title: The 'Walking for Wellbeing in the West' randomised controlled trial of a pedometer-based walking programme in combination with physical activity consultation with 12 month follow-up: rationale and study design Effects of a 12-month physical activity counselling intervention on glycaemic control and on the status of cardiovascular risk factors in people with Type 2 diabetes A community-based walking trial to improve neighborhood quality of life in older adults: a multilevel analysis Prevalence of Physical Activity in the United States: Behavioral Risk Factor Surveillance System, 2001 Pedometer indices for weekly physical activity recommendations in postmenopausal women. Controlled outcome evaluation of the First Step Program: a daily physical activity intervention for individuals with type II diabetes A randomised controlled trial of senior Lay Health Mentoring in older people with ischaemic heart disease: The Braveheart Project. Accumulating brisk walking for fitness, cardiovascular risk, and psychological health. Increasing physical activity in people with type 2 diabetes. The effect of pedometer use in combination with cognitive and behavioral support materials to promote physical activity. The effect of moderate exercise on mood in mildly hypertensive volunteers: a randomized controlled trial. Promoting walking with pedometers in the community: the step-by-step trial. A home-based pedometer-driven walking program to increase physical activity in older adults with osteoarthritis of the knee: a preliminary study. Pedometer-determined step count guidelines for classifying walking intensity in a young ostensibly healthy population. Increasing daily walking improves glucose tolerance in overweight women. The effectiveness of physical activity counseling in a work-site setting. A randomized, controlled trial. Walking towards health in a university community: a feasibility study. Pedometers as a means to increase ambulatory activity for patients seen at a family medicine clinic. Walking in (Affective) Circles: Can Short Walks Enhance Affect? Physical activity patterns among walkers and compliance with public health recommendations. An intervention to promote walking in sedentary women in the community. Promoting physical activity in a socially and economically deprived community: a 12 month randomized control trial of fitness assessment and exercise consultation Randomised controlled trial of home-based walking programmes at and below current recommended levels of exercise in sedentary adults Daily exercise lowers blood pressure and reduces visceral adipose tissue areas in overweight Japanese men. Long-term effects of varying intensities and formats of physical activity on participation rates, fitness, and lipoproteins in men and women aged 50 to 65 years. Health benefits of a pedometer-based physical activity intervention in sedentary workers.
abstract: Background Scotl and has a policy aim ed at increasing physical activity levels in the population , but evidence on how to achieve this is still developing . Studies that focus on encouraging real world participants to start physical activity in their setting s are needed . The Walking for Well-being in the West study was design ed to assess the effectiveness of a pedometer-based walking programme in combination with physical activity consultation . The study was multi-disciplinary and based in the community . Walking for Well-being in the West investigated whether Scottish men and women , who were not achieving the current physical activity recommendation , increased and maintained walking behaviour over a 12 month period . This paper outlines the rationale and design of this innovative and pragmatic study . Methods Participants were r and omised into two groups : Group 1 : Intervention ( pedometer-based walking programme combined with a series of physical activity consultations ) ; Group 2 : Waiting list control for 12 weeks ( followed by minimal pedometer-based intervention ) . Physical activity ( primary outcome ) was measured using  pedometer step counts ( 7 day ) and the International Physical Activity Question naire ( long version ) . Psychological processes were measured using question naires relating to the Transtheoretical Model of Behaviour Change , mood ( Positive and Negative Affect Schedule ) and quality of life ( Euroqol EQ-5D instrument ) . Physiological measures included anthropometric and metabolic outcomes . Environmental influences were assessed subjectively ( Neighbourhood Quality of Life Survey ) and objective ly ( neighbourhood audit tool and GIS mapping ) . The qualitative evaluation employed observation , semi-structured interviews and focus groups . A supplementary study undertook an economic evaluation . Discussion Data analysis is on-going . Walking for Well-being in the West will demonstrate if a pedometer based walking programme , in combination with physical activity consultation results in a sustainable increase in walking behaviour in this sample of Scottish adults over a 12 month period . The study will examine the complex relationships between behavioural change , health consequences and the role of the environment , in conjunction with the cost effectiveness of this approach and a detailed insight into the participants ' experiences of the intervention . Trial registration Current Controlled Trials IS RCT Aims /hypothesisThe aim of this study was to investigate the effectiveness of physical activity counselling in promoting physical activity in people with Type 2 diabetes and to evaluate result ant physiological and biochemical effects . Methods A total of 70 inactive people with Type 2 diabetes were given st and ard exercise information and r and omised to receive physical activity counselling ( n=35 , experimental ) or not ( n=35 , control ) . Physical activity consultations were delivered at baseline and after 6 months , with follow-up phone calls after 1 , 3 , 6 and 9 months . Changes from baseline after 6 and 12 months were assessed for physical activity ( 7-day recall and accelerometer ) , for physiological characteristics ( body mass index and blood pressure ) and for biochemical variables ( HbA1c , lipid profile , fibrinogen , tissue plasminogen activator and microalbuminuria ) . Results Significant differences between groups were recorded for physical activity after 6 and 12 months ( p<0.01 ) . The experimental group had increased levels of physical activity from baseline to 6 months ( p<0.01 ) , with no decrease from 6 to 12 months ( p>0.05 ) . In the control group , accelerometer counts per week decreased from baseline to 12 months ( p=0.03 ) . Between-group differences ( p<0.05 ) were recorded for the change in HbA1c ( experimental : 0.26 % decrease ; control : 0.15 % increase ) , for systolic blood pressure ( experimental : 7.7 mm Hg decrease ; control : 5.6 mm Hg increase ) and for fibrinogen ( experimental : 0.28 mmol/l decrease ; control : 1.43 mmol/l increase ) from baseline to 6 months , and for total cholesterol ( experimental : 0.33 mmol/l decrease ; control : 0.04 mmol/l increase ) from baseline to 12 months ( p<0.05 ) . No significant differences were recorded in other measured variables . Conclusions /interpretationsPhysical activity counselling was effective in promoting physical activity in people with Type 2 diabetes . The counselling improved glycaemic control as well as the status of cardiovascular risk factors in these patients Background : Few studies have considered the neighborhood as a context in which to examine the physical activity and quality of life relationship . Purpose : The goal of this study was to evaluate the effects of a neighborhood walking program on  quality of life among older adults . It was design ed as a r and omized trial involving a multilevel design with neighborhoods corresponding to primary sampling units and residents to secondary units . Methods : Five hundred eighty-two communitydwelling senior residents ( 65 years of age or older ) in neighborhoods in the northeast metropolitan area of Portl and , Oregon , were recruited through telephone , direct mail , and referrals . The walking intervention was delivered at the neighborhood level . Neighborhoods ( N = 56 ) were r and omly assigned to a 6-month , 3 times per week , leader-led walking group activity ( n = 28 ) or an information-only control group ( n = 28 ) . Primary outcome measures included SF-12 ( Physical , Mental summary scores ) and life satisfaction ( SWLS ) ; the secondary outcome measure was neighborhood walking activity , assessed at baseline , 3 months , and 6 months of the study period . Results : Compared to the control neighborhoods , results from multilevel , longitudinal analyses indicated significant improvements in the primary outcomes of SF-12 Physical ( p < .05 ) , SF-12 Mental ( p < .05 ) summary scores , and SWLS ( p < .05 ) , over the course of the 6-month intervention . A significant increase was also observed in the secondary outcome of walking activity ( p < .05 ) . Conclusions : Implementing a neighborhood-based walking program of low to moderate intensity is feasible and beneficial for promoting quality of life among senior