Yale Physical Activity Survey Research Articles

Physical Inactivity and Pain in Older Men and Women with Hip Fracture History

Hip fracture patients often suffer from pain for several months after surgery. This may lead to physical inactivity and subsequent mobility limitation and disability. The purpose of this study was to investigate the association between severe musculoskeletal pain and the level of physical activity in older people with a history of hip fracture. Data were collected from 60- to 85-year-old (n = 78) community-dwelling people, 0.7–7.5 years after hip fracture. Physical activity was assessed with the Yale Physical Activity Survey (YPAS). According to the YPAS summary index distribution, the participants were divided into the physically inactive and physically active groups. Musculoskeletal pain in the lower back, hip or knee region was assessed by the Visual Analog Scale. Pain was defined as severe pain if the subject rated the pain 66 mm or over (upper third of the scale) in at least one of the relevant body regions in the lower body. Thirty-three subjects (42%) experienced severe pain in the lower body, of whom 23 (70%) reported severe pain in the operated hip. Twenty-three patients (30%) used pain medication prescribed by a physician. The level of musculoskeletal pain was significantly higher in the physically inactive (62%) than in the physically active (31%) group (p = 0.011). Logistic regression analysis showed that people with severe pain had over three times (OR: 3.5, 95% CI: 1.30–9.39) the risk for physical inactivity compared to those with less or no pain. Multivariate adjustments for balance confidence, time since fracture, number of chronic diseases and type of surgery did not materially change the estimate (OR: 3.0, 95% CI: 1.00–9.30). Pain is an important associated factor of physical inactivity in older people with a hip fracture history. Pain management may be important in restoring and sustaining the level of physical activity after hip fracture. Further prospective and experimental studies are, however, needed to explore the causality between pain and physical activity as well as the role of pain management and physical activity interventions in preventing mobility limitation and disability among older people recovering from hip fracture.

Validation Of The Yale Physical Activity Survey In Persons With Rheumatoid Arthritis

Physical activity survey instrumentation remains the most practical method for assessing activity levels in large epidemiologic-type descriptive studies of activity and health status and for monitoring intervention outcomes, but features such as relevance, reliability, accuracy, and validity have yet to be demonstrated in special populations, in particular, those at high risk for disability, such as people with rheumatoid arthritis. PURPOSE: The purpose of this study was to examine the validity of the Yale Physical Activity Survey (YPAS) for use in persons with rheumatoid arthritis. METHODS: A convenience sample of 69 subjects with rheumatoid arthritis (RA), 20 to 81 years of age, wore an Actigraph accelerometer over the right hip for 7 continuous days during normal daily activity. All subjects then responded to the Yale Physical Activity Survey within three days after accelerometer use. Spearman correlations were done between accelerometer measured physical activity level (average counts/day and sum of moderate or vigorous minutes) and the YPAS summary indices (Activity Dimensions Summary Index (ADSI), Total Time (TTI), Energy Expenditure (EEI). RESULTS: Spearman rho's between average accelerometer counts/day and the ADSI, TTI, and EEI were.421,.451, and.515 respectively (all results p<.001). Spearman rho's between total moderate or vigorous accelerometer minutes and the ADSI, TTI, and EEI were.432,.523, and.566 respectively (all results p<.001). CONCLUSIONS: The YPAS captures both total and moderate/vigorous intensity activity in persons with RA, with the Energy Expenditure Index having the strongest correlation with accelerometer data. The YPAS is a valid instrument for comparisons within groups of persons with RA. However, its use for comparing those with RA to healthy elders has not been established.

