Using Pedometers to Increase Physical Activity and Improve Health

Context

 Without detailed evidence of their effectiveness,pedometers have recently become popular as a tool for motivatingphysical activity.

Objective

To evaluate the association of pedometer usewith physical activity and health outcomes among outpatientadults.

Study Selection

Studies were eligible for inclusion ifthey reported an assessment of pedometer use among adult outpatients,reported a change in steps per day, and included more than 5participants.

Data Extraction and Data Synthesis

Two investigators independentlyabstracted data about the intervention; participants; numberof steps per day; and presence or absence of obesity, diabetes,hypertension, or hyperlipidemia. Data were pooled using random-effectscalculations, and meta-regression was performed.

Results

Our searches identified 2246 citations; 26 studieswith a total of 2767 participants met inclusion criteria (8randomized controlled trials [RCTs] and 18 observational studies).The participants' mean (SD) age was 49 (9) years and 85% werewomen. The mean intervention duration was 18 weeks.

In the RCTs,pedometer users significantly increased their physical activityby 2491 steps per day more than control participants (95% confidenceinterval [CI], 1098-3885 steps per day, P < .001).Among the observational studies, pedometer users significantlyincreased their physical activity by 2183 steps per day overbaseline (95% CI, 1571-2796 steps per day, P < .0001).

Overall, pedometer users increased their physical activity by26.9% over baseline. An important predictor of increased physicalactivity was having a step goal such as 10 000 steps perday (P = .001). When data from all studies were combined,pedometer users significantly decreased their body mass indexby 0.38 (95% CI, 0.05-0.72; P = .03). This decreasewas associated with older age (P = .001) and havinga step goal (P = .04). Intervention participants significantlydecreased their systolic blood pressure by 3.8 mm Hg (95% CI,1.7-5.9 mm Hg, P < .001). This decrease was associatedwith greater baseline systolic blood pressure (P = .009)and change in steps per day (P = .08).

Conclusions

The results suggest that the use of a pedometeris associated with significant increases in physical activityand significant decreases in body mass index and blood pressure.Whether these changes are durable over the long term is undetermined.