In November of 2007 the JAMA published a review about using pedometers to increase physical activity and improve health. The objective of the study was to evaluate the association of pedometer use with physical activity and health outcomes among outpatient adults. The review identified 2246 citations, 26 studies and included a total of 2767 participants.
In order to be included, the studies had to meet the following criteria:
1) report an assessment of pedometer use among adult outpatients (mean age 49 years) ,
2) reported a change in steps per day, and
3) included more than 5 participants.
In controlled trials, pedometer use increased the user’s steps significantly by an average of 2491 steps per day. In observational studies, the, pedometer users significantly increased their physical activity by 2183 steps per day, over their baseline value. Overall pedometer users increased their physical activity by 26.9%.
One important predictor of increased physical activity was having a step goal such as 10,000 steps per day. When the data from all the included studies were combined, pedometer users significantly decreased their body mass index by 0.38 as well as systolic blood pressure (3.8 mmHg). Reducing systolic blood pressure by 2 mmHg is associated with a 10% reduction in stroke mortality and a 7% reduction in mortality from vascular causes in middle-aged populations.
Researchers also found that the reduction in systolic blood pressure was independent of decreases in BMI, and was consistent with the results of other studies. By highlighting the health benefits from physical activity aside from weight loss, health professionals may encourage patients who are frustrated by an inability to lose weight to engage in physical activity.
Notably, participants in the studies that did not require the use of a step diary did not significantly increase their activity over baseline, whereas participants in interventions that required the use of a diary did (mean change 2649 steps per day).
In my clinical practice when a patient decides to work with us to lose weight, we use the pedometer and give the patient a goal to increase their steps to 10,000 per day. I have found this to be an effective way to use goal setting and recording to increase physical activity for patients on a daily basis.
JAMA, November 21,2007—Vol 298, No 19 pages 2296-23303