Cognitive Performance In Relation To APOE Genotype, Physical Activity, And Cardiovascular Fitness

Physical activity has been correlated with improved cognitive function for older adult APOE-e4 carriers, but it is unclear whether the association is related to physical activity level as indicated by kilocalories expended or to cardiovascular fitness as indicated by VO2 max. PURPOSE: To determine if there is a positive relationship between physical activity level or cardiovascular fitness and cognitive function for carriers of the APOE-e4 allele. We predicted that there would be a greater magnitude of effect for e4 carriers compared to non-carriers. METHODS: Study participants, ages 50-70, were screened for depression using Beck Depression Inventory (BDI) and for dementia using the Cambridge Cognitive Exam (CAMCOG). APOE genotype was determined through DNA analysis of whole blood or saliva. Body mass index (BMI) was determined from measured height and weight. Salthouse Activity Inventory was used to assess intellectual activity. Weekly kilocalorie expenditure was calculated from Yale Physical Activity Survey. Estimated VO2 max was determined using the Rockport Walk Test. 78 participants completed the Sternberg working memory task and 80 completed the Wisconsin Card-Sorting Test (WCST) to determine cognitive function. RESULTS: Hierarchical regression revealed a significant inverse relationship for APOE-e4 carriers between 6 letter match reaction time on the Sternberg task and self-reported weekly kilocalorie expenditure (ΔR2 =.068, p =.022), as well as an inverse relationship between % perseverative error on the WCST and estimated VO2 max (ΔR2 =.075, p =.015), after accounting for age, education, intellectual activity, and BMI. The pattern of findings revealed no such relationship in non-carriers. CONCLUSION: The results support a benefit of cardiovascular fitness and physical activity on cognitive performance for carriers of the APOE-e4 allele. The associations appeared to be task dependent, with different findings for cardiovascular fitness or physical activity possibly relating to unique neural processes involved in each cognitive test. Because the APOE-e4 allele is associated with increased risk for development of late-onset Alzheimer's disease, these findings may have implications for a possible protective advantage for individuals genetically at risk for dementia.

Physical Activity And Intra-individual Cognitive Variability In Young, Middle-aged, And Older Adults

Reaction time (RT), an index of cognitive health, increases with advanced age. Physical activity has been shown to improve cognitive health (e.g. decrease mean RT) in older adults. Within individual variability in RT tasks is a unique indicator of cognitive health. However there is minimal research examining the impact of physical activity on cognitive variability. Additionally, there is a dearth of research examining cognitive variability in middle-aged adults (40-60 years). PURPOSE: To examine the relationship between age, physical activity and cognitive variability. METHODS: 107 participants were grouped based on age: young adults (YA, n= 36, mean = 23 years), middle age adults (MA, n= 36, mean = 52 years), and older adults (OA, n=35, mean = 72 years). Each age group was subdivided into either physically active or sedentary groups based on individual Yale Physical Activity Survey scores. Subjects performed a modified Erickson flanker paradigm. In this task subjects indicated the direction of a central cue that was surrounded by congruent (<<<<<) or incongruent (<<><<) arrows as quickly as possible. Mean RT and standard deviation (SD) of RT were calculated. RESULTS: Mean RT in the congruent condition (456.8 ± 6.7 ms) was significantly faster than the incongruent condition (528.6 ± 7.3). All age groups mean RT was significantly different from each other (YA 440.1 ± 11.8, MA 479.2 ± 11.8, and OA 558.7 ± 11.8). SD RT in the congruent condition (81.5 ± 4. 1) was significantly smaller than in the incongruent condition (94.9 ± 4.1). OA's SD (116.0 ± 6.8) was significantly longer than MA (78.6 ± 6.7) and YA (70.0 ± 6.7). There was a trend (p = 0.07) for an age by physical activity interaction so that sedentary OA (130.4 ± 9.5) had greater variability than any other group (active YA 75.8 ± 9.5, sedentary YA 64.1 ± 9.5, active MA 82.9 ± 9.5, sedentary MA 74.4 ± 9.5, and active OA 101.517 ± 9.8). Post hoc analysis revealed an effect for physical activity only in the OA group - with sedentary OA having a larger SD than active OA. CONCLUSION: The cross-sectional data suggests that age-related increases in cognitive variability do not appear until the 7th decade of life. Physical activity is advantageous in minimizing age-related increases in cognitive variability. The neurological mechanisms underlying this benefit remain to be elucidated.

