Background: A plethora of tools are available to measure physical activity (PA), sedentary behaviour (SB) and sleep quality (SQ). Ideally, the measurement and evaluation of these outcomes would be combined to reflect their synergistic relationships across the 24-hour day. Current guidance focusses only on PA (Burtin et al. Chest 2021).

Aim: To synthesise the measurement approaches used in PR trials examining changes in PA, SB and SQ.

Methods: Systematic review of randomised trials of PR, reporting PA, SB or SQ outcomes. Behaviours (e.g. PA), measurement tools (e.g. ActiGraph) and outcomes (e.g. steps) extracted are presented in a radial plot.

Results: From 32 included articles (N=2494; 94% COPD), 21 articles (66%) assessed PA only, 1 article assessed SQ only (3%), and no articles assessed SB only. The remaining 10 articles assessed multiple movement behaviours (PA+SB: n=9; 28% and PA+SB+SQ: n=1; 3%). Of the 31 articles measuring PA, 26 articles used steps/day as an outcome (using 8 different tools). |Of the 10 studies measuring SB, 8 articles used sedentary time as an outcome (using 3 different tools). Different tools were used for the 2 articles measuring SQ (Fig 1).

Conclusion: Few studies have evaluated the combined impact of PR on PA, SB and SQ. Variation in the selection of measurement tools and outcomes must be overcome in developing standardised measurement approaches for 24-hour movement behaviours.