title: Can older adults improve the identification of moderate intensity using walking cadence? Pedometer Step Count Targets during Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease. A Randomized Controlled Trial Cognitive Benefits of Social Dancing and Walking in Old Age: The Dancing Mind Randomized Controlled Trial Older Adults’ Experiences Using a Commercially Available Monitor to Self-Track Their Physical Activity A Primary Care Nurse-Delivered Walking Intervention in Older Adults: PACE (Pedometer Accelerometer Consultation Evaluation)-Lift Cluster Randomised Controlled Trial The feasibility of using pedometers and brief advice to increase activity in sedentary older women – a pilot study Efficacy of an accelerometer-guided physical activity intervention in community-dwelling older women. Promoting Activity in Geriatric Rehabilitation: A Randomized Controlled Trial of Accelerometry Healthy Steps Trial: Pedometer-Based Advice and Physical Activity for Low-Active Older Adults Increasing older adults’ walking through primary care: results of a pilot randomized controlled trial Effectiveness of a Pragmatic Education Program Designed to Promote Walking Activity in Individuals With Impaired Glucose Tolerance A 12-Week Physical and Cognitive Exercise Program Can Improve Cognitive Function and Neural Efficiency in Community-Dwelling Older Adults: A Randomized Controlled Trial. Effects of low-intensity exercise and home-based pulmonary rehabilitation with pedometer feedback on physical activity in elderly patients with chronic obstructive pulmonary disease. Effect of a Pedometer-Based Intervention on Daily Step Counts of Community-Dwelling Older Adults A home-based pedometer-driven walking program to increase physical activity in older adults with osteoarthritis of the knee: a preliminary study. Do pedometers increase physical activity in sedentary older women? A randomized controlled trial. Randomised controlled trial of a pedometer-based telephone intervention to increase physical activity among cardiac patients not attending cardiac rehabilitation. Efficacy of an Individually Tailored, Internet-Mediated Physical Activity Intervention in Older Adults: A Randomized Controlled Trial A telerehabilitation intervention for patients with Chronic Obstructive Pulmonary Disease: a randomized controlled pilot trial
abstract: Background The majority of older adults do not reach the physical activity guidelines . One possible explanation for this may be that older adults overestimate their physical activity levels , because they are unable to identify exercise intensity . Methods Forty-four older adults were recruited and r and omly assigned into two walking groups lasting 6 weeks . The intervention group was asked to walk a minimum of 150 min per week at moderate intensity using walking cadence indicated with a pedometer . The control group did not get any feedback on walking intensity . Results The ability to identify moderate intensity while walking did not significantly improve in neither groups ( p = 0.530 ) . However , participants in the intervention group increased significantly the time spent at moderate intensity , in 10 min bouts ( p < 0.01 ) . Discussion A pedometer providing walking cadence to reach moderate intensity is a good tool for increasing time walked at the recommended intensity , but not because participants know more what is considered moderate intensity Rationale : Increasing physical activity is a key therapeutic aim in chronic obstructive pulmonary disease ( COPD ) .  Pulmonary rehabilitation ( PR ) improves exercise capacity , but there is conflicting evidence regarding its ability to improve physical activity levels . Objectives : To determine whether using pedometers as an adjunct to PR can enhance time spent in at least moderate‐intensity physical activity ( time expending ≥3 metabolic equivalents [ METs ] ) by people with COPD . Methods : In this single‐blind r and omized controlled trial , participants were assigned 1:1 to receive a control intervention ( PR comprising 8 wk , two supervised sessions per week ) or the trial intervention ( PR plus pedometer‐directed step targets , review ed weekly for 8 wk ) . In the r and omization process , we used minimization to balance groups for age , sex , FEV1 percent predicted , and baseline exercise capacity and physical activity levels . Outcome assessors and PR therapists were blinded to group allocation . The primary analysis was based on the intention‐to‐treat principle . Measurements and Main Results : The primary outcome was change from baseline to 8 weeks in accelerometer‐measured daily time expending at least 3 METs . A total of 152 participants ( 72 % male ; mean [ SD ] FEV1 percent predicted , 50.5 % [ 21.2 ] ; median [ first quartile , third quartile ] time expending ≥3 METs , 46 [ 21 , 92 ] min ) were enrolled and assigned to the intervention ( n = 76 ) or control ( n = 76 ) arm . There was no significant difference in change in time expending at least 3 METs between the intervention and control groups at 8 weeks ( median [ first quartile , third quartile ] difference , 0.5 [ −1.0 , 31.0 ] min ; P = 0.87 ) or at the 6‐month follow‐up ( 7.0 [ −9 , 27 ] min ; P = 0.16 ) . Conclusions : Pedometer‐directed step‐count targets during an outpatient PR program did not enhance moderate‐intensity physical activity levels in people with COPD . Clinical trial registered with www . clinical trials.gov ( NCT01719822 ) Background A physically active lifestyle has the potential to prevent cognitive decline and dementia , yet the optimal type of physical activity/exercise remains unclear . Dance is of special interest as it complex sensorimotor rhythmic activity with additional cognitive , social , and affective dimensions . Objectives To determine whether dance benefits executive function more than walking , an activity that is simple and functional . Methods Two-arm r and omized controlled trial among community-dwelling older adults . The intervention group received 1 h of ballroom dancing twice weekly over 8 months ( ~69 sessions ) in local community dance studios . The control group received a combination of a home walking program with a pedometer and optional biweekly group-based walking in local community park to facilitate socialization . Main outcomes Executive function tests : processing speed and task shift by the Trail Making Tests , response inhibition by the Stroop Color-Word Test , working memory by the Digit Span Backwards test , immediate and delayed verbal recall by the Rey Auditory Verbal Learning Test , and visuospatial recall by the Brief Visuospatial Memory Test ( BVST ) . Results One hundred and fifteen adults ( mean 69.5 years , SD 6.4 ) completed baseline and delayed baseline ( 3 weeks apart ) before being r and omized to either dance ( n = 60 ) or walking ( n = 55 ) . Of those r and omized , 79 ( 68 % ) completed the follow-up measurements ( 32 weeks from baseline ) . In the dance group only , “ non-completers ” had significantly lower baseline scores on all executive function tests than those who completed the full program . Intention-to-treat analyses showed no group effect . In a r and om effects model including participants who completed all measurements , adjusted for baseline score and covariates ( age , education , estimated verbal intelligence , and community ) , a between-group effect in favor of dance was noted only for BVST total learning ( Cohen ’s D Effect size 0.29 , p = 0.07 ) and delayed recall ( Cohen ’s D Effect size = 0.34 , p = 0.06 ) . Conclusion The superior potential of dance over walking on executive functions of cognitively healthy and active older adults was not supported . Dance improved one of the cognitive domains ( spatial memory ) important for learning dance . Controlled trials targeting inactive older adults and of a higher dose may produce stronger effects , particularly for novice dancers . Trial registration Australian and New Zeal and Clinical Trials Register ( ACTRN12613000782730 ) Background Physical activity contributes to older adults ’ autonomy , mobility , and quality of life as they age , yet fewer than 1 in 5 engage in activities as recommended . Many older adults track their exercise using pencil and paper , or their memory . Commercially available physical activity monitors ( PAM ) have the potential to facilitate these tracking practice s and , in turn , physical activity . An assessment of older adults ’ long-term experiences with PAM is needed to underst and this potential . Objective To assess short and long-term experiences of adults > 70 years old using a PAM ( Fitbit One ) in terms of acceptance , ease-of-use , and usefulness : domains in the technology acceptance model . Methods This prospect i ve study included 95 community-dwelling older adults , all of whom received a PAM as part of r and omized controlled trial piloting a fall-reducing physical activity promotion intervention . Ten-item surveys were administered 10 weeks and 8 months after the study started . Survey ratings are described and analyzed over time , and compared by sex , education , and age . Results Participants were mostly women ( 71/95 , 75 % ) , 70 to 96 years old , and had some college education ( 68/95 , 72 % ) . Most participants ( 86/95 , 91 % ) agreed or strongly agreed that the  PAM  was easy to use , useful , and