Impact of home-based, supervised exercise on congestive heart failure

Comparison of supervised home-based exercise program as adjunctive therapy, with comprehensive disease management alone, on symptoms and quality of life in congestive heart failure patients. 8 women and 11 men were enrolled in a randomized trial. The mean subject age was 69 (±4.44) in the controls and 70 (±4.05) in the intervention group. Baseline and 3, 6, and 12-month evaluations consisted of the Chronic Heart Failure Questionnaire (CHFQ), measuring perceived functional capacity (perceived symptoms of dyspnea, fatigue, and emotional function) and the Yale Physical Activity Survey (YPAS). A stress test was given at baseline and 12 months. The home-based exercise intervention caused a significant change in perceived fatigue between study groups (p=0.015), after 6 months of study participation, with the control group feeling less fatigued than the intervention group. After 12 months of participation, there were no significant differences in perceived functional capacity. Home-based exercise was well tolerated and favorably evaluated. This pilot study demonstrates the feasibility of studying home-based exercise in patients with moderate congestive heart failure. Larger and longer studies will be required to determine treatment effects.

Dimensions of Physical Activity in African American Women

Obesity and hypertension are among the international problems for which health professionals urge exercise. Exercise might increase if advisers knew how patients normally expend energy. Using the Yale Physical Activity Survey (YPAS), this U.S. study measured energy expenditure in several dimensions of physical activity including exercise, in African American women with hypertension (N = 100). Over half expended at least 6,000 (kilocalories) kcal per week; most expended over 3,500 of those kcal in everyday work activities. Such activities could be enhanced to supplement aerobic exercise. When physical activity is urged to promote health, it is important to consider kcal expenditure beyond exercise.

Factors associated with recurrence of venous leg ulcers: A survey and retrospective chart review

Background Chronic venous leg ulcers have a significant impact on older individuals’ well-being and health care resources. Unfortunately after healing, up to 70% recur. Objective To examine the relationships between leg ulcer recurrence and physical activity, compression, nutrition, health, psychosocial indicators and self-care activities in order to provide information for preventive strategies. Design Survey and retrospective chart review. Settings Two metropolitan hospital and three community-based leg ulcer clinics. Subjects A sample of 122 community living patients with leg ulcer of venous aetiology which had healed between 12 and 36 months prior to the survey. Methods Data were collected from medical records on demographics, medical history and previous ulcer history and treatments; and from self-report questionnaires on physical activity, nutrition, psychosocial measures, ulcer recurrences and history, compression and other self-care activities. All variables clinically or statistically significantly associated with recurrence at the bivariate level were entered into a logistic regression model to determine their independent influences on recurrence. Results Median follow-up time was 24 months (range 12–40 months). Sixty-eight percent of participants had recurred. Bivariate analysis found recurrence was positively associated with ulcer duration, cardiac disease, a body mass index ≤ 20, scoring as at risk of malnutrition and depression; and negatively associated with increased physical activity, leg elevation, wearing Class 2 (20–25 mmHg) or Class 3 (30–40 mmHg) compression hosiery, and higher self-efficacy scores. After adjusting for all variables, an h/day of leg elevation (OR = 0.04, 95% CI = 0.01–0.17), days/week in Class 2 or 3 compression hosiery (OR = 0.53, 95% CI = 0.34–0.81), Yale Physical Activity Survey score (OR = 0.95, 95% CI = 0.92–0.98), cardiac disease (OR = 5.03, 95% CI = 1.01–24.93) and General Self-efficacy scores (OR = 0.83, 95% CI = 0.72–0.94) remained significantly associated ( p < 0.05) with recurrence. Conclusions Results indicate a history of cardiac disease is a risk factor for recurrence; while leg elevation, physical activity, compression hosiery and strategies to improve self-efficacy are likely to prevent recurrence.

