Using pedometers to increase physical activity and improve health - A systematic review

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 [Cl], 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% Cl, 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% Cl, 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 mmHg ( 95% Cl, 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.