Should clinicians recommend the use of pedometers for their adult patients to improve health outcomes?

Pedometer use is associated with increased physical activity (average increase = 2200 steps daily), reduced blood pressure, and minimal weight loss (0.39 reduction in baseline body mass index). Patients setting a personal step goal monitored with a daily diary were most likely to significantly increase activity. Current studies are short term and do not evaluate true patient-oriented outcomes. (LOE = 1a-)

Bravata DM, Smith-Spangler C, Sundaram V, et al. Using pedometers to increase physical activity and improve health. A systematic review. JAMA 2007;298(19):2296-2304.  [PMID:18029834]

Meta-analysis (other)

Foundation

Various (meta-analysis)

These investigators thoroughly searched for studies that evaluated the effect of pedometer use. Their search included MEDLINE, EMBASE, the Cochrane Library, bibliographies of retrieved articles, and conference abstracts for English language-only studies. Both randomized and observational trials were included. Two authors independently searched for and critiqued all studies, and discrepancies were resolved by consensus. Heterogeneity assessment occurred using sensitivity analysis. Funnel plots and analyses of the number of missing studies required to change the results determined the potential for publication bias. From an initial identification of 2246 articles, only 26 studies (evaluating 2767 participants) met eligibility criteria, including 8 methodologically acceptable randomized controlled trials (RCTs). The remainder were classified as observational studies. The mean age of participants was 49 years. Separate analysis of both the RCTs and observational trials found a statistically significant increase in physical activity (2000 to 2400 steps per day) in the pedometer use group. Patients setting a personal step goal and using a step diary were most likely to increase their physical activity. Participants using pedometers significantly decreased their baseline body mass index by an average of 0.38 units. Although average blood pressure levels were minimally decreased in the intervention group (3.8 mm Hg systolic; 0.3 mm Hg diastolic), there were no significant improvements in lipid or glucose levels compared with the control group.