Unhealthy Weight Gain During Treatment for Alcohol and Drug Use in Four Residential Programs for Latina and African American Women

Weight gain in women (n = 52) in four alcohol and drug user residential treatment programs in Boston, Massachusetts, was studied in 2004 through focus groups (n = 52) and weekly weights (n = 10). Focus group theme analyses revealed that weight gain was primarily attributed to availability of food and lack of exercise. Participants were very interested in improving nutrition, diet, and exercise in the programs. Weight gain (mean = 6.4 pounds) occurred in nine women (n = 10) in the first 12 weeks of treatment. The two-dimensional Food Model Chart and the Yale Physical Activity Survey were used. Limitations are noted and future research is suggested.

A Pilot Community-Based Walking-for-Exercise Program for Senior Women

Purpose The demographic groups at most risk for physical inactivity, as determined by the 1996 Surgeon General's report on Physical Activity and Health, were the elderly women and minorities. To address these risk groups, this pilot study determined whether a physical therapy-based program would result in differences in the scores of the Yale Physical Activity Survey for senior women who participated in a daily walking-for-exercise program using assistive devices, as needed, and those who did not participate. Methods Twenty-four volunteer senior adults participating in the Senior Citizens Nutrition and Activity Program were randomly assigned to a control or walking intervention group. Each subject completed a demographic form and the Mini-Mental State Examination to determine cognitive status. Volunteers were interviewed using the Yale Physical Activity Questionnaire for older adults. Results Community-dwelling senior women participating in a walking-for-exercise program, exhibited increases in total energy expenditure (P = .046) and vigorous activity levels (P = .026) from baseline to the conclusion of the program. Pre- to posttest changes were also seen in vigorous activity levels in the control group. Conclusion Increase in total energy expenditure and vigorous physical activity levels were seen in senior women who engaged in a 8-week walking-for-exercise program with or without physical therapist recommended assistive devices when compared with controls. This has implications for physical therapy and public health policies that should encourage walking as an effective means for promoting increased physical activity to combat the effects of a sedentary lifestyle.

Feelings of well being in elderly people: Relationship to physical activity and physical function

The aim of the research was to investigate in a sample of Spanish elderly whether measures of physical activity and physical function are related to feelings of well being, and whether level of dependence is a moderator in the relation of well being, physical activity and physical function. The sample was a cohort of 151 elderly people (89 women and 62 men, aged 60–98 years) from the North of Spain. Participants completed surveys including demographic characteristics, and measures of physical activity (Yale Physical Activity Survey, YPAS), instrumental activities of daily living (Barthel Index, BI) and well being (Psychological Well Being Scale, from Spanish: Escala de Bienestar Psicológico = EBP). Components of the physical function were measured by the Senior Fitness Test (SFT). Upper and lower body strength, dynamic balance, aerobic endurance, self-reported weekly energy expenditure and physical activity total time were significantly correlated with both Material and Subjective well being. All components of physical function were significantly impaired in dependent subjects when compared to independent individuals of the same sex and physical activity category. Significant differences were also observed in Subjective well being among less active dependent or independent individuals. In conclusion, physical function and physical activity are related to feelings of well being, and results emphasize the positive functional and psychological effects of physical activity in dependent subjects.

Construct Validation of Physical Activity Surveys in Culturally Diverse Older Adults

The purpose of this study was to establish validity evidence of four physical activity (PA) questionnaires in culturally diverse older adults by comparing self-report PA with performance-based physical function. Participants were 54 older adults who completed the Continuous Scale Physical Functional Performance 10-item Test (CS-PFP10), Physical Activity Scale for the Elderly (PASE), CHAMPS Physical Activity Questionnaire for Older Adults, Yale Physical Activity Survey (YPAS), and modified Baecke questionnaire. The total PASE score, three outcome scores for the CHAMPS, and three summary indices for the YPAS were significantly correlated with total CS-PFP10 score. The modified Baecke exhibited no correlations with CS-PFP10 scores. The PASE, CHAMPS, and YPAS appear to be the most valid PA self-report questionnaires for culturally diverse older adults.

