Mean Daily Step Count Research Articles

P76 The effect of outside temperature on daily physical activity in COPD patients

IntroductionCOPD is characterised by breathlessness, leading to reduced physical activity. Breathlessness varies dependent upon the degree and intensity of physical activity (1). Common logic dictates that weather variation such as...

P78 Physical Inactivity is Associated with Mid-Thigh Intramuscular Fat in Patients with COPD

IntroductionQuadriceps muscle impairment is an important complication of COPD occurring in mild as well as more advanced disease1. This is driven by physical inactivity and can include muscle atrophy and/or...

Establishing a threshold for the number of missing days using 7 d pedometer data

The purpose of this study was to examine the threshold of the number of missing days of recovery using the individual information (II)-centered approach. Data for this study came from 86 participants, aged from 17 to 79 years old, who had 7 consecutive days of complete pedometer (Yamax SW 200) wear. Missing datasets (1 d through 5 d missing) were created by a SAS random process 10 000 times each. All missing values were replaced using the II-centered approach. A 7 d average was calculated for each dataset, including the complete dataset. Repeated measure ANOVA was used to determine the differences between 1 d through 5 d missing datasets and the complete dataset. Mean absolute percentage error (MAPE) was also computed. Mean (SD) daily step count for the complete 7 d dataset was 7979 (3084). Mean (SD) values for the 1 d through 5 d missing datasets were 8072 (3218), 8066 (3109), 7968 (3273), 7741 (3050) and 8314 (3529), respectively (p > 0.05). The lower MAPEs were estimated for 1 d missing (5.2%, 95% confidence interval (CI) 4.4–6.0) and 2 d missing (8.4%, 95% CI 7.0–9.8), while all others were greater than 10%. The results of this study show that the 1 d through 5 d missing datasets, with replaced values, were not significantly different from the complete dataset. Based on the MAPE results, it is not recommended to replace more than two days of missing step counts.

Presence and Duration of Reactivity to Pedometers in Adults

This study aimed to examine the presence and duration of reactivity to wearing a pedometer and recording daily step counts in free-living adults. On the first visit to the laboratory, 90 participants (69% were females, age = 26.8 ± 13.0 yr, body mass index = 23.4 ± 4.0 kg·m(-2)), blinded to the study aim, were provided with a sealed pedometer (New Lifestyles NL-800) and informed that it was a "body posture monitor" (covert condition). Participants wore the pedometer throughout waking hours for 1 wk. On their return to the laboratory, stored step counts were recorded, and participants were informed that the device was a pedometer. Participants wore the pedometer unsealed (no restriction on viewing the step count display) for 2 wk, during which they recorded their daily step count in a diary (diary condition). Mean daily step counts recorded during the covert condition and during weeks 1 and 2 of the diary condition were compared using a repeated-measures ANOVA. There was a significant overall effect of study condition (P < 0.001), with post hoc analyses revealing that mean daily step counts reported during the first week of the diary condition (9898 ± 3002 steps per day) were significantly higher than those reported during the covert condition (8331 ± 3010 steps per day) and during the second week of the diary condition (8226 ± 3170 steps per day, P < 0.001). Reactivity to wearing unsealed pedometers and step count recording seems to last for 1 wk. In the absence of any intervention material, step counts return to normal levels during the second week of monitoring and therefore represent a more accurate estimate of habitual activity. These findings have important implications to both researchers and practitioners interested in the use of pedometers for physical activity surveillance and promotion.

Abdominal adiposity and daily step counts as determinants of glycemic control in a cohort of patients with type 2 diabetes mellitus