acceptable both 10 weeks and 8 months after enrolling in the study . Ratings dropped between these time points in all survey domains : ease-of-use ( median difference 0.66 points , P=.001 ) ; usefulness ( median difference 0.16 points , P=.193 ) ; and acceptance ( median difference 0.17 points , P=.032 ) . Differences in ratings by sex or educational attainment were not statistically significant at either time point . Most participants 80 + years of age ( 28/37 , 76 % ) agreed or strongly agreed with survey items at long-term follow-up , however their ratings were significantly lower than participants in younger age groups at both time points . Conclusions Study results indicate it is feasible for older adults ( 70 - 90 + years of age ) to use PAMs when self-tracking their physical activity , and provide a basis for developing recommendations to integrate PAMs into promotional efforts . Trial Registration Clinical trials.gov NCT02433249 ; https:// clinical trials.gov/ct2/show/NCT02433249 ( Archived by WebCite at http://www.webcitation.org/6gED6eh0I Background Brisk walking in older people can increase step-counts and moderate to vigorous intensity physical activity ( MVPA ) in ≥10-minute bouts , as advised in World Health Organization guidelines . Previous interventions have reported step-count increases , but not change in objective ly measured MVPA in older people . We assessed whether a primary care nurse-delivered complex intervention increased objective ly measured step-counts and MVPA . Methods and Findings A total of 988 60–75 year olds , able to increase walking and r and omly selected from three UK family practice s , were invited to participate in a parallel two-arm cluster r and omised trial ; r and omisation was by household . Two-hundred-ninety-eight people from 250 households were r and omised between 2011 and 2012 ; 150 individuals to the intervention group , 148 to the usual care control group .  Intervention participants received four primary care nurse physical activity ( PA ) consultations over 3 months , incorporating behaviour change techniques , pedometer step-count and accelerometer PA intensity feedback , and an individual PA diary and plan . Assessors were not blinded to group status , but statistical analyses were conducted blind . The primary outcome was change in accelerometry assessed average daily step-counts between baseline and 3 months , with change at 12 months a secondary outcome . Other secondary outcomes were change from baseline in time in MVPA weekly in ≥10-minute bouts , accelerometer counts , and counts/minute at 3 months and 12 months . Other outcomes were adverse events , anthropometric measures , mood , and pain . Qualitative evaluations of intervention participants and practice nurses assessed the intervention ’s acceptability . At 3 months , eight participants had withdrawn or were lost to follow-up , 280 ( 94 % ) individuals provided primary outcome data . At 3 months changes in both average daily step-counts and weekly MVPA in ≥10-minute bouts were significantly higher in the intervention than control group : by 1,037 ( 95 % CI 513–1,560 ) steps/day and 63 ( 95 % CI 40–87 ) minutes/week , respectively . At 12 months corresponding differences were 609 ( 95 % CI 104–1,115 ) steps/day and 40 ( 95 % CI 17–63 ) minutes/week . Counts and counts/minute showed similar effects to steps and MVPA . Adverse events , anthropometry , mood , and pain were similar in the two groups . Participants and practice nurses found the intervention acceptable and enjoyable . Conclusions The PACE-Lift trial increased both step-counts and objective ly measured  MVPA  in ≥10-minute bouts in 60–75 year olds at 3 and 12 months , with no effect on adverse events . To our knowledge , this is the first trial in this age group to demonstrate objective MVPA increases and highlights the value of individualised support incorporating objective PA assessment in a primary care setting . Trial Registration Controlled-Trials.com IS RCT Background People over the age of 70 carry the greatest burden of chronic disease , disability and health care use . Participation in physical activity is crucial for health , and walking accounts for much of the physical activity undertaken by sedentary individuals . Pedometers are a useful motivational tool to encourage increased walking and they are cheap and easy to use . The aim of this pilot study was to evaluate the feasibility of the use of pedometers plus a theory-based intervention to assist sedentary older women to accumulate increasing amounts of physical activity , mainly through walking . Methods Female participants over the age of 70 were recruited from primary