A review of previous studies indicates that use of a pedometer, especially with a daily step goal, is associated with significant increases in physical activity (additional walking of about a mile a day) and decreases in body mass index and blood pressure, according to an article in the November 21 issue of JAMA.
More than half of all adults in the United States do not get adequate physical activity and approximately one-quarter do not get any leisure time physical activity, according to background information in the article. "The costs associated with physical inactivity are high. For example, if 10 percent of adults in the United States began a regular walking program, an estimated $5.6 billion in heart disease costs could be saved," the authors write. Pedometers are small, relatively inexpensive devices worn at the hip to count the number of steps walked per day. Although there is not detailed evidence of their effectiveness, they have recently experienced a surge in popularity as a tool for motivating and monitoring physical activity.
Dena M. Bravata, M.D., M.S., of Stanford University, Calif., and colleagues evaluated the association between pedometer use and physical activity and health outcomes among adults. The authors searched databases for studies and articles on this topic, and identified 26 studies with a total of 2,767 participants that met inclusion criteria (eight randomized controlled trials [RCTs] and 18 observational studies). The participants' average age was 49 years and 85 percent were women. The average intervention duration was 18 weeks.
In the RCTs, pedometer users significantly increased their physical activity by 2,491 steps per day more than control participants. Among the observational studies, pedometer users significantly increased their physical activity by 2,183 steps per day over baseline (2,000 steps is about one mile). Overall, pedometer users increased their physical activity by 26.9 percent over baseline. Among the intervention characteristics, having a step goal was the key predictor of increased physical activity. The three studies that did not include a step goal had no significant improvement in physical activity with pedometer use in contrast to increases of more than 2,000 steps per day with the use of a 10,000-step-per-day goal or other goal.
Intervention participants significantly decreased their body mass index by 0.38 from baseline. This reduction was associated with older age and having a step goal. Participants also significantly decreased their systolic blood pressure by 3.8 mm Hg, which was associated with greater systolic blood pressure at baseline and change in steps per day.
"Our results suggest that the use of these small, relatively inexpensive devices is associated with significant increases in physical activity and improvements in some key health outcomes, at least in the short term. The extent to which these results are durable over the long term is unknown," the researchers write.
(JAMA. 2007;298(19):2296-2304. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.