Change In Step Count Research Articles

An Internet-Based Virtual Coach to Promote Physical Activity Adherence in Overweight Adults: Randomized Controlled Trial

BackgroundAddressing the obesity epidemic requires the development of effective, scalable interventions. Pedometers and Web-based programs are beneficial in increasing activity levels but might be enhanced by the addition of nonhuman coaching.ObjectivesWe hypothesized that a virtual coach would increase activity levels, via step count, in overweight or obese individuals beyond the effect observed using a pedometer and website alone.MethodsWe recruited 70 participants with a body mass index (BMI) between 25 and 35 kg/m2 from the Boston metropolitan area. Participants were assigned to one of two study arms and asked to wear a pedometer and access a website to view step counts. Intervention participants also met with a virtual coach, an automated, animated computer agent that ran on their home computers, set goals, and provided personalized feedback. Data were collected and analyzed in 2008. The primary outcome measure was change in activity level (percentage change in step count) over the 12-week study, split into four 3-week time periods. Major secondary outcomes were change in BMI and participants’ satisfaction.ResultsThe mean age of participants was 42 years; the majority of participants were female (59/70, 84%), white (53/70, 76%), and college educated (68/70, 97%). Of the initial 70 participants, 62 completed the study. Step counts were maintained in intervention participants but declined in controls. The percentage change in step count between those in the intervention and control arms, from the start to the end, did not reach the threshold for significance (2.9% vs –12.8% respectively, P = .07). However, repeated measures analysis showed a significant difference when comparing percentage changes in step counts between control and intervention participants over all time points (analysis of variance, P = .02). There were no significant changes in secondary outcome measures.ConclusionsThe virtual coach was beneficial in maintaining activity level. The long-term benefits and additional applications of this technology warrant further study.Trial RegistrationClinicalTrials.gov NCT00792207; http://clinicaltrials.gov/ct2/show/NCT00792207 (Archived by WebCite at http://www.webcitation.org/63sm9mXUD)

Is There a Dose Response for Valgus Unloader Brace Usage on Knee Pain, Function, and Muscle Strength?

Hurley ST, Hatfield Murdock GL, Stanish WD, Hubley-Kozey CL. Is there a dose response for valgus unloader brace usage on knee pain, function, and muscle strength? ObjectiveTo examine whether there was a dose response for valgus unloader brace wear on knee pain, function, and muscle strength in participants with medial compartment knee osteoarthritis. DesignIn this single-group study, participants with medial compartment knee osteoarthritis were followed for approximately 6 months. SettingRecruitment was conducted in the general community, and testing was performed at a university laboratory. ParticipantsA convenience sample of patients (N=32) who were prescribed a valgus unloader brace agreed to participate, met the inclusion criteria, and completed the baseline data collection. Twenty-four participants (20 men, 4 women) completed baseline and follow-up collections. InterventionParticipants wore their valgus unloader brace as needed. Main Outcome MeasuresKnee extensor, flexor, and plantar flexor strength was tested at baseline and follow-up. Participants filled out Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Medical Outcomes Study 36-Item Short-Form Health Survey questionnaires to assess pain and function. Self-selected walking velocity and stride length were objective measures of function. Brace usage (dose) and activity (step count) were recorded at least 4 days/week for the study duration. ResultsPositive relationships existed between brace wear usage and percent change in step count (r=.59, P=.006) and percent change in hamstrings strength (r=.37, P=.072). At follow-up, there was significant improvement in hamstrings strength (P=.013), and trends toward improvements in WOMAC pain (P=.059) and WOMAC function (P=.089). ConclusionsOur results indicate that greater brace use may positively affect physical activity level, but there was minimal effect of brace wear dosage on lower-limb muscle strength. Only knee flexion showed a positive relationship. Our finding of no decreased muscle strength indicates that increased brace use over a 6-month period does not result in muscle impairment.

Get Fit Kids: A Feasibility Study of a Pedometer-Based Walking Program

Introduction: Childhood obesity has reached epidemic proportions in the United States and is a complex health problem with many biological, environmental, and psychosocial causative factors. While there are many factors that must be addressed to combat the prevalence of childhood obesity, prevention is typically viewed as the best solution for children. In an effort to address childhood obesity prevention and promote daily physical activity, a 12-week, pedometer-based walking program, Get Fit Kids, was designed and implemented with elementary school children. The primary aim of this study was to assess the feasibility and effectiveness of Get Fit Kids with an underserved population of Baltimore City public elementary-school children. Methods: Children in third through fifth grades participated in this quasi-experimental study during the 2008–2009 school year. The primary research aim was to evaluate the feasibility and effectiveness of the program as measured by the change in step counts from the children...