Objective:Favorable effects of walking levels on glycemic control have been hypothesized to be mediated through reductions in abdominal adiposity, but this has not been well studied. We addressed this issue in patients treated for type 2 diabetes.Design:Cross-sectional analysis.Subjects:A total of 201 subjects with type 2 diabetes underwent assessments of pedometer-measured daily step counts, blood pressure, A1C and anthropometric measures (2006–2010). Associations of anthropometric indicators of abdominal adiposity (that is, waist circumference; waist-to-hip ratio (WHR)) with A1C were evaluated through linear regression models adjusting for age, ethnicity, sex and the use of insulin and oral hypoglycemic agents. Models including waist circumference were additionally adjusted for body mass index (BMI). A similar approach was used to examine A1C and daily step associations.Results:Among the 190 subjects (mean age 60 years; mean BMI 30.4 kg m−2), mean values (s.d.) for waist circumference and WHR were respectively, 99.1 cm (13.3) and 0.88 (0.07) in women, and 104.5 cm (13.1) and 0.97 (0.06) in men. Mean A1C and daily step count were respectively, 7.6% (1.4) and 5 338 steps per day (2609), and were similar for both sexes.There was a 0.51% (95% confidence interval (CI): 0.10, 0.93) A1C increment per s.d. increase in waist circumference and a 0.32% (95% CI: 0.08, 0.56) A1C increment per s.d. increase in WHR in fully adjusted models. Each s.d. increase in daily step count was associated with clinically significant reductions in waist circumference and BMI. Each s.d. increase in daily steps was associated with a 0.21% (95% CI: 0.02, 0.41) A1C decrement that declined to 0.16% (95% CI: −0.35, 0.04) with further adjustment for anthropometric indicators of abdominal adiposity.Conclusion:Higher daily steps may be associated with lower A1C values both directly and via changes in abdominal adiposity.

Effect of physical activity intervention based on a pedometer on physical activity level and anthropometric measures after childbirth: a randomized controlled trial.

BackgroundPregnancy and childbirth are associated with weight gain in women, and retention of weight gained during pregnancy can lead to obesity in later life. Diet and physical activity are factors that can influence the loss of retained pregnancy weight after birth. Exercise guidelines exist for pregnancy, but recommendations for exercise after childbirth are virtually nonexistent. The aim of this study was to evaluate the effect of physical activity intervention based on pedometer on physical activity level and anthropometric measures of women after childbirth.MethodsWe conducted a randomized controlled trial in which 66 women who had given birth 6 weeks to 6 months prior were randomly assigned to receive either a 12 week tailored program encouraging increased walking using a pedometer (intervention group, n = 32) or routine postpartum care (control group, n = 34). During the 12-week study period, each woman in the intervention group wore a pedometer and recorded her daily step count. The women were advised to increase their steps by 500 per week until they achieved the first target of 5000 steps per day and then continued to increase it to minimum of 10,000 steps per day by the end of 12th week. Assessed outcomes included anthropometric measures, physical activity level, and energy expenditure per week. Data were analyzed using the paired t-test, independent t-test, Mann-Whitney, chi-square, Wilcoxon, covariance analysis, and the general linear model repeated measures procedure as appropriate.ResultsAfter 12 weeks, women in the intervention group had significantly increased their physical activity and energy expenditure per week (4394 vs. 1651 calorie, p < 0.001). Significant differences between-group in weight (P = 0.001), Body Mass Index (P = 0.001), waist circumference (P = 0.001), hip circumference (P = 0.032) and waist-hip ratio (P = 0.02) were presented after the intervention. The intervention group significantly increased their mean daily step count over the study period (from 3249 before, to 9960 after the intervention, p < 0.001).ConclusionA physical activity intervention based on pedometer is an effective means to increase physical activity; reducing retention of weight gained during pregnancy and can improve anthropometric measures in postpartum women.Trial registrationISRCTN: IRCT201105026362N1

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.

The Validity of a Computerized Use of Time Recall, the Multimedia Activity Recall for Children and Adolescents

This study examined the convergent validity of a computerized use of time diary (MARCA) relative to pedometry. Participants aged 9-16 years wore a pedometer and completed the MARCA. Comparing pedometer data and self-report data collected for the same day (n = 297 participants), the correlation (Spearman's rho) with PAL was 0.54 and with MVPA was 0.50. Comparing mean daily step counts over 6-7 days with averaged self-report data collected on different days (n = 1713 participants) Spearman's rho for PAL was 0.45 and for MVPA was 0.44. Thus, the MARCA showed validity similar or superior to most self-report instruments for young people.

Relationship of Dietary Intake and Lifestyle Factors to Health-Related Quality of Life in the Community-Dwelling Elderly