residents at a community level Introduction The health benefits of regular cardiovascular exercise are well-known . Such exercise , however , has traditionally been defined as vigorous physical activity , such as jogging , swimming , or aerobic dance . Exercise of moderate intensity also promotes health , and many U.S. adults may be experiencing the health benefits of exercise through lifestyle activities of moderate intensity , such as yard work , housework , or walking for transportation . Until recently , public health surveillance systems have not included assessment s of this type of physical activity , focusing on exercise of vigorous intensity . We used an enhanced surveillance tool to describe the prevalence and amount of both moderate-intensity and vigorous-intensity physical activity among U.S. adults . Methods We analyzed data from the 2001 Behavioral Risk Factor Surveillance System , a state-based , r and om-digit  – dialed telephone survey administered to U.S. adults aged 18 years and older ( n = 82,834 men and 120,286 women ) .  Physical activity behavior was assessed using questions design ed to quantify the frequency of participation in moderate- or vigorous-intensity physical activities performed during leisure time or for household chores and transportation . Results Overall , 45 % of adults ( 48 % of men and 43 % of women ) were active at recommended levels during nonworking hours ( at least 30 minutes five or more days per week in moderate-intensity activities , equivalent to brisk walking , or at least 20 minutes three or more days per week in vigorous activities , equivalent to running , heavy yard work , or aerobic dance ) . Less than 16 % of adults ( 15 % of men and 17 % of women ) reported no moderate or vigorous activity in a usual week . Conclusion Integrating surveillance of lifestyle activities into national systems is possible , and doing so may provide a more accurate representation of the prevalence of recommended levels of physical activity . These results , however , suggest that the majority of U.S. adults are not active at levels associated with the promotion and maintenance of health PURPOSE The aim of this study was to quantify pedometer-determined steps per day associated with 50 , 100 , and 150 % of the current public health recommendation for weekly physical activity in sedentary postmenopausal women . METHODS A sample of 111 women from the DREW ( Dose Response to Exercise in Women ) study provided data . We r and omly assigned women into one of three exercise groups expending 4 , 8 , or 12 kcal(-1).kg(-1).wk(-1 ) ( KKW ) . Participants exercised alternately on a treadmill and recumbent cycle ergometer for a 6-month training period . Only treadmill sessions done with zero grade , at slow to moderate speeds ( 48 - 97 m.min(-1 ) ) were used in this analysis . We controlled intensity at a HR equivalent to 50 % of VO(2peak ) . Participants wore pedometers at baseline and throughout the study to assess their free-living physical activity ( steps.d(-1 ) ) RESULTS Baseline averages were < 5400 steps.d(-1 ) for the 4- , 8- , and 12-KKW groups . During 6 months of exercise training , free-living step counts remained < 5400 steps.d(-1 ) and did not significantly differ from baseline for each group . Average speeds and distances per exercise session were 2.7 + /- 0.4 mph , 1.2 + /- 0.2 miles ( 4 KKW ) , 2.6 + /- 0.4 mph , 2.2 + /- 0.4 miles ( 8 KKW ) , and 2.8 + /- 0.3 mph , 2.7 + /- 0.4 miles ( 12 KKW ) . This yielded 2771 ( 4 KKW ) , 5457 ( 8 KKW ) , and 6534 ( 12 KKW ) steps per exercise session 3 - 4 d.wk(-1 ) . CONCLUSIONS Initially sedentary postmenopausal women can meet 50 % ( 4 KKW ) , 100 % ( 8 KKW ) , and 150 % ( 12 KKW ) of the current public health recommendation of weekly physical activity through planned moderate-intensity walking , accumulating an average of about 2800 ( 50 % ) , 5500 ( 100 % ) , and 6500 steps.d(-1 ) ( 150 % ) 3 - 4 d.wk(-1 ) OBJECTIVE : To conduct a r and omised trial of a physical activity ( PA ) intervention , The First Step Program ( FSP ) for adults with type II diabetes . DESIGN : A 16-week intervention study and 24-week follow-up assessment . PARTICIPANTS : A total of 47 overweight/obese , sedentary individuals ( age=52.7±5.2 y ; BMI = 33.3±5.6 kg/m2 ) recruited through a diabetes education centre . MEASUREMENTS : Primary outcome :  daily PA assessed by pedometer ( steps/day ) . Secondary outcomes : anthropometric measures ( weight , BMI , waist girth , hip girth ) ; indicators of cardiovascular health ( resting heart rate and blood pressure ) ; glycemic control ( fasting glucose , insulin , HbA1c , glucose concentration 120 min postglucose load ) ; plasma lipid status ( total cholesterol , HDL cholesterol , LDL cholesterol , and triglycerides ) . RESULTS : Relative to the CONTROL group , FSP participants increased  their PA > 3000 steps/day ( approximately 30 min/day ) during the intervention ( P<0.0001 ) . Waist and hip girth decreased ( approximately 2–3 cm ) , but did not differ significantly between groups . Significant changes did not emerge for any of the other variables . CONCLUSIONS : The FSP is a practical intervention that elicits an immediate and profound change in walking behaviour . Such change is an important ‘ first step ’ towards increasing the volume and /or intensity of PA necessary to improve long-term health outcomes in this largely sedentary and overweight or obese population . Relapse by 24 weeks indicates that other strategies such as booster sessions are needed to maintain lifestyle change . Further research must determine realistic and responsive health outcomes for this population that are achievable through practical , real-world programming OBJECTIVE to examine the effects and feasibility of educating and empowering older people with ischaemic heart disease using trained senior lay health mentors . DESIGN r and omised controlled trial with blinded evaluation . SETTING Falkirk and District Royal Infirmary . PARTICIPANTS in patients and out patients aged 60 or over attending secondary care with a diagnosis of angina or acute myocardial infa rct ion . Three-hundred and nineteen entered and 289 completed exit assessment s. The intervention group took part in mentoring groups for 1 year , meeting monthly for 2 hours , each led by two trained lay health mentors in addition to st and ard care . MAIN OUTCOME MEASURES primary outcome measures were changes in coronary risk factors , medication usage and actual use of secondary care health services . Secondary outcomes were total and cardiovascular events ; changes in medication compliance , non-medical support requirement , health status and psychological functioning , and social inclusion . RESULTS there were significant improvements in a reported current exercise score ( mean + 0.33 , + 0.02 to + 0.52 ) , in the average time spent walking per week by 72 minutes ( + 1 to + 137 minutes ) , and in the SF36 Physical Functioning Score ( + 6.1 , + 2.4 to + 9.5 ) . There was a 1.0 % reduction in total fat ( 95 % CI -3.0 % to -0.6 % ) and a 0.6 % reduction in saturated fat ( 95 % CI -1.5 % to -0.03 % ) . The intervention group showed reduced outpatient attendance for coronary heart disease ( -0.25 appointments , -0.61 to -0.08 ) . Attendance rates were high . Socio-economic grouping did not affect participation . CONCLUSIONS Lay Health Mentoring is feasible , practical and inclusive , positively influencing diet , physical activity , and health re source utilisation in older subjects with ischaemic heart disease without causing harm PURPOSE To compare the effects of different patterns of regular brisk walking on fitness , risk factors for cardiovascular disease , and psychological well-being in previously sedentary adults . METHODS Twenty-one subjects ( 14 women ) , aged 44.5 + /- 6.1 yr ( mean + /- SD ) were r and omly assigned to two different , 6-wk programs of brisk walking in a cross-over design , with an interval of 2 wk . One program comprised one 30-min walk per day , 5 d.wk(-1 ) ( long bout ) and the other three 10-min walks per day , also 5 d.wk(-1 ) ( short bouts ) . All walking was at 70 - 80 % of predicted maximal heart rate . Maximal oxygen uptake ( (.)VO(2max ) ) , body composition , resting arterial blood pressure , fasting plasma lipoprotein variables , and psychological parameters were assessed before and after each program . RESULTS Overall , subjects completed 88.2 + /- 1.1 % and 91.3 + /- 4.1 % of prescribed total walking time in the short- and long-bout programs , respectively . Both programs increased plasma concentrations of high-density lipoprotein cholesterol , and decreased concentrations of triacylglycerol and total cholesterol ( all < 0.05 ) . There were no changes in body mass , but the sum of four skinfolds , waist circumference , and hip circumference were decreased after both walking programs ( all P<0.05 ) . Predicted (.)VO(2max ) increased with both programs ( P<0.05 ) , but this increase was greater with the program based on short bouts ( P<0.05 ) . Both walking patterns result ed in similar decreases in tension/anxiety ( P<0.05 ) . CONCLUSION These findings suggest that three short bouts ( 10 min ) of brisk walking accumulated throughout the day are at least as effective as one continuous bout of equal total duration in reducing cardiovascular risk and improving aspects of mood in previously sedentary individuals OBJECTIVE To evaluate effect of exercise consultation on physical activity and result ant physiological and biochemical variables at 6 months in people with type 2 diabetes . RESEARCH DESIGN AND METHODS A total of 70 inactive people with type 2 diabetes were given st and ard exercise information and were r and omized to receive an exercise consultation ( n = 35 ) or not ( n = 35 ) . Exercise consultation , based on the transtheoretical model , combines motivational theory and cognitive behavioral strategies into an individualized intervention to promote physical activity . Changes from baseline to 6 months were assessed in 1 ) physical activity ( 7-day recall , accelerometer , cardiorespiratory fitness , stage , and processes of change ) , 2 ) physiological variables ( blood pressure and BMI ) , and 3 ) biochemical variables ( HbA(1c ) , lipid profile , and fibrinogen ) . RESULTS Between-group differences were recorded for the change in minutes of moderate activity ( P < 0.001 ) and activity counts ( P < 0.001 ) per week . Experimental participants recorded an increase in activity counts per week and minutes of moderate activity per week ( P < 0.001 ) . The control group recorded no significant changes . More experimental participants increased stage of change ( chi(2 ) = 22.6 , P < 0.001 ) . Between-group differences were recorded for the change in total exercise duration and peak gradient ( P < 0.005 ) , HbA(1c ) ( P = 0.02 ) , systolic BP ( P = 0.02 ) , and fibrinogen ( P = 0.03 ) . CONCLUSIONS Exercise consultation increased physical activity and improved glycemic control and cardiovascular risk factors in people with type 2 diabetes OBJECTIVE 1 . To demonstrate that combining pedometer use with cognitive and behavioral support material s has a positive effect on  physical activity ( PA ) and attitudes towards pedometer  use . 2 . To investigate how familiar the study sample is with pedometers and the ' 10,000 steps/day ' recommendation . METHODS From a r and om sample , drawn from the phone book , 304 volunteered ( 18 - 75 year ) to complete a question naire about familiarity with pedometers and the ' 10,000 steps/day ' recommendation . A sample of 103 participants agreed to wear a pedometer  for 3 weeks , and was r and omly assigned to a condition with cognitive and behavioral support material s ( n=51 ) or without these material s ( n=52 ) . Participants completed the  International Physical Activity Question  naire before and after 21 days of pedometer use and an additional question naire on the attitudes towards pedometer use . RESULTS More than 58 % had never heard of a pedometer . In both conditions , walking ( F=10 , p=0.002 ) , moderate PA ( F=11 , p=0.001 ) , and vigorous PA ( F=14 , p<0.001 ) increased over time , however no interaction effects could be found . Significantly more participants in the condition with support material s had a positive attitude towards pedometer use . CONCLUSION Wearing a pedometer , with or without support material s , may increase PA . In our study , cognitive and behavioral support material s only affected attitudes towards pedometer use . PRACTICE IMPLICATION S More research is needed to investigate the effect of combining pedometer use with support material s on a longer time base and in less motivated people This study reports an investigation of the effect of participating in moderate exercise ( three 40-min sessions of brisk walking a week for 6 months ) on mood state in 177 sedentary , mildly hypertensive volunteers .  Mood was assessed by the Profile of Mood States , Bipolar Form ( POMS-BI ) , and no significant differences were found between control and exercise groups . The intervention group increased its  exercise output more than the control group , but there was also a significant increase in  exercise  done by the control group . We conclude that exercise has no major effect on mood in hypertensive volunteers BACKGROUND Pedometers have been identified as a potential motivational aid for increasing physical activity , but their efficacy has not been demonstrated in a community-based , non clinical sample . DESIGN A r and omized controlled trial was conducted from August to December 2005 . Analysis was completed in June 2006 . SETTING / PARTICIPANTS Inactive adults aged 30 - 65 years ( n=369 ) recruited from the community . INTERVENTION Comparison