The accuracy of a uniaxial accelerometer for assessing physical activity in preschool-aged children was assessed by using an indirect calorimeter which provides the physical activity ratio (PAR) for free living activities. Subjects were 5- to 6-yr-old Japanese girls and boys (n=24, 6.1±0.3 years). PAR was assessed for nine activities (lying down, watching a video while sitting and standing, line drawing for coloring-in, playing with blocks, walking, stair climbing, ball toss, and running) using the Douglas bag method. “Exercise intensities” were recorded with the uniaxial accelerometer (Lifecorder EX ; Suzuken Co. Ltd, Nagoya, Japan). PARs were also predicted by using the equations presented by Higuchi et al. (2003) and Kumahara et al. (2004). Significant correlation was observed between “exercise intensities” as measured by the uniaxial accelerometer and PAR for all activities (r=0.827). Predicted PAR values for walking and running were overestimated according to the equations. On the other hand, PAR values for stair climbing and ball toss were underestimated. These findings indicate that although the uniaxial accelerometer may help in evaluating daily physical activity in preschool-aged children, its use as a proxy measure of PAR based on the above equations may be limited.

Although cardiac rehabilitation (CR) has been shown to improve exercise tolerance and prognosis in patients with cardiovascular diseases, there remains low participation in outpatient CR. This may be attributed to the patients’ busy schedules and difficulty in visiting the hospital due to distance, cost, avoidance of exercise, and severity of coronary disease. To overcome these challenges, many countries are exploring the possibility of remote CR. Specifically, there is increasing attention on the development of remote CR devices, which allow transmission of vital information to the hospital via a remote CR application linked to a wearable device for telemonitoring by dedicated hospital staff. In addition, remote CR programs can support return to work after hospitalization. Previous studies have demonstrated the effects of remote CR on exercise tolerance. However, the preventive effects of remote CR on cardiac events and mortality remain controversial. Thus, safe and effective remote CR requires exercise risk stratification for each patient, telenursing by skilled staff, and multidisciplinary interventions. Therefore, quality assurance of telenursing and multi-disciplinary interventions will be essential for remote CR. Remote CR may become an important part of cardiac management in the future. However, issues such as costeffectiveness and insurance coverage still persist.