Quality of life (QOL) encompasses a broad notion of health and is increasingly used to evaluate the effectiveness of health care services. The purpose of this cross-sectional study was to assess health-related quality of life (HR-QOL) in the community-dwelling elderly (mean age, 72.7±0.3 y; female 46.4%, n=179) in Japan and to explore diminished factors. We assessed HR-QOL by the 36-Item Short-Form Health Survey (SF-36), maximum walking speed, step counts, Tokyo Metropolitan Institute of Gerontology (TMIG) index, dietary intake and blood biochemistry. Two summary scores of the SF-36 were calculated (physical component score: PCS, mental component score: MCS). We divided participants into two groups based on the standard values of PCS and MCS classified by age (high and low group), which was further stratified into a high PCS and high MCS (BH) group and a low PCS and low MCS (BL) group. Mean maximum walking speed and daily step counts were 207.7±2.8 cm/s and 7,008±289. Eighty-one percent of the participants had full scores in the TMIG index. Daily intake of energy and protein were 2,081±33 kcal and 74.5±0.9 g. The maximum walking speed, TMIG index, alcohol consumption and chewing ability were significantly higher in the BH group than those in the BL group, but not dietary intake. Stepwise logistic regression analysis indicated that maintaining maximum walking speed might be associated with sustaining HR-QOL in the healthy elderly.

Randomized Controlled Pilot Study of Neuromuscular Electrical Stimulation of the Quadriceps in Patients with Non-Small Cell Lung Cancer

Patients with lung cancer experience muscle wasting and weakness. Therapeutic exercise may be beneficial but is not always practical. An alternative approach may be neuromuscular electrical stimulation (NMES) of the quadriceps muscles, but this has not been formally examined in patients with cancer. Thus, we have undertaken this pilot study to assess feasibility and inform the design of future studies. Sixteen patients were randomized to receive usual care (control group) or usual care plus NMES for four weeks. NMES consisted of daily stimulation to both thighs for up to 30 minutes (frequency 50 Hz, “on” cycle 11%–25%). Adherence was assessed by a self-report diary and a semistructured evaluation form. Quadriceps muscle strength, exercise endurance, and free-living physical activity were assessed using a Cybex NORM dynamometer, an endurance shuttle walk test, and an ActivPAL accelerometer (mean daily step count), respectively. Changes in outcome from baseline were compared between groups by mean differences and their 95% confidence intervals using independent t-test ( P = 0.05). Median (range) adherence to the program was 80% (69%– 100%). All patients found the NMES device easy to use. Changes in outcome favored the NMES group, with mean differences of 9.4 Nm (21%) in quadriceps muscle strength, 768 steps (15%) in free-living activity, and 138 m (8%) in exercise endurance, but none of the differences were statistically significant. In conclusion, NMES warrants further study in patients with lung cancer.

Pedometers and Text Messaging to Increase Physical Activity

OBJECTIVETo assess whether pedometers and text messaging increase physical activity in adolescents with type 1 diabetes.RESEARCH DESIGN AND METHODSA 12-week randomized controlled trial was conducted. A total of 78 subjects participated in the trial (mean ± SD age 14.4 ± 2.37 years, 36 [47%] male). Intervention participants wore an open pedometer and received regular motivational text messages. Control participants received usual care. Primary outcomes were daily step count (4-day closed pedometer) and physical activity questionnaire.RESULTSBaseline median step count was 11,063 steps/day (range 1,541–20,158). At 12 weeks, mean daily step count reduced by 840 (95% CI −1,947 to 266) in the control group and by 22 (−1,407 to 1,364) in the intervention group (P = 0.4). Mean self-reported moderate or vigorous physical activity increased by 38.5 min/week in the control group and by 48.4 in the intervention group (P = 0.9).CONCLUSIONSA 12-week intervention using pedometers and text messaging as motivational tools in adolescents with type 1 diabetes did not increase physical activity.

Reactivity: an issue for short-term pedometer studies?

Objectives:To investigate the influence of wearing a pedometer and recording daily step counts on ambulatory activity.Methods:During the first visit to the laboratory, 50 healthy volunteers, blinded to the study aim,...