Parental Influence on Child Change in Physical Activity During a Family-Based Intervention for Child Weight Gain Prevention

This study examined the association between parent and child change in physical activity during a family-based intervention for child weight gain prevention. Daily step counts were recorded for parents and children in 83 families given a goal to increase activity by 2000 steps per day above baseline. Linear mixed effects models were used to predict child change in daily step counts from parental change in step counts. Both maternal (P < .0001) and paternal (P < .0001) change in step counts for the current day strongly predicted child change in step counts for that day. On average, a child took an additional 2117.6 steps above baseline on days his or her mother met her goal versus 1175.2 additional steps when the mother did not meet her goal. The respective values were 1598.0 versus 1123.1 steps for fathers. Day of week moderated the maternal effect (P = .0019), with a larger impact on Saturday and Sunday compared with weekdays. A similar but nonsignificant pattern was observed for fathers. Encouraging parents to increase physical activity, particularly on weekends, may be a highly effective way to leverage parental involvement in interventions to increase children's physical activity.

Summer to Winter Variability in the Step Counts of Normal Weight and Overweight Adults Living in the UK

This study investigated whether pedometer-determined activity varies between summer and winter in normal-weight and overweight adults. Forty-five normal-weight (58% female, age = 39.1 ± 12.4 years, BMI = 22.2 ± 2.1 kg/m²) and 51 overweight (49% female, age = 42.1 ± 12.5 years, BMI = 29.3 ± 4.5 kg/m²) participants completed a within-subject biseasonal pedometer study. All participants completed 2 4-week monitoring periods; 1 period in the summer and 1 period the following winter. Changes in step counts across seasons were calculated and compared for the 2 BMI groups. Both BMI groups reported significant summer to winter reductions in step counts, with the magnitude of change being significantly greater in the normal-weight group (-1737 ± 2201 versus -781 ± 1673 steps/day, P = .02). Winter step counts did not differ significantly between the 2 groups (9250 ± 2845 versus 8974 ± 2709 steps/day, P = .63), whereas the normal-weight group reported a significantly higher mean daily step count in the summer (10986 ± 2858 versus 9755 ± 2874 steps/day, P = .04). Both normal-weight and overweight individuals experienced a reduction in step counts between summer and winter; however, normal-weight individuals appear more susceptible to winter decreases in ambulatory activity, with the greatest seasonal change occurring on Sundays. Effective physical activity policies should be seasonally tailored to provide opportunities to encourage individuals to be more active during the winter, particularly on weekends.

Innovation to motivation—pilot study of a mobile phone intervention to increase physical activity among sedentary women

Objectives This uncontrolled pilot study assessed changes in pedometer-measured step counts and self-reported physical activity during a 3-week mobile phone-based intervention. We also explored whether age, BMI, and psychosocial factors were associated with changes in step counts. Methods Forty-one sedentary adult women in San Francisco, California were asked to report their pedometer steps using a study-supplied mobile phone from June to September 2008. In the second and third weeks, daily prompts delivered by the mobile phone encouraged participants to increase steps by 20% from the previous week. Results Mean age was 48 years. Average daily total steps increased by approximately 800 or 15% over three weeks ( p < 0.001). Lower BMI, no antidepressant use, and lower self-reported health status were associated with higher step counts at baseline. Improvements in self-reported will-power were associated with increases in step counts ( p < 0.001). Neither age ( p = 0.55) nor BMI ( p = 0.13) was significantly associated with changes in activity over the 3 weeks. Conclusions The intervention appeared to motivate sedentary women to increase their physical activity. A randomized controlled clinical trial is warranted and feasible.

The Impact of a Student-Led Pedometer Intervention Incorporating Cognitive-Behavioral Strategies on Step Count and Self-Efficacy

This study evaluated the effectiveness of a student-led physical activity intervention that incorporated pedometers and cognitive-behavioral strategies. Undergraduate students (N = 117) enrolled in upper division exercise and sport science courses recruited participants. Participants in the cognitive-behavioral intervention condition received weekly mentoring from students on strategies to foster self-regulation, whereas those in a minimal intervention control condition (i.e., pedometer and self-monitoring) did not. All volunteers wore a pedometer for 6 weeks, maintained a step-count log, and completed physical activity and barrier self-efficacy measures pre- and postintervention. Repeated measures analysis of variance revealed that intervention condition participants increased their steps more so than those in the control condition, F(5, 570) = 10.1, p < .0001, starting at Week 3, with effect sizes in the moderate range. Intervention condition participants also reported increased physical activity self-efficacy, whereas those in the control condition did not, F(1, 77) = 5.6, p < .03, Cohen d = .47. There were no significant changes in barrier self-efficacy for either group. Overall, these findings suggest a student-led cognitive-behavioral pedometer intervention results in more favorable changes in step counts and physical activity self-efficacy than simply wearing a pedometer and self-monitoring step counts.

