#5 Motivating Patients to Move: A Light at the End of the Couch?
CLINICAL QUESTION
How do I motivate my patients to participate in regular physical activity?
BOTTOM LINE
Pedometers, used with specific exercise goals, provide an inexpensive, tangible measure of a patient’s physical activity, and have been demonstrated to increase physical activity levels.
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EVIDENCE
2007 systematic review1 (26 studies, 2767 patients) assessed the use of pedometers to increase physical activity levels and improve health over a mean of 18 weeks:
- Pedometers significantly increased physical activity by ~2500 steps/day.
- Having a “step goal” (most commonly working up to 10,000 steps/day) predicted increased activity.
- Multiple studies show that increased activity is associated with reduced mortality. Two examples are:
- A prospective study5 (252,925 patients) found that regular moderate (e.g. brisk walking ≥30 minutes most days) was associated with a 27% relative decrease in mortality compared to no activity.
- In a prospective cohort6 (9777 men), the mortality rate of active men was a third of that of inactive men (40 vs. 122 deaths per 10,000 patient-years, respectively).
- In patients with chronic disease, the most successful interventions to increase physical activity are those that involve specific behavioural strategies and encourage self-monitoring.7
- Use of a pedometer fulfills both.
- Other benefits of pedometers include:
- Weight reduction of 1.3 kg in 16 weeks.8
- Reductions in systolic blood pressure of 3.8 mmHg over 18 weeks.1
- Improved blood glucose (BG) levels in patients with impaired glucose tolerance up to 12 months later (i.e. fasting BG reduced by 0.31 mmol/L, two-hour BG reduced by 1.3 mmol/L.4
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