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Review
Clinician's Corner
November 21, 2007

Using Pedometers to Increase Physical Activity and Improve HealthA Systematic Review

Author Affiliations
 

Author Affiliations: Center for Primary Care and Outcomes Research (Drs Bravata and Lin and Mss Sundaram, Gienger, and Lewis), Department of Internal Medicine (Dr Smith-Spangler), Stanford University School of Medicine, Lane Medical Library (Mr Stave), and Department of Statistics (Dr Olkin), Stanford University, Stanford; Department of Internal Medicine, California Pacific Medical Center, San Francisco (Dr Bravata); Veterans Affairs Palo Alto Health Care System, Palo Alto, California (Ms Sundaram); and School of Public Health, University of Minnesota, Minneapolis (Dr Sirard).

JAMA. 2007;298(19):2296-2304. doi:10.1001/jama.298.19.2296
Context

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

Objective To evaluate the association of pedometer use with physical activity and health outcomes among outpatient adults.

Data Sources English-language articles from MEDLINE, EMBASE, Sport Discus, PsychINFO, Cochrane Library, Thompson Scientific (formerly known as Thompson ISI), and ERIC (1966-2007); bibliographies of retrieved articles; and conference proceedings.

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

Data Extraction and Data Synthesis Two investigators independently abstracted data about the intervention; participants; number of steps per day; and presence or absence of obesity, diabetes, hypertension, or hyperlipidemia. Data were pooled using random-effects calculations, and meta-regression was performed.

Results Our searches identified 2246 citations; 26 studies with a total of 2767 participants met inclusion criteria (8 randomized controlled trials [RCTs] and 18 observational studies). The participants' mean (SD) age was 49 (9) years and 85% were women. The mean intervention duration was 18 weeks. In the RCTs, pedometer users significantly increased their physical activity by 2491 steps per day more than control participants (95% confidence interval [CI], 1098-3885 steps per day, P < .001). Among the observational studies, pedometer users significantly increased their physical activity by 2183 steps per day over baseline (95% CI, 1571-2796 steps per day, P < .0001). Overall, pedometer users increased their physical activity by 26.9% over baseline. An important predictor of increased physical activity was having a step goal such as 10 000 steps per day (P = .001). When data from all studies were combined, pedometer users significantly decreased their body mass index by 0.38 (95% CI, 0.05-0.72; P = .03). This decrease was associated with older age (P = .001) and having a step goal (P = .04). Intervention participants significantly decreased their systolic blood pressure by 3.8 mm Hg (95% CI, 1.7-5.9 mm Hg, P < .001). This decrease was associated with greater baseline systolic blood pressure (P = .009) and change in steps per day (P = .08).

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

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