care and r and omised to receive either pedometer plus a theory-based intervention or a theory-based intervention alone . The theory-based intervention consisted of motivational techniques , goal - setting , barrier identification and self-monitoring with pedometers and daily diaries . The pedometer group were further r and omised to one of three target groups : a 10 % , 15 % or 20 % monthly increase in step count to assess the achievability and acceptability of a range of targets . The primary outcome was change in daily activity levels measured by accelerometry . Secondary outcome measures were lower limb function , health related quality of life , anxiety and depression . Results 54 participants were recruited into the study , with an average age of 76 . There were 9 drop outs , 45 completing the study . All participants in the pedometer group found the pedometers easy to use and there was good compliance with diary keeping ( 96 % in the pedometer group and 83 % in the theory-based intervention alone group ) . There was a strong correlation ( 0.78 ) between accelerometry and pedometer step counts i.e. indicating that walking was the main physical activity amongst participants . There was a greater increase in activity ( accelerometry ) amongst those in the 20 % target pedometer group compared to the other groups , although not reaching statistical significance ( p = 0.192 ) . Conclusion We have demonstrated that it is feasible to use pedometers and provide theory-based advice to community dwelling sedentary older women to increase physical activity levels and a larger study is planned to investigate this further BACKGROUND Although many Japanese older adults spend more than an hour each day walking for exercise , the intensity is often lower than the minimum level associated with various health benefits . The purpose of this study was to evaluate the efficacy of a lifestyle physical activity intervention on improving quantity and quality of daily physical activity ( DPA ) as well as cardiorespiratory endurance in community-dwelling older women . METHODS 68 women ( 60 - 78 yr of age ) were r and omly assigned to either a lifestyle physical activity intervention group ( LIFE ) or control group . During the 12-wk intervention , feedback based on accelerometer DPA data ( number of daily steps ( STEPS ) and time spent performing daily moderate intensity physical activity ( MPA ) was provided to each participant in LIFE every two weeks . Cardiorespiratory endurance was evaluated using the 12-Minute Walk Test ( 12-MW ) . RESULTS Following the 12-wk intervention , significant group interactions were observed for STEPS , MPA , and cardiorespiratory endurance . LIFE increased STEPS by 16 % , MPA by 53 % , and the distance walked during the 12-MW by 10 % . CONCLUSIONS Promotion of DPA using accelerometers can significantly improve quantity and quality of daily physical activity as well as cardiorespiratory endurance in older women Background Low activity levels in inpatient rehabilitation are associated with adverse outcomes . The study aim ed to test whether activity levels can be increased by the provision of monitored activity data to patients and clinicians in the context of explicit goal setting . Methods A r and omized controlled trial in three sites in Australia included 255 in patients aged 60 and older who had a rehabilitation goal to become ambulant . The primary outcome was patients ’ walking time measured by  accelerometers  during the rehabilitation admission .  Walking times from accelerometry were made available daily to treating therapists and intervention participants to motivate patients to improve incidental activity levels and reach set goals . For the control group , ‘ usual care ’ was followed , including the setting of mobility goals ; however , for this group , neither staff nor patients received data on walking times to aid the setting of daily walking time targets . Results The median daily walking time in the intervention group increased from 10.3 minutes at baseline to 32.1 minutes at day 28 , compared with an increase from 9.5 to 26.5 minutes per day in the control group . Subjects in the intervention group had significantly higher non-therapy walking time by about 7 minutes [ mean ( 95 % CI ) : 24.6 ( 21.7 , 27.4 ) ] compared to those in the control group [ mean(95 % CI ) : 17.3 ( 14.4 , 20.3 ) ] ( p = 0.001 ) . Conclusions Daily feedback to patients and therapists using an accelerometer increased walking times during rehabilitation admissions . The results of this study suggest objective monitoring of activity levels could provide clinicians with information on clinical ly important , mobility-related