Relationship between Physical Activity Level, Telomere Length, and Telomerase Activity

The purpose of this study was to examine the relationship of exercise energy expenditure (EEE) with both telomere length and telomerase activity in addition to accounting for hTERT C-1327T promoter genotype. Sixty-nine (n = 34 males; n = 35 females) participants 50-70 yr were assessed for weekly EEE level using the Yale Physical Activity Survey. Lifetime consistency of EEE was also determined. Subjects were recruited across a large range of EEE levels and separated into quartiles: 0-990, 991-2340, 2341-3540, and >3541 kcal x wk(-1). Relative telomere length and telomerase activity were measured in peripheral blood mononuclear cells (PBMC). The second EEE quartile exhibited significantly longer telomere lengths [1.12 +/- 0.03 relative units (RU)] than both the first and fourth EEE quartiles (0.94 +/- 0.03 and 0.96 +/- 0.03 RU, respectively; P < 0.05) but was not different from the third quartile. Telomerase activity was not different among the EEE quartiles. An association was observed between telomerase enzyme activity and hTERT genotype with the TT genotype (1.0 x 10(-2) +/- 4.0 x 10(-3) attomoles (amol) per 10,000 cells; n = 19) having significantly greater telomerase enzyme activity than both the CT (1.3 x 10(-3) +/- 3.2 x 10(-3); n = 30) and CC groups (5.0 x 10(-4) +/- 3.9 x 10(-3); n = 20; P = 0.01). These results indicate that moderate physical activity levels may provide a protective effect on PBMC telomere length compared with both low and high EEE levels.

The Unique Relation of Physical Activity to Executive Function in Older Men and Women

To determine whether physical activity participation was specifically and positively associated with executive function in older individuals after accounting for age, education, and IQ. Participants were 120 healthy men (N = 38) and women (N = 82) aged 65-92 yr (mean = 78.9, SD = 5.8), who were free of depression and dementia (Beck Depression Inventory and Mini-Mental Status Exam, respectively), had above-average intelligence (mean = 118.1, SD = 9.4) as indexed by the Kaufman Brief Intelligence Test (K-BIT), and stable patterns of physical activity during a 3- to 5-yr period before the study. Participants completed the Yale Physical Activity Survey (YPAS) for older adults and the Stroop Color and Word Test to assess inhibitory executive function. Hierarchical regression analyses revealed that YPAS summary index scores explained a small, but significant amount of variance in Stroop color-word and interference scores (DeltaR2 = 2 and 4%, respectively) after accounting for intelligence and age. The YPAS index was unrelated to nonexecutive performance. The results support specificity of the physical activity/cognition relationship in older individuals. The results may be explained by additive benefit from participation in physical activity to the frontal lobe (i.e., beyond any benefits from cognitive stimulation), a region that mediates executive function and experiences accelerated age-related decline. In summary, habitual physical activity is positively related to executive performance in older men and women into the 10th decade.

Associations of dietary intake and physical activity with intramyocellular lipid content in older men and women

Lipid accumulation within skeletal muscle has been associated with insulin resistance, functional disability, and aging. We examined associations of dietary intake and physical activity with intramyocellular lipid (IML) content in 49 overweight (BMI 29.9 ± 3.5 kg/m2) subjects (20 M/29 F) aged 55–80 y. Computed tomography of trunk (mean of rectus abdominis, paraspinals, and lateral abdominals) and thigh (mean of quadriceps and hamstrings) muscle was used to determine skeletal muscle attenuation (a marker of IML content). Habitual dietary intake and physical activity patterns were assessed using 5-d weighed food records and the Yale Physical Activity Survey for Older Adults. Total dietary energy and macronutrient intakes were not significantly associated with skeletal muscle attenuation. Dietary intake of both glucose (r=0.346, P<0.05) and fructose (r=0.333, P<0.05), adjusted for energy intake, were independently correlated with trunk muscle attenuation, indicating that greater intakes were associated with less IML content. Dietary intake of vitamin D was negatively associated with thigh muscle attenuation (r=−0.302, P<0.05). Physical activity variables were not associated with IML content in the trunk or thigh. These results suggest that dietary glucose, fructose, and vitamin D intakes may regulate the accumulation of skeletal muscle fat. NIH RO1AG15385, F32AG21374, MO1RR14288, and UAMS MRE.

