Exercise as it relates to Disease/Using Pedometers to increase Physical activity and improve health

This analyses the journal article "Using Pedometers to Increase Physical Activity and Improve Health:A Systematic Review" by Brevata, D. et al. (2007)

What is the background to this research?
Approximately one in five adults around the world are physically inactive. The worldwide prevalence of physical activity is around 17.4% where developed countries have a 9.1% higher rate of physical inactivity than developing countries. Regular physical activity has been shown to not only reduce the chances of chronic diseases such as heart disease, type II diabetes and some cancers, but also enhances and preserves function with age. Regular walking and physical activity have been proven to reduce the risk of all cause mortality. Interventions involving pedometers have been proven to work and this is due to a number of factors. Pedometers are an affordable and easily accessible tool for measuring steps given over a certain period. Pedometers promote physical activity by motivating the user based on personal goals or tailored goals.

Where is the research from?
DM Bravata, C Smith-Spangler, V Sundaram, AL Gienger, N Lin, R Lewis, CD Stave, I Olkin, and JR Sirard published the research into the Journal of the American Medical Association. This research contained results from 26 different studies where 8 were randomised control studies and the other 18 were observational studies. Studies were focused on outpatients and their short term health outcomes.

What kind of research was this?
A study of 26 groups, which included 2767 outpatients were reviewed and cross analysed to give the results accurately and concisely. Randomised controls and observational studies were included. The studies that did not include a pedometer were excluded. The average intervention was implemented for 18 weeks.

What did the research involve?
This research involved the researcher collecting data from 26 different interventions where 8 were randomised control trials and 18 were observational studies. Criteria were set for the specific selection process such as: The mean age of participants was 49 and 85% of participants were female. Most participants were overweight and relatively inactive. Assessed outcomes in the interventions were steps taken, BMI and blood pressure being both diastolic ans systolic. A significant change in the number of steps taken between the intervention group and control group were observed where the mean difference in change was 2,491 steps. Overall increases in physical activity were seen at 26.9%, which was a major increase. Use of daily goals, having the intervention set up also outside of work and using a step diary were all shown to increase physical activity. Use of pedometer was also Shown to decrease BMI by an average of 0.38. Also a decrease in both diastolic and systolic blood pressure was seen at .3mmhg and 3.8 mmhg respevtively.
 * Intervention must have used a pedometer to assess steps taken
 * Studies required more than five participant
 * Interventions required to be implemented on adult outpatients.
 * Studies that reported a change in steps taken, blood pressure and BMI were also included

What were the basic results?
The results showed a positive correlation between using a pedometer to increase physical activity and increasing physical health. There was a significant difference between the control groups and the intervention groups in a much greater number of steps taken, an average decrease in BMI, and also a decrease in both diastolic and systolic blood pressures.

How did the researchers interpret the results?
The researchers compiled the information from all 26 studies and used meta-regression to combine the results in relation to physical activity and participant characteristics. Differences between the studies was assessed using a Q-statistic and an I-squared statistic. The results were based on steps taken, BMI, and also diastolic and systolic blood pressure all before and after the intervention was performed.

What conclusions should be taken away from this research?
Using a pedometer is an effective way of promoting physical activity. Motivation is a major effect in the use of pedometers where the user becomes aware that they are being monitored on how many steps are being taken therefore the user aims to improve this number. Using a pedometer is also an effective way to increase fitness and well being, with many health benefits coming from the use.

What are the implications of these results?
A major implication in this research is that short term effects of pedometer use were studied but long term effects were not studied at all. This study only focused on steps taken, BMI, and blood pressure. Other measurements could have been assessed such as skin folds being measured and body fat %. Motivation in participants over the 18 week period may have been lost during some studies. Due to the amount of different studies reviewed a greater range of people has been assessed therefore more accurate results in relation to population.