Physical activity is an important factor in the care of adults 65 years and older who have had a cardiac event. Valid and reliable measurement is critical to nursing assessment, screening, and ongoing evaluation. This article describes the process used to evaluate the quality, including the reliability and validity, of a physical activity instrument for use in a rural population. The sample consisted of 32 adults who had participated in one of four rural cardiac rehabilitation programs. The Physical Activity Scale for the Elderly (PASE), which was selected for this study, was found to be reliable. Experts judged the content to be appropriate and valid for older adults living in rural areas. Perceived health was positively related to physical activity (r = 0.31, p = .08). The PASE was found to be marginally valid. Although further investigation of the instrument's construct validity is warranted, the use of such physical activity surveys has potential clinical relevance for the rehabilitation of older adults from diverse geographic and cultural backgrounds.