Relationship between exercise energy expenditure and telomere length and telomerase activity

Shortened telomere length and decreased telomerase activity have recently been associated with perceived psychological stress and cardiovascular disease risk factors. The purpose of this study was to examine the relationship between exercise energy expenditure (EEE) and telomere length and telomerase activity. Thirty-eight male (n = 20) and female (n = 18) participants 50–70 yr. were assessed for weekly EEE level using the exercise component of the Yale Physical Activity Survey. Lifetime consistency of EEE was also determined. Subjects were recruited across a range of EEE levels and grouped into tertiles according to EEE (0–1000, 1001–3500, and >3500 Kcal/wk). Relative telomere length and telomerase activity were measured in peripheral blood mononuclear cells (PBMCs). After covarying for BMI, perceived psychological stress, and sex, relative telomere length was significantly higher in the moderate EEE group compared to both the low and high EEE groups (p<0.05; means ± SE relative T/S ratio; low = 0.93 ± 0.06, n=11; moderate = 1.10 ± 0.05, n=15; high = 0.94 ± 0.06, n=12). Telomerase activity was not different among the three groups. In conclusion, the results indicate that moderate exercise energy expenditure levels may provide a protective effect on PBMC telomere length compared to both low and high exercise energy expenditure levels. Research support provided by AG025505, AG00268, and AG022791.

Normal-Weight Adults Consume More Fiber and Fruit than Their Age- and Height-Matched Overweight/Obese Counterparts

Objectives To assess differences in dietary intake of overweight/obese subjects and sex-, age-, and height-matched controls and to identify dietary components associated with increased deposition of body fat. Design/subjects A convenience sample of 52 overweight/obese and 52 normal-weight adults matched for sex, age (±1 year), and height (±1 inch) were recruited from the local area. Dietary intake was assessed with the Block 60-item food frequency questionnaire, physical activity was measured by the Yale Physical Activity Survey, and percent body fat was measured via dual-energy x-ray absorptiometry. Statistical Analyses Performed Independent t tests compared between-group consumption of dietary components. The ability of dietary components to predict percent body fat before and after controlling for age-, sex-, and physical activity-related energy expenditure and other macronutrients was assessed with multiple regression analyses. Spearman correlation coefficients examined relationships among nutrients, Food Guide Pyramid servings, and percent body fat. Results Overweight/obese subjects consumed more total fat, saturated fat, and cholesterol and less carbohydrate, complex carbohydrate, and dietary fiber than control subjects. Reported intake of dietary fiber was inversely related to percent body fat without ( R 2=0.052, P=0.02) and with ( R 2=0.045, P=0.013) control for potential confounding factors. Servings of fruit per day were negatively related to percent body fat ( r=−0.40, P<0.01). Conclusions These findings suggest that the composition of a diet, especially low dietary fiber and fruit intake, plays a role in the etiology of obesity.

Comparison of Two Methods of Measuring Physical Activity in South African Older Adults

The aim of this study was to assess the validity and reliability of the Yale Physical Activity Survey (YPAS) and the short version of the International Physical Activity Questionnaire (IPAQ) in older South African adults. The YPAS includes measures of weekly energy expenditure (EE) for housework, yard work, caregiving, exercise, and recreation. The IPAQ measures total time and EE during vigorous and moderate activity, walking, and sitting. The instruments were administered twice for test-retest reliability (men, n = 52, 68 +/- 5.4 years, and women, n = 70, 66 +/- 5.8 years). Data for criterion validity were obtained from accelerometers. YPAS reliability ranged from r = .44 to.80 for men and r = .59 to .99 for women (p < .0001). IPAQ reliability was lower for men (r = .29 to .76) than for women (r = .46 to .77). Criterion validity of the YPAS was .31 to .54 for men and .26 to .29 for women. The YPAS and short IPAQ had comparable results for reliability and criterion validity.

