Quick, easy intervention; Pedometers: can they move sedentary people?
INDIANAPOLIS -- A pedometer may be just the tool that time-stretched physicians need to raise
sedentary patients from their lounging chairs and nudge them into health-enhancing activity, Dr.
Steven Stovitz said at the annual meeting of the American College of Sports Medicine.
Pedometers are becoming so ubiquitous that even McDonald's distributed them earlier this year with
some adult-oriented low-fat meals, said Dr. Stovitz, a professor of family practice and community
health at the University of Minnesota, Minneapolis.
In a pilot study of 94 patients, Dr. Stovitz and his colleagues found that patients who received a
pedometer and instructions on its use were significantly more likely to increase their physical activity
than were those in a control group who received encouragement to exercise but no pedometer.
"This intervention is so simple that it could easily be used by physicians," Dr. Stovitz said in an
interview. "Historically, our attempts at motivating our patients to increase their physical activity have
been shown not to have a great effect, so [physicians] have some cynicism in this area."
Unlike a health risk such as smoking, sedentary lifestyle usually is not easily quantified and not usually
noted on a patient's chart, Dr. Stovitz continued. But he maintained that in less than 1 minute out of a
typical office visit, offering a pedometer along with instruction on its use could be "one more tool that
we could use."
In the study, Dr. Stovitz met with all patients aged older than 18 years at a family practice clinic until
50 were randomized to the pedometer group. Patients were excluded if they already were meeting
certain physical activity guidelines, they had a medical condition that precluded additional physical
activity, or they were unable to give follow-up information over the phone.
The mean body mass index of both the 50-member pedometer group and the 44-member control
group met the criteria for obesity. The 21 patients in the pedometer group who completed the study--
meaning they filled in their activity logs and were available for telephone follow-ups at 2 weeks and at
the 9-week end point--had a mean increase in steps per day of 2,089, which translated into walking
about 20 minutes more each day, Dr. Stovitz said.
Of these 21 pedometer users, 11 (52.4%) improved by at least 1,500 steps per day, or about 15
additional minutes of walking, and 6 (28.6%) improved by at least 10,000 steps per day, he said.
Of the 44 control patients--who received the same 30- to 60-second speech about the benefits of
physical activity but not the pedometer--23 completed the study. They reported a nonsignificant
increase in activity in four of the seven areas surveyed by investigators: number of blocks walked per
day, number of times the patients chose the stairs instead of the elevator, number of days exercising
at least 30 minutes, and how often they engaged in physical activity for fun.
Those who stayed with the pedometer program to the end of the study walked significantly more
blocks daily than did controls and tended to choose stairs rather than an elevator, exercise on more
days, be physically active for fun, walk rather than drive, and complete short trips from home on foot
more often than did controls.
Although this intervention won't help everybody, it is quick, inexpensive (simple pedometers typically
cost less than $20), and easy enough for physicians to fit into the brief time they have with their
patients, Dr. Stovitz said in the interview.
"Inertia [in physical habits] is a tough thing to change, but a good percentage of our patients would
find this useful and motivating, and I think it's a tool we should use," he said.