#5 Motivating Patients to Move: A Light at the End of the Couch?

CLINICAL QUESTION

QUESTION CLINIQUE

How do I motivate my patients to participate in regular physical activity?

BOTTOM LINE

RÉSULTAT FINAL

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

DONNÉES PROBANTES

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.

Another meta-analysis from 2009² and newer randomized controlled trials (RCT)^3,4demonstrated similar results, including sustained results for up to one year.⁴ Context:

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

Reviewed: July 13, 2016 by ricky