of a theoretically based self-help walking program ( WP ) and weekly diaries ( sent by mail ) ; the same walking program with a pedometer ( WPP ) ( also by mail ) ; and a no-treatment control group ( C ) . MEASURES Change in self-reported leisure time in any sports/recreation in the last 3 months , and all- purpose walking ( APW ) for exercise , recreation , and travel , and other moderate , vigorous physical activity in the last week . Proportions meeting physical activity recommendations ( equal to or greater than 150 minutes and equal to or greater than five sessions/week(-1 ) ) were determined . RESULTS A 3-month follow-up interview was conducted with 314 ( 85 % ) participants . Intention-to-treat analyses indicated significance within-group increases of APW and leisure-time walking ( LTW ) , but mean and median sessions and minutes changes were greatest in the WPP group . There were no significant between-group differences in regular LTW ( walked equal to or greater than 5 sessions/week(-1 ) for at least 30 minutes/session ) , but the WPP group increased significantly participation in other sports/recreations and was more likely than the control group to meet physical activity recommendations by all leisure-time physical activity ( adjusted odds ratio=2.40 , 95 % CI=1.17 - 4.93 ) , by APW ( adjusted odds ratio=1.75 95 % CI=0.92 - 3.34 ) and all physical activity ( adjusted odds ratio=1.59 95 % CI=0.92 - 2.79 ) in the last week . CONCLUSIONS Pedometers enhanced the effects of the self-help walking program . This low-cost intervention should be tested for sustainability 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 PURPOSE ( a ) To establish pedometer steps/min intensity categories ( i.e. , light , moderate , hard , very hard ) for adults under controlled conditions , and ( b ) use these cut-points to ascertain the number of steps expected in 30 minutes of moderate intensity activity . METHODS 25 men and 25 women , ages 18 - 39 years , performed 6-min exercise bouts at 3 treadmill speeds ( 4.8 , 6.4 , and  9.7 km/hr ) . Yamax SW-200 pedometers indicated steps  , and steady-state VO2 was recorded . METs were calculated by dividing steady-state VO2 by 3.5 ml x kg(-1 ) x min(-1 ) . Linear regression was used to quantify the relationships between steps/min and METs across all speeds . Ten participants ( 5 M , 5 F ) were r and omly selected from the original 50 and constituted a holdout sample for cross-validation purpose s ( i.e , comparing actual and predicted METs ; paired t-test ) . RESULTS The regression equation for males was : METs = -7.065 + ( 0.105 x steps/min ) r2 = 0.803 . For females it was : METs = -8.805 + ( 0.110 x steps/min ) r2 = 0.830 . Cross-validation was confirmed . CONCLUSIONS Pedometer cut-points corresponding to minimal moderate intensity walking were 96 steps/min in men and 107 steps/min in women , or roughly 100 steps/min for both . This translates to approximately 3,000 steps in 30 min of moderate-intensity ambulatory activity for both genders BACKGROUND Physical activity ( PA ) has been shown to benefit glucose tolerance . Walking is a convenient low-impact mode of PA and is reported to be the most commonly performed activity for those with diabetes . The purpose of this study was to determine whether a recommendation to accumulate 10,000 steps/day for 8 weeks was effective at improving glucose tolerance in overweight , inactive women . METHODS Eighteen women ( 53.3 + /- 7.0 years old , 35.0 + /- 5.1 kg/m(2 ) ) with a family history of type 2 diabetes completed a 4-week control period followed by an 8-week walking program with no changes in diet . The walking program provided a goal of accumulating at least 10,000 steps/day , monitored by a pedometer . RESULTS During the control period , participants walked 4972 steps/day . During the intervention period , the participants increased their accumulated steps/day by 85 % to 9213 , which result ed in beneficial changes in 2-h postload glucose levels ( P < 0.001 ) , AUC(glucose ) ( P = 0.025 ) , systolic blood pressure ( P < 0.001 ) , and diastolic blood pressure ( P = 0.002 ) . There were no changes in body mass , body fat percentage , and waist circumference during the walking intervention . CONCLUSIONS The 10,000 steps/day recommendation result ed in improved glucose tolerance and a reduction in systolic and diastolic blood pressure in overweight women at risk for type 2 diabetes . This demonstrates that activity can be accumulated throughout the day and does not have to result in weight loss to benefit this population Voluntary employees ( N = 