure physical activity, providing an objective alternative to questionnaire-based PA assessment.

  • PA was measured using accelerometers over a 2-week period
  • Outcomes calculated included daily average number of steps, low-intensity PA (LPA), and moderate-to-vigorous-intensity PA (MVPA)
  • The authors note that prior research in this area often relied on subjective measures such as questionnaires and interviews
  • This cross-sectional study included participants who had been receiving outpatient care under stable conditions for at least 6 months

The study population consisted of 1126 stable outpatient CVD patients with a median age of 74.0 years, of whom 278 were female.

  • All participants had CVD and had been receiving outpatient care under stable conditions for at least 6 months
  • Median age was 74.0 years, indicating an older adult population
  • 278 of 1126 participants were female (approximately 24.7%)
  • IADL frequency was assessed using the Frenchay Activities Index (FAI)
  • Cross-sectional study design was used

What This Means

This research examined whether how often people with heart disease perform everyday tasks — like cooking, shopping, and leisure activities — is related to how physically active they actually are in daily life. Unlike many previous studies that asked patients to self-report their activity levels, this study used accelerometers (motion-tracking devices similar to fitness trackers) worn over two weeks to objectively measure movement. The study included over 1,100 stable heart disease patients, mostly older adults with a median age of 74, who were being managed as outpatients. The researchers found that patients who more frequently engaged in instrumental activities of daily living (IADLs) — practical tasks beyond basic self-care — took more steps per day and spent more time in both light and moderate-to-vigorous physical activity. When they broke down the types of activities, they found that both housework and leisure activities were linked to more steps and light-intensity movement, but only leisure activities were linked to higher-intensity physical activity (the kind that provides greater cardiovascular benefit). This research suggests that supporting heart disease patients in maintaining or increasing their everyday activities — particularly leisure pursuits like hobbies, social outings, or recreational activities — could be a practical way to help them stay more physically active. Since leisure activities were uniquely tied to more vigorous movement, healthcare providers working with older adults who have cardiovascular disease might consider focusing rehabilitation and lifestyle counseling not just on formal exercise programs, but also on helping patients remain engaged in meaningful leisure activities.

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Citation

Kariya H, Yamaoka-Tojo M, Hamazaki N, Ryo-Koriyama K, Kobayashi S, Shibuya M, et al.. (2026). Instrumental activities of daily living and objective physical activity in people with cardiovascular disease.. Annals of physical and rehabilitation medicine. https://doi.org/10.1016/j.rehab.2026.102119