Comparison of the Step Activity Monitor and Yale Physical Activity Survey among Older Adults

Comparison of the Step Activity Monitor and Yale Physical Activity Survey among Older Adults

Calcium-fortified beverage supplementation on body composition in postmenopausal women

BackgroundWe investigated the effects of a calcium-fortified beverage supplemented over 12 months on body composition in postmenopausal women (n = 37, age = 48–75 y).MethodsBody composition (total-body percent fat, %FatTB; abdominal percent fat, %FatAB) was measured with dual energy x-ray absorptiometry. After baseline assessments, subjects were randomly assigned to a free-living control group (CTL) or the supplement group (1,125 mg Ca++/d, CAL). Dietary intake was assessed with 3-day diet records taken at baseline and 12 months (POST). Physical activity was measured using the Yale Physical Activity Survey.ResultsAt 12 months, the dietary calcium to protein ratio in the CAL group (32.3 ± 15.6 mg/g) was greater than the CTL group (15.2 ± 7.5 mg/g). There were no differences from baseline to POST between groups for changes in body weight (CAL = 0.1 ± 3.0 kg; CTL = 0.0 ± 2.9 kg), %FatTB (CAL = 0.0 ± 2.4%; CTL = 0.5 ± 5.4%), %FatAB (CAL = -0.4 ± 8.7%; CTL = 0.6 ± 8.7%), or fat mass (CAL = 1.3 ± 2.6 kg; CTL = 1.3 ± 2.7 kg).ConclusionThese results indicate that increasing the calcium to protein ratio over two-fold by consuming a calcium-fortified beverage for 12 months did not decrease body weight, body fat, or abdominal fat composition in postmenopausal women.

An Assessment Of Daily Physical Activity In Individuals With Chronic Heart Failure

PURPOSE To determine the physical activity patterns of chronic heart failure (CHF) patients and whether they are meeting the Surgeon General's recommendations for physical activity. These recommendations have been defined as at least 30 minutes of moderate physical activity per day (most days of the week) in at least 10-minute bouts. METHODS Seventeen women (58.8 ± 13.8 yrs) and 19 men (61.9 ± 12.96 yrs) with CHF (NYHA Classification II or III) completed the Yale Physical Activity Survey (YPAS) and wore an accelerometer (in pedometer mode) for seven days. Data for meeting the Surgeon General's recommendations was determined subjectively by totaling the amount of time reported in exercise and leisure walking activities in the YPAS. Meeting the recommendations was also assesses objectively by totaling the number of days that an individual engaged in moderate (80 steps/min) physical activity for at least three 10-minute bouts. The cut point of 80 steps/min was determined through a series of timed walking trials on a treadmill. RESULTS Data from the YPAS indicated that individuals with CHF engaged in 21.4 hours of daily living physical activity per week (SD ± 16.3 hours) and that they expended 4,286 Kcal in daily living physical activity per week (SD ± 3,627 Kcal). YPAS results also suggested that 13 (33%) of the CHF patients met the Surgeon General's recommendations for physical activity. Accelerometry data indicated that, on average, CHF patients took 6319 steps per day (± 2792). Accelerometry results suggested that only 4 (11%) of the CHF patients met the Surgeon General's recommendations. CONCLUSIONS Individuals with CHF spend most of their time engaged in daily living activities and are not meeting the Surgeon General's recommendations for physical activity. However, the likelihood of identifying those CHF patients who are meeting the recommendations varies by the methods selected to measure activity. Individuals with CHF are not meeting the recommendations for two reasons: 1. they are not engaging in enough moderate intensity activity (>2 METS), and 2. the activities that they do engage in are not continuous (> 10-minutes at a time).