155 ) from nine different companies were screened by question naire for the study . They were r and omized into three study groups : counseling ( n = 52 ) , counseling + fitness testing ( n = 51 ) and control group ( n = 52 ) . The counseling was based on a goal -oriented conversation session for each participant and three follow-up appointments with an occupational nurse over a period of 1 year . The fitness tests were adapted from the UKK Health-related Fitness Test Battery . The outcome measures were the changes in the amount of leisure-time physical activity ( LTPA ) assessed by diary , pedometer and question naire at baseline and at 6 and 12 month follow-up visits . As a result , no statistically significant differences were detected between the three groups at either of the follow-up visits . It seemed , thus , that the two PA counseling methods implemented had no direct mid- or long-term effects on the LTPA of voluntary employees with no specific disease-related indication to increase LTPA OBJECTIVE Using a r and omised control trial design , this study assessed the impact of two walking interventions , on the work day step counts and health of UK academic and administrative , university employees . METHOD A convenience sample of 58 women ( age 42+/-10 years ) and 6 men ( age 40+/-11 years ) completed baseline and intervention measures for step counts , % body fat , waist circumference and systolic/diastolic blood pressure , during a ten-week period ( October to December , 2005 ) . Before intervention , baseline step counts ( five working days ) were used to r and omly allocate participants to a control ( maintain normal behaviour , n=22 ) and two treatment groups ( " walking routes " , n=21 ; " walking in tasks " , n=21 ) . Intervention effects were evaluated by calculating differences between pre-intervention and intervention data . A one-way ANOVA analysed significant differences between groups . RESULTS A significant intervention effect ( p<0.002 ) was found for step counts , with mean differences indicating a decrease in steps for the control group ( -767 steps/day ) and increases in the " walking routes " ( + 926 steps/day ) and " walking in tasks " ( + 997 steps/day ) groups . Small , non-significant changes were found in % body fat , waist circumference and blood pressure . CONCLUSIONS Findings have implication s for work-based physical activity promotion and the development of walking interventions within the completion of work-based tasks Because of their frequent encounters with sedentary patients , family physicians are poised to be on the forefront of the medical community 's response to physical inactivity . The purpose of this pilot study was to examine whether the addition of a pedometer to brief physician counseling could help patients increase their ambulatory activity .  Ninety four participants recruited from a family medicine clinic were r and omly assigned to 2 groups . Both groups received a brief physician endorsement of regular physical activity , a h and out on the benefits of an active lifestyle , and 3 follow-up phone calls from a health educator . In addition , the intervention group received a pedometer and was instructed to record their steps daily over the 9-week study period . Measurements were taken for self-reported walking , walking stage-of-change , walking self-efficacy , and pedometer steps ( intervention group only ) . Among completers , mean daily step counts in the pedometer group rose from 6779 at baseline to 8855 at study end . Average individual improvement was 41 % over the study period . Both groups significantly increased blocks walked per day , stair climbing versus using the elevator , days per week walking > or = 30 minutes , and walking for fun/leisure . The frequency of walking short trips improved significantly more in the pedometer group relative to the comparison group . The results of this pilot study highlight the need for further research on the use of pedometers as a motivational tool in the context of medical encounters with inactive patients Recent physical activity recommendations call for activities that are of moderate intensity and can be performed intermittently during the day , such as walking . These proclamations were based partly on the assumption that moderate activities are generally more enjoyable than physically dem and ing ones , and they are , therefore , also more likely to be continued over the long haul . However , little is actually known about the affective outcomes of short bouts of walking and extant findings are equivocal . Four experimental