The pedometer-based community intervention “10,000 Steps Ghent”: Who used a pedometer and who increased their steps?

Background: The pedometer-based “10,000 Steps Ghent” intervention was found to be effective in increasing steps. This study aimed to examine the characteristics of intervention participants who (1) used a pedometer and (2) increased their steps. The third aim was to examine the mediational effect of pedometer use on step count change.

Moderators and mediators of pedometer use and step count increase in the "10,000 Steps Ghent" intervention

BackgroundThe European pedometer-based "10,000 Steps Ghent" whole community intervention for 228,000 residents was found to be effective in increasing step counts by an average of 896 steps/day in a sub-sample of adults. The present study aimed to examine the characteristics of intervention participants (n = 438) who (1) used a pedometer and (2) increased their step counts. Additionally, the third aim was to examine the mediational effect of pedometer use on step count change.MethodsThe study sample consisted of 438 adults (207 male, mean age 49.8 (13.1) years). Binary logistic regressions were used to examine whether individual characteristics (gender, age, educational level, employment status, self-reported health condition, baseline step counts, baseline sitting time, baseline transport-related PA) and intervention exposure variables (having heard/seen a PA promotion message, being aware of the PA guidelines, and knowing about "10,000 Steps Ghent") were associated with (1) pedometer use and (2) a step count increase of 896 steps/day or more. Using pooled data (n = 864) from the intervention and comparison participants, a mediation analysis was conducted to see if the change in step counts was mediated by pedometer use.ResultsAge (49 years or more: OR = 3.19, p < 0.005), awareness of a PA promotion message (OR = 2.62, p < 0.01) and awareness of "10,000 Steps Ghent" (OR = 2.11, p < 0.05) were significantly associated with pedometer use. Participants with a college or university degree (OR = 1.55, p < 0.05) and those who used a pedometer (OR = 2.06, p < 0.05) were more likely to increase their steps by 896 steps/day or more. This increase was less likely among those with baseline step counts above 10,000 steps/day (OR = 0.38, p < 0.001). The mediation analysis revealed that pedometer use partly mediated step count change.ConclusionPedometer use was more likely in older participants and in those who were aware of the "10,000 Steps" campaign. Increasing step counts was more likely among those with higher education, baseline step counts below 10,000 steps/day and those who used a pedometer. Pedometer use only partly mediated the intervention effect on step counts.

Using pedometers as motivational tools: Are goals set in steps more effective than goals set in minutes for increasing walking?

Background Pedometers are popular devices that measure walking steps. There has been a recent surge in promoting the pedometer as a motivational tool to increase walking. However, little empirical evidence exists to support this suggestion. Objective To examine the effectiveness of a pedometer as a motivational tool to increase walking. Methods 50 participants (7 men and 43 women, mean age (SD) 40.16 (8.81) years, range 25–61 years) were randomly assigned to either an intervention group who followed a four-week walking programme with goals set in steps (using an open pedometer for feedback) or a comparison group who followed an equivalent four-week walking programme with goals set in minutes. Participants had step-counts recorded at baseline, weeks 1, 2, 3, 4, and at weeks 16 and 52 for follow-up. Results Both groups significantly increased step- counts from baseline to week 4 with no significant difference between groups. However, a significantly greater number of participants in the intervention group (77%) compared with the comparison group (54%) achieved their week 4 goals (p=0.03). There was no significant change in step-counts from week 4 to week 16. There was a significant decrease from week 16 to week 52. Conclusion In the short term, both goals set in minutes and goals set in steps using a pedometer may be effective at promoting walking. In the long term, additional support may be required to sustain increases in walking.

Impact of a Three-week Pedometer Intervention on High School Students' Daily Step Counts and Perceptions of Physical Activity

There is a pressing need to promote simple, healthy physical activities in West Virginia, especially to the growing number of inactive adolescents. The purpose of the study was to measure the impact of pedometers on daily step counts and perceptions of physical activity. Across four high schools, 165 students were recruited and randomly assigned to a pedometer-only group or a pedometer plus goal setting group. Students wore their pedometers daily for three weeks and reported steps on a weekly basis. Attrition was low for both survey (16%) and pedometer (22%) data, suggesting good internal validity for the intervention. Overall less than 25% of participants met recommended step guidelines, with mean daily steps ranging from 8800–9400. Further, neither of the two intervention groups significantly increased steps. There was no evidence that self-efficacy, barriers, or outcome expectations mediated changes in step counts, From the qualitative data, 70% of participants reported that their awareness or motivation towards health and physical activity was positively impacted by using pedometers. The short length of the pedometer intervention coupled with environmental barriers may have limited the effectiveness of the pedometer intervention in this setting.