Tools for Practice

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

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

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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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)3,4 demonstrated 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

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  • Christina Korownyk MD CCFP
  • G. Michael Allan MD CCFP

1. Bravata DM, Smith Spangler C, Sundaram V, et al. JAMA. 2007; 298:2296-304.

2. Kang M, Marshall SJ, Barreira TV, et al. Res Q Exerc Sport. 2009; 80:648-55.

3. Baker G, Gray SR, Wright A, et al. Int J Behav Nutr Phys Act. 2008; 5:44.

4. Yates T, Davies M, Corely T, et al. Diabetes Care. 2009; 32:1404-10.

5. Leitzmann MF, Park Y, Blair A, et al. Arch Intern Med. 2007; 167:2453-60.

6. Blair SN, Kohl HW, Barlow CE, et al. JAMA. 1995; 273:1093-8.

7. Conn VS, Hafdahl AR, Brown SA, et al. Patient Educ Couns. 2008; 70:157-72.

8. Richardson CR, Newton TL, Abraham JL, et al. Ann Fam Med. 2008; 6:69-77.

9. Swinburn BA, Walter LG, Arroll B, et al. Am J Public Health. 1998; 88:288-91.

Authors do not have any conflicts of interest to declare.