studies examined the affective responses associated with short ( 10- to 15-min ) bouts of walking using a dimensional conceptual model of affect , namely , the circumplex . Results consistently showed that walking was associated with shifts toward increased activation and more positive affective valence . Recovery from walking for 10–15 min was associated with a return toward calmness and relaxation . This pattern was robust across different self-report measures of the circumplex affective dimensions , across ecological setting s ( field and laboratory ) , across time , and across sample PURPOSE Walking is the most common leisure-time physical activity ( LTPA ) among U.S. adults . The purpose of this study was to estimate the prevalence of  walking for physical activity  and the proportion of  walkers who met current public health  physical activity recommendations . METHODS We analyzed data from the 1998 Behavioral Risk Factor Surveillance System , a collection of state-based , r and om-digit-dialed telephone surveys of adults . Physical activity measures included the type , frequency , and duration of the two LTPAs in which respondents engaged most often during the previous month . We calculated the prevalence of walking and the prevalence of three physical activity patterns defined by combinations of walking duration and frequency . We also examined the effect on these patterns of participating in a second LTPA . RESULTS In 1998 , an estimated 38.6 % of U.S. adults walked for physical activity . Among walkers , 21.3 % walked a minimum of 30 min five or more times per week . This approximates compliance with current physical activity recommendations . Compliance increased to 34.5 % when the criteria were relaxed to include at least 150 min of walking per week accumulated over three or more occasions . Relaxing the criteria further to include a minimum of 150 min.wk(-1 ) regardless of frequency produced only a small increase in compliance ( 37.6 % ) . However , compliance with each of these three activity patterns approximately doubled when a second LTPA was taken into account . CONCLUSIONS Less than 40 % of walkers complied through walking with even our most liberal physical activity pattern ( > or = 150 min.wk(-1 ) regardless of frequency ) . For walkers to meet current public health recommendations , many need to walk more frequently and /or to engage in additional physical activities OBJECTIVE To evaluate a telephone counseling intervention that was design ed to help sedentary women begin and maintain a walking program . METHODS Females ( N = 197 ) were r and omly assigned to either an intervention , attention control , or no-attention control group . Assessment s were made at baseline and 6 months . RESULTS Women in the intervention group reported more time walked each day than did control women ( P < .05 ) . The intervention worked equally for African American and European American women as well as for different income groups . CONCLUSION Overall , a counseling intervention via telephone appears to be a good way to help women begin a walking program The main aim of this study was to assess the effects of a fitness assessment and exercise consultation on physical activity over 1 year in non-regularly active participants drawn from a socially and economically deprived community . Of 3000 people invited to volunteer for either intervention , 225 fitness assessment volunteers  were r and omly assigned to an experimental or control group ; 145 exercise consultation volunteers  were similarly assigned . Physical activity was measured at baseline , 4 weeks , 3 months ( plus an intervention re-test ) , 6 months and 1 year . Analysis of variance and follow-up Bonferroni analysis showed that , for those not regularly active at baseline , physical activity increased significantly to 4 weeks , was maintained to 6 months but had fallen by 1 year . Only those receiving an exercise consultation significantly increased their physical activity after 1 year . Compared with fitness assessment s , chi-square analysis showed that significantly more non-regularly active participants volunteered for an exercise consultation and those receiving an exercise consultation had significantly better long-term study adherence than those receiving a fitness assessment . The study also showed that , contrary to popular opinion , those in a socially and economically deprived community are not ' hard to reach ' and respond well to physical activity interventions Objectives : To determine , using unsupervised walking programmes , the effects of exercise at