activities to assist goal setting . Trial Registration Australian New Zeal and Clinical Trials Registry ACTRN12611000034932 PURPOSE We compared the effectiveness of 2 physical activity prescriptions delivered in primary care — the st and ard time-based Green Prescription and a pedometer step-based Green Prescription — on physical activity , body mass index ( BMI ) , blood pressure , and quality of life in low-active older adults . METHODS We undertook a r and omized controlled trial involving 330 low-active older adults ( aged = 65 years ) recruited through their primary care physicians ’ patient data bases . Participants were r and omized to either the pedometer step-based Green Prescription group ( n = 165 ) or the st and ard Green Prescription group ( n = 165 ) . Both groups had a visit with the primary care practitioner and 3 telephone counseling sessions over 12 weeks aim ed at increasing physical activity . Outcomes were the changes in physical activity ( assessed with the Auckl and Heart Study Physical Activity Question naire ) , blood pressure , BMI , quality of life ( assessed with the 36-Item Short Form Health Survey ) , physical function status ( assessed with the Short Physical Performance Battery ) , and falls over a 12-month period . RESULTS Of the patients invited to participate , 57 % responded . At 12 months , leisure walking increased by 49.6 min/wk for the pedometer Green Prescription compared with 28.1 min/wk for the st and ard Green Prescription ( P=.03 ) . For both groups , there were significant increases across all physical activity domains at 3 months ( end of intervention ) that were largely maintained after 12 months of follow-up . BMI did not change in either group . Significant improvements in blood pressure were observed for both groups without any differences between them . CONCLUSIONS Pedometer use result ed in a greater increase in leisure walking without any impact on overall activity level . All participants increased physical activity , and on average , their blood pressure decreased over 12 months , although the clinical relevance is unknown Background . Physical activity can positively influence health for older adults . Primary care is a good setting for physical activity promotion . Objective . To assess the feasibility of a pedometer-based walking programme in combination with physical activity consultations . Methods . Design : Two-arm ( intervention/control ) 12-week r and omized controlled trial with a 12-week follow-up for the intervention group . Setting : One general practice in Glasgow , UK . Participants : Participants were aged ≥65 years . The intervention group received two 30-minute physical activity consultations from a trained practice nurse , a pedometer and a walking programme . The control group continued as normal for 12 weeks and then received the intervention . Both groups were followed up at 12 and 24 weeks . Outcome measures : Step counts were measured by sealed pedometers and an activPALTM monitor . Psychosocial variables were assessed and focus groups conducted . Results . The response rate was 66 % ( 187/284 ) , and 90 % of those r and omized ( 37/41 ) completed the study . Qualitative data suggested that the pedometer and nurse were helpful to the intervention . Step counts ( activPAL ) showed a significant increase from baseline to week 12 for the intervention group , while the control group showed no change . Between weeks 12 and 24 , step counts were maintained in the intervention group , and increased for the control group after receiving the intervention . The intervention was associated with improved quality of life and reduced sedentary time . Conclusions . It is feasible to recruit and retain older adults from primary care and help them increase walking . A larger trial is necessary to confirm findings and consider cost-effectiveness OBJECTIVE To investigate whether a pragmatic structured education program with and without pedometer use is effective for promoting physical activity and improving glucose tolerance in those with impaired glucose tolerance ( IGT ) . RESEARCH DESIGN AND METHODS Overweight and obese individuals with IGT were recruited from ongoing screening studies at the University Hospitals of Leicester , U.K. Participants were r and omly assigned to one of three groups . Group 1 received a 3-h group-based structured education program design ed to promote walking activity using personalized steps-per-day goals and pedometers . Group 2 received a 3-h group-based structured education program design ed to promote walking activity using generic time-based goals . Group 3 received a brief information leaflet ( control condition ) . Outcomes included an oral glucose tolerance test , st and ard anthropometric measures , ambulatory activity , and psychological variables . Follow-up was conducted at 3 , 6 , and 12 months . RESULTS A total of 87 individuals ( 66 % male , mean age 65 years ) were included in this study . At 12 months , significant decreases in 2-h postchallenge glucose and fasting glucose of −1.31 mmol/l ( 95 % CI −2.20 to −0.43 ) and −0.32 mmol/l ( −0.59 to −0.03 ) , respectively , were seen in the pedometer group compared with the control group . No significant improvements in glucose control were seen in those given the st and ard education program . CONCLUSIONS This study suggests that a pragmatic structured education program that incorporates pedometer use is effective for improving glucose tolerance in those with IGT . This result is likely to have important implication s for future primary care – based diabetes prevention initiatives OBJECTIVES To investigate whether a 12-week physical and cognitive exercise program can improve cognitive function and brain activation efficiency in community-dwelling older adults . DESIGN R and omized controlled trial . SETTING Kyoto , Japan . PARTICIPANTS Community-dwelling older adults ( N = 48 ) were r and omized into an exercise group ( n = 24 ) and a  control group ( n = 24 ) . INTERVENTION Exercise group participants received a weekly dual task-based multimodal exercise class in combination with pedometer-based daily walking exercise during the 12-week intervention phase . Control group  participants did not receive any intervention and were instructed to spend their time as usual during the intervention phase . MEASUREMENTS The outcome measures were global cognitive function , memory function , executive function , and brain activation ( measured using functional magnetic resonance imaging ) associated with visual short-term memory . RESULTS Exercise group participants had significantly greater postintervention improvement in memory and executive functions than the control group ( P < .05 ) . In addition , after the intervention , less activation was found in several brain regions associated with visual short-term memory , including the prefrontal cortex , in the exercise group ( P < .001 , uncorrected ) . CONCLUSION A 12-week physical and cognitive exercise program can improve the efficiency of brain activation during cognitive tasks in older adults , which is associated with improvements in memory and executive function PURPOSE We evaluated the effects of low-intensity and home-based pulmonary rehabilitation ( PR ) on physical activity ( PA ) and the feedback provided by a pedometer in stable elderly patients with chronic obstructive pulmonary disease ( COPD ) . METHODS We assessed PA using a newly developed triaxial accelerometer ( A-MES ™ , Kumamoto , Japan ) , which measures the time spent walking , st and ing , sitting and lying down .  Twenty-seven elderly patients with COPD ( age 74 ± 8 yrs ; % FEV1 56.6 ± 18.7 % ) participated . They were r and omly selected to undergo PR ( pulmonary rehabilitation only ) or PR + P ( PR plus the feedback from using a pedometer ) . Their PA and pulmonary function , exercise capacity ( 6-min walking distance ; 6MWD ) , quadriceps femoris muscle force ( QF ) were evaluated before the PR began ( baseline ) and at 1 year later . We compared the patients ' changes in PA and other factors between the baseline values and those obtained 1 year later and analyzed the relationships between the changes in PA and other factors in the both groups . RESULTS The increase in the time spent walking in the PR + P group ( 51.3 ± 63.7 min/day ) was significantly greater than that of PR group ( 12.3 ± 25.5 min/day ) after the PR . The improvement rate of daily walking time after PR was significantly correlated with that of the 6MWD and QF in all subjects . CONCLUSIONS These data suggest that low-intensity and home-based PR with the feedback from using pedometer was effective in improving PA , and the improvements of physiological factors were correlated with increased walking time in stable elderly patients with COPD This study investigated the effect of a 12-week pedometer-based intervention on daily step counts of 147 older adults r and omly assigned to an intervention or wait-list control group ( M age = 72.9 years , SD = 8.8 ) . The intervention group significantly increased their daily step counts after 12 weeks ( M = 639 , SD = 2,239 ) and continued to significantly increase during a 12-week maintenance period ( M = 680 , SD = 1,721 ) . The control group exhibited no change during the control period ( M = -393 , SD = 2,050 ) but had a significant increase in