UK adults exhibit higher step counts in summer compared to winter months

Background: Seasonal differences in step counts have been observed in a limited number of studies conducted on US adults. Due to the diverse global climate, assessment and interpretation of seasonal patterns in ambulatory activity may vary between countries, and regionally specific studies are necessary to understand global patterns. Currently, no studies have assessed whether a seasonal trend is present when ambulatory activity is measured objectively in adults living in the UK.Aim: The present study investigated whether pedometer-determined step counts of adults living in the UK vary between summer and winter.Subjects and methods: Ninety-six adults (52% male, age = 41.0 ± 12.3 years, BMI = 26.1 ± 5.1 kg m–2) completed a within-subject bi-seasonal pedometer study. All participants completed two 4-week monitoring periods; one during the summer and one the following winter. The same Yamax SW-200 pedometer was worn throughout waking hours during both seasons, and daily step counts were recorded in an activity log. Intra-individual seasonal changes in mean daily steps were analysed using a paired samples t-test.Results: Summer mean daily step counts (10 417 ± 3055 steps day–1) were significantly higher than those reported during the winter (9132 ± 2841 steps day–1) (p < 0.001). A follow-up study conducted the subsequent summer in a sub-sample (n = 28) reinforced this trend. Summer step counts were significantly higher than winter step counts on all days of the week (p ≤ 0.001). A significant day of the week effect was present in both seasons, with step counts reported on a Sunday being on average 1500 steps day–1 lower than those reported Monday through to Saturday.Conclusion: Step counts in the sample of UK adults surveyed decreased significantly in the winter compared to the summer, suggesting future pedometer surveillance studies should capture step counts throughout the year for a non-biased reflection of habitual ambulatory activity. Public health initiatives should target these seasonal differences, and opportunities should be provided that encourage individuals to increase their activity levels during the colder, darker months of the year.

Four-week pedometer-determined activity patterns in normal weight and overweight UK adults

To assess pedometer-determined physical activity levels and activity patterns in a sample of free-living normal weight and overweight UK adults. Pedometer-based 4-week observational study. One hundred and twenty-two healthy participants, recruited from two regions in the UK, classified as normal weight (33 females and 26 males) or overweight (31 females and 32 males), in the age range of 18 to 65 years, completed the study. Daily step counts were measured using a Yamax SW-200 pedometer, and were then recorded in an activity log. Comparisons were made between activity patterns occurring over different days of the week for the normal weight and overweight groups. Measurements of height, weight and percentage body fat, by bioelectrical impedance, were taken pre- and post-study. A consistent reduction in activity was observed on a Sunday in the overweight group, and mean daily step counts accumulated on Sundays were significantly lower, by an average of 2221 steps/day, when compared with all other days of the week (all P<0.001). In comparison, no day-of-the-week effect was observed in the normal weight group. Mean step counts reported on each day of the week did not differ significantly between the two groups, with the exception of Sunday when the overweight group reported significantly fewer steps than the normal weight participants (8093 versus 10 538, P<0.001). Activity levels dropped dramatically in the sample of overweight adults on a Sunday. Simple instructions to at-risk individuals, to increase their general activity levels on a Sunday, via general practitioners and public health messages could prove to be a subtle, but effective, strategy to tackle obesity.

Pedometers As a Means to Increase Ambulatory Activity for Patients Seen at a Family Medicine Clinic

Because of their frequent encounters with sedentary patients, family physicians are poised to be on the forefront of the medical community's response to physical inactivity. The purpose of this pilot study was to examine whether the addition of a pedometer to brief physician counseling could help patients increase their ambulatory activity. Ninety four participants recruited from a family medicine clinic were randomly assigned to 2 groups. Both groups received a brief physician endorsement of regular physical activity, a handout on the benefits of an active lifestyle, and 3 follow-up phone calls from a health educator. In addition, the intervention group received a pedometer and was instructed to record their steps daily over the 9-week study period. Measurements were taken for self-reported walking, walking stage-of-change, walking self-efficacy, and pedometer steps (intervention group only). Among completers, mean daily step counts in the pedometer group rose from 6779 at baseline to 8855 at study end. Average individual improvement was 41% over the study period. Both groups significantly increased blocks walked per day, stair climbing versus using the elevator, days per week walking > or = 30 minutes, and walking for fun/leisure. The frequency of walking short trips improved significantly more in the pedometer group relative to the comparison group. The results of this pilot study highlight the need for further research on the use of pedometers as a motivational tool in the context of medical encounters with inactive patients.

Pedometer-Assessed Physical (Ambulatory) Activity in Cypriot Children

This study examined gender, seasonal and school versus after-school timedifferences in physical activity levels assessed by pedometer. Year 6 primary school children ( n= 256) wore pedometers for five days in winterand for the same period of time in the summer. Two-way analysis of varianceshowed that boys acquired significantly higher mean daily step counts than girls in winter (15,480 ± 4153 vs 11,160 ± 2694), and summer (17,624 ± 5035 vs 13,607 ± 4396). Children’s mean dailystep counts were significantly higher in summer than in winter. Children attained significantly higher mean step counts during after-school time than during school time. No significant differences could be found between activity levels on school days or on Sundays. Expected daily step counts are utilized to describe the physical activity levels of the children.