Review: use of pedometers increases physical activity in adults
D M Bravata
Dr D M Bravata, Primary Care and Outcomes Research, Stanford, CA, USA;
In adult outpatients, does the use of pedometers increase physical activity?
Studies selected assessed pedometer use among >5 adult outpatients. Studies were excluded if participants were admitted to hospital or confined to a research centre, pedometers were sealed so that participants in the intervention group could not see the number of steps, or pedometers were used to measure the effects of a drug on a person’s ability to be physically active. Outcome was change in number of steps walked daily.
Medline (to Feb 2007); EMBASE/Excerpta Medica, Sport Discus, PsycINFO, Cochrane Library, Thompson Scientific, and ERIC (to May 2006); reference lists; and conference proceedings were searched for English-language studies. Experts in exercise physiology were consulted. 8 randomised controlled trials (RCTs) (n = 305) and 18 observational studies (n = 2462) were included (mean age 49 y, 85% women). Studies were done in the USA or Canada (20 studies), Japan (2 studies), Europe (2 studies), or Australia (2 studies). Duration of physical activity interventions ranged from 3 to 104 weeks (mean 18 wks).
In 8 RCTs, use of pedometers increased the number of steps walked daily; statistical heterogeneity was present, but the effect persisted even after removal of 1 study that showed a much higher increase in physical activity (table).
In adults, use of pedometers increases physical activity.
A modified version of this abstract appears in Evidence-Based Medicine.
Bravata DM, Smith-Spangler C, Sundaram V, et al. Using pedometers to increase physical activity and improve health: a systematic review. JAMA 2007;298:2296–304.
Clinical impact ratings: Cardiology 6/7; Family/general practice 6/7; General/internal medicine 5/7; Health promotion 6/7
Source of funding: National Institute on Aging and, in part, National Science Foundation.
Obesity has reached epidemic proportions in many countries. In Canada in 2005, almost one-half of the population 12 years and older reported inactivity during leisure time.1 Other authors report an increase from 14% to 23% in obesity in Canadian adults from 1978 to 2004.2 Similar results can be found in US adults.3 In a meta-analysis of psychobehavioural obesity interventions, over one-half of the successful studies cited included interventions that increased physical activity.4
Obesity has been strongly linked to several chronic diseases including, but not limited to, diabetes mellitus, coronary artery disease, hypertension, and depression. Thus, it appears that interventions that decrease obesity by increasing physical activity will improve the health of many people. Bravata et al reviewed the literature to investigate the efficacy of a safe, inexpensive intervention (pedometers) to increase physical activity. Their use seems to provide motivation to continue—the lack of motivation is a potential barrier to the successful and sustained increase in physical activity among obese adults.
Nurses can use this review to motivate themselves and other groups in the prevention and control of obesity; to role-model with colleagues, family, and friends; and to suggest and implement an intervention for clients in all clinical areas. Although additional research looking at long-term effects needs to be completed, these results can assist nurses to positively influence patients’ lives and promote healthier living.