daily step counts ( M = 1,580 , SD = 2,305 ) when enrolled in the intervention . The pedometer-based intervention was effective in increasing participants ' daily step counts OBJECTIVES To determine whether a home-based pedometer-driven walking program with arthritis self-management education ( Walk + ) would increase physical activity , muscle strength , and functional performance in older adults with osteoarthritis ( OA ) of the knee as opposed to arthritis self-management education alone ( EDU ) . DESIGN A r and omized two-by-three ( group-by-time ) design with participants assigned to  Walk + ( n = 17 , mean age + /- st and ard deviation = 69.6 + /- 6.7 ) or EDU ( n = 17 , age = 70.8 + /- 4.7 ) . SETTING Community located in the Baltimore-Washington area . PARTICIPANTS Thirty-four community-dwelling adults , aged 60 and older with symptomatic knee OA and self-reported functional impairment . INTERVENTIONS Both groups received 12 hours of the Arthritis Self-Management program over 12 weeks and were followed for an additional 12 weeks . In addition , the Walk + group received individualized instruction in the use of a pedometer , with the goal of increasing their step count by 30 % of their baseline step count . MEASUREMENTS The outcome measures were physical activity ( daily step counts and total activity vector magnitude as measured by a pedometer and Tritrac-R3D accelerometer ) , quadriceps femoris strength ( isometric peak torque ) , and functional performance tasks ( 100-foot walk-turn-walk , timed stair climb , timed chair rise , and pain status ) . RESULTS Daily steps walked showed a significant group-by-time interaction ( P = .04 ) after controlling for age . From baseline to completion of training , a 23 % increase in daily steps occurred in the Walk + group and a 15 % decrease in the EDU group . Although steps increased in the Walk + group , total activity vector magnitude was maintained , suggesting a more efficient gait . The Walk + group became quicker than the EDU group in the normal-pace walk-turn-walk ( P = .04 ) . An isometric strength gain of 21 % postintervention was seen in the Walk + group , compared with a loss of 3.5 % in the EDU group . CONCLUSION In older adults with symptomatic knee OA , Walk + appears to increase walking , with improvements in muscle strength and walking performance . The use of a home-based pedometer-driven program to increase physical activity , strength , and function in this population warrants further research OBJECTIVES To determine the effectiveness of a behavior change intervention ( BCI ) with or without a pedometer in increasing physical activity in sedentary older women . DESIGN Prospect i ve r and omized controlled trial . SETTING Primary care , City of Dundee , Scotl and . PARTICIPANTS Two hundred four sedentary women aged 70 and older . INTERVENTIONS Six months of BCI , BCI plus pedometer ( pedometer plus ) , or usual care . MEASUREMENTS PRIMARY OUTCOME change in daily activity counts measured by accelerometry . SECONDARY OUTCOMES Short Physical Performance Battery , health-related quality of life , depression and anxiety , falls , and National Health Service re source use . RESULTS One hundred seventy-nine of 204 ( 88 % ) women completed the 6-month trial .  Withdrawals were highest from the BCI group ( 15/68 ) followed by the pedometer plus group ( 8/68 ) and then the control group ( 2/64 ) . After adjustment for baseline differences , accelerometry counts increased significantly more in the BCI group at 3 months than in the control group ( P = .002 ) and the pedometer plus group ( P = .04 ) . By 6 months , accelerometry counts in both intervention groups had fallen to levels that were no longer statistically significantly different from baseline . There were no significant changes in the secondary outcomes . CONCLUSION The BCI was effective in objective ly increasing physical activity in sedentary older women . Provision of a pedometer yielded no additional benefit in physical activity , but may have motivated participants to remain in the trial OBJECTIVE To determine the effectiveness of a pedometer-based telephone intervention on the physical activity levels of cardiac patients who did not attend a CRP . METHODS A r and omised controlled trial was conducted with 215 patients referred to a CRP but who could not or chose not to attend . The 6-week intervention included self-monitoring of physical activity using a pedometer and step calendar ; and behavioural counselling and goal setting sessions . Data were collected at baseline , 6 weeks and 6 months . RESULTS Study groups did not differ significantly at baseline . After 6 weeks , improvements in total