Clinical Inquiries

Do pedometers increase activity and improve health outcomes?

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Yes. In overweight and obese patients, exercise interventions using a pedometer increase steps by about a mile per day over the same interventions without access to pedometer information (strength of recommendation [SOR]: A, meta-analysis of randomized controlled trials [RCTs]) and are associated with a modest 4 mm Hg reduction in systolic blood pressure (BP) over baseline (SOR: B, meta-analysis of RCTs and cohort studies). In overweight patients with diabetes, pedometer use with nutritional counseling is associated with 0.86 kg greater weight loss than nutritional counseling alone (SOR: B, meta-analysis of lower quality RCTs).

Pedometers increase activity in patients with various musculoskeletal conditions and may help reduce pain (SOR: B, meta-analysis of RCTs with heterogeneous outcomes). In low-activity elderly patients, pedometers do not appear to increase total activity when added to an exercise program, but they do appear to increase walking (SOR: B, RCT).

There is no evidence concerning the impact of pedometers on cardiovascular outcomes.




A systematic review and meta-analysis identified 26 studies evaluating activity and health outcomes with the use of pedometers.1 The studies included 8 RCTs and 18 observational studies with 2767 patients (mean body mass index [BMI]: 30 kg/m2; mean age: 49 years; 85% women). The studies ranged from 3 to 104 weeks. From the RCT data, patients using pedometers had an increase of 2491 steps per day (about one mile) more than control group patients (8 trials, n=305; 95% confidence interval [CI], 1098-3885 steps/day; P<.001).

Across all of the observational studies, pedometer users had a 26.9% increase from their baseline physical activity (P=.001). When data from all of the studies were combined, the researchers found a decrease from baseline BMI (18 studies, n=562; mean difference [MD]=0.38 kg/m2; 95% CI, 0.05-0.72; P=.03) and a decrease in systolic BP (12 studies, n=468; MD=3.8 mm Hg; 95% CI, 1.7-5.9 mm Hg; P<.001). No statistically significant change was noted in cholesterol or fasting glucose levels. Weaknesses of this review include the heterogeneity of the interventions, relatively small study sizes, and short study durations.

Reduced weight, BMI in patients with type 2 diabetes

A systematic review and meta-analysis of 11 RCTs (N=1258) evaluated pedometer effects in overweight patients with type 2 diabetes.2 (One RCT was included in the above meta-analysis.) Studies ran from 6 to 48 weeks, and mean enrollment BMI (where reported) was 30 kg/m2 or more in at least one treatment arm. Compared to controls, patients using pedometers had greater reductions in weight (weighted mean difference [WMD]= -0.65 kg; 95% CI, -1.12 to -0.17 kg) and BMI (WMD= -0.15 kg/m2; 95% CI, -0.29 to -0.02 kg/m2). The effect persisted in the subset of studies in which the intervention and control groups both received dietary counseling (WMD weight= -0.86 kg; 95% CI, -1.45 to -0.27 kg; WMD BMI= -0.30 kg/m2; 95% CI, -0.50 to -0.10 kg/m2). Study quality was low to moderate, and 5 studies used per-protocol analysis instead of intention-to-treat analysis.


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