Using Pedometers To Monitor Physical ActivityFriday, March 25, 2011
Earlier this week I posted on the importance of self-monitoring and asked about how my readers monitor their food and activity – the responses were overwhelming. While almost all readers acknowledged how self-monitoring helped them maintain their weight losses, there was a wide range of tools and programs that were recommended – my response is: whatever works!
While a food journal (electronic or otherwise) works to monitor food intake, keeping track of activity is not quite that easy. While there are sophisticated (and expensive) devices that accurately measure motion in three planes, somtimes even in combination with changes in heart rate, most of my patients tend to use simple pedometers to measure their activity levels.
While measuring steps is probably better than measuring nothing, there are limitations to the use of pedometers.
This topic was extensively discussed in a classic paper by Catrine Tudor-Locke and Lesley Lutes from the Pennington Biomedical Research Center, Baton Rouge, LA, published in Sports Medicine back in 2009.
As the authors point out, two independent meta-analyses concluded that using a pedometer does increase physical activity, probably because it acts as a motivational tool.
In an effort to begin to outline why pedometers work, for whom, and under what conditions, the authors explored the published literature to identify factors related to using pedometers to increase physical activity.
They were particularly interested in the following issues:
(i) gain a better understanding of the activity-promoting characteristics of pedometers;
(ii) determine effective elements of pedometer-based programming;
(iii) identify participants who engage in, and benefit most from, such programming.
From their analysis of the (then) published literature, the authors concluded that pedometers are most sensitive to walking behaviours (both an advantage and a limitation) and offer an affordable and accessible technology that is simplistic in output, low-literacy friendly, and immediately understandable to end-users.
However, they also point out that more research is needed to compare the effectiveness of self-selected individualized goals with tailored goals (based on a specified baseline characteristic, for example), standardized goals (e.g. percentage-based increments) and pre-set uniformly administered goals (i.e. a volume total of 10 000 steps/day or an incremental total of 2000 extra steps/day for everyone).
They also note that since most studies of pedometer-based programmes have been of relatively short duration, it is unknown to what extent observed changes are sustainable or whether it is possible to continue to accrue benefits over long-term adherence.
In addition, the majority of pedometer-based programme participants to date have been women, suggesting that more research is needed on men and how they react to this form of physical activity intervention.
As expected, increases in steps/day are generally the greatest in those who start out with the lowest number of daily steps.
So, while the final verdict is still out on who benefits most, and/or requires additional or alternative strategies to succeed in their personal behaviour-change attempts, current evidence certainly supports the use of pedometers to promote physical activity (irrespective of whether or not this actually results in weight loss).
But pedometers are the simplest devices – I am sure that some of my readers are using more sophisticated equipment?
Also, while recording steps in a diary is certainly effective, I am also sure that many of my readers are probably using propriety software that comes with some of these devices or are entering their steps into online applications.
Looking forward to your responses.
Tudor-Locke C, & Lutes L (2009). Why do pedometers work?: a reflection upon the factors related to successfully increasing physical activity. Sports medicine (Auckland, N.Z.), 39 (12), 981-93 PMID: 19902981
Friday, March 25, 2011
I wear a Weight Watchers Points Plus Pedometer (available only in the U.S. right now). This pedometer, in addition to recording my daily activity, also automatically calculates the number of “activity points” I have earned during the day. There is a base-line established, based on your height, sex, age, weight and stride, that must be achieved before you even start earning activity points. Once you achieve that minimum daily base-line, you start earning activity points based on the amount of activity you undergo during the day.
One “activity point” can be exchanged for one “food point” or “Point Plus,” which equates to approximately 50 calories. You can either exchange these activity points for extra food points if you are hungry, or choose not to use the activity points you have earned in a day – it’s up to you. Activity points are NOT transferable from day to day. You either use them that day in exchange for extra food points, or you lose them – there is no “carrying them over” to the next day.
Friday, March 25, 2011
It’s not because it’s simple and cheap that it’s worthted !!
Pedometers do not measure intensity. I have seen to many individuals reaching 10000 steps per day without doing any minutes in moderate intensity for more than 10 minutes (as recommended by the PA guideline).
For my part using a pedometer is only good to make people realise that they need to move more.
Friday, March 25, 2011
It does not matter to me whether something is simple or cheap if my ADHD is not inclined to particpate in that activity I cannot do that activity. my pedomiter use is like my meal planning. Woefully non-compliant. I wish I could get past this and participate in these two actiities. For now I will have to be glad that I can do my food journaling–paper and pen are best for me. If you could find something to get past the ADHD for me in these two activities I am sure others would appreciate it. Thanks for the information
Friday, March 25, 2011
I love my pedometer and find that it does motivate me. I agree that some don’t measure how strenuous you are working out – however, mine does give me a breakdown of how many steps are “aerobic” and then a daily total. My pedometer makes me very aware of how active (or inactive) I am. For instance, I can have a day at home where I am “very busy” working around the house – cleaning, going up and down stairs, folding laundry & putting it away etc. – very tired in the evening – BUT I can end the day with only 5,000 (or less) steps! If I didn’t have my pedometer on, I would have thought that I hit at least 10,000 steps. Another example in the other direction is this past week when we got our big snow storm – I didn’t get my daily walk in but I did shovel the snow. Shovelling was hard work – I was sweating but I ended the day with just shy of 3,000 (!!) steps! Also, if I go biking, my pedometer doesn’t count that (of course). It is just a tool, but it does really help to make me move.
Saturday, March 26, 2011
A recent study in Preventative Medicine examined the use of pedometers versus a single continuous exercise session and short bouts of physical activity. The researchers found that those who used a pedometer with the goal of 10,000 steps per day, increased their activity much more so than those in the single, continuous or multiple bouts group. Since we know there are so many health benefits associated with accumulating 10K steps (which equals walking about 5 miles!), I think this is an excellent tool for helping people become more physically active. I believe there must be some validation in the immediate feedback associated with pedometers that motivates people to accumulate additional steps. Of course, this assumes you can convince a person to wear a pedometer. As addressed by LucyA above, just getting someone to wear a pedometer and track their steps may be the most difficult step.
Dr. Sharma, since it seems that many of your patients are wearing pedometers, I am curious if you have any suggestions to convince people to wear them?
Cited article: A randomized controlled trial of continuous activity, short bouts, and a 10,000 step guideline in inactive adults. Preventative Medicine, 52 (2011).
Tiana Y. Samuels, Thomas D. Raedeke ⁎, Matthew T. Mahar, Kristina H. Karvinen, Katrina D. DuBose
Tuesday, March 29, 2011
At our clinic we typically recommend the use of the Omron HJ-112 (http://www.omronhealthcare.com/products/hj-112) which our patients tend to really like.
Interestingly, we used to sell a less expensive “no frills” type of pedometer (the Omron costs $35 and our previous cost $15) but the more expensive pedometer has resulted in more patients purchasing and using a pedometer. Perhaps there is something to do with the perceived value here?
We have also had a couple patients purchase a product from Body Media (http://www.bodymedia.com) where an armband is worn and it measures motion in conjunction with a few other things to predict caloric expenditure. The blue tooth version will even send the data straight to a PDA!
Patients can also enter food intake into the program and it will calculate calorie balance for the day. I can’t attest to the fact that it is actually “measuring” calorie output or BMR, but our patients who are using it are doing well.
I’m thinking that just monitoring both sides of the input and output equation is half the battle.