physical activity time ( p=0.027 ) , total physical activity sessions ( p=0.003 ) , walking time ( p=0.013 ) and walking sessions ( p=0.002 ) in the intervention group were significantly greater than the control group after adjusting for baseline differences , and remained significant at 6 months . CONCLUSION The findings that the pedometer-based telephone intervention was successful in increasing physical activity levels in cardiac patients who did not attend a CRP could result in major health benefits for this group of people . PRACTICAL IMPLICATION S The pedometer-based telephone intervention could be offered as an effective and accessible option for patients not attending a CRP to increase and maintain their physical activity levels after hospitalisation Objective : This study determined the effectiveness of an individually tailored , Internet-mediated physical activity ( PA ) intervention for increasing walking behavior in inactive older adults . Method : This 12-week r and omly controlled intervention divided participants ( N = 170 ) into three groups :  control ( CON , n = 51 ) ,  pedometer only ( PED , n = 62 ) , and an individually tailored , Internet-mediated pedometer ( TI-PED , n = 57 ) group . The PED group was instructed to increase weekly step count by 10 % until 10,000 steps per day was achieved . The TI-PED group was given the same goal and received tailored feedback via an online platform . Changes in average step count pre-to-post were assessed . Results : Total retention rate at postintervention was 75.3 % . PED ( p < .001 ) and TI-PED ( p < .001 ) increased step count pre-to-post , which was higher than the CON group at 12 weeks ( PED , p < .001 ; TI-PED , p < .001 ) . The TI-PED group had a higher step count at 12 weeks than the PED group ( p < .001 ) . Discussion : Individually tailored , Internet-mediated PA interventions are an effective way to significantly increase PA in older adults Objective : First , to investigate the effects of a telerehabilitation intervention on health status and activity level of patients with Chronic Obstructive Pulmonary Disease ( COPD ) , compared to usual care . Second , to investigate how patients comply with the intervention and whether compliance is related to treatment outcomes . Design : a r and omized controlled pilot trial Subjects : Thirty-four patients diagnosed with COPD . Intervention : The telerehabilitation application consists of an activity coach ( 3D-accelerometer with smartphone ) for ambulant activity registration and real-time feedback , complemented by a web portal with a symptom diary for self-treatment of exacerbations . The intervention group used the application for 4 weeks . The control group received usual care . Main measures : Activity level measured by a pedometer ( in steps/day ) , health status by the Clinical COPD Question naire at baseline and after intervention . Compliance was expressed as the time the activity coach was worn . Results : Fourteen intervention and 16 control patients completed the study .  Activity level ( steps/day ) was not significantly affected by the intervention over time . There was a non-significant difference in improvement in health status between the intervention ( −0.34±0.55 ) and control group ( 0.02±0.57 , p=0.10 ) . Health status significantly improved within the intervention group ( p=0.05 ) . The activity coach was used more than prescribed ( 108 % ) and compliance was related to the increase in activity level for the first two feedback weeks ( r=0.62 , p=0.03 ) . Conclusions : This pilot study shows the potential of the telerehabilitation intervention : compliance with the activity coach was high , which directly related to an improvement in activity levels
target: No impact of patient and intervention characteristics on the effect estimates were found .
  Short conclusion Low quality of evidence was found for a moderate effect of physical activity monitor-based interventions on physical activity compared with control interventions .
background: Background The body of evidence related to the effect of physical activity monitor-based interventions has grown over the recent years .
  However , the effect of physical activity monitor-based interventions in older adults remains unclear and should be systematic ally review ed .
  Objective The objective of this systematic review was to estimate the effect of physical activity monitor-based interventions on physical activity behavior  in participants aged 65 and above .
  Subsequently we explored the effect on body mass index , physical capacity , and health-related quality of life and finally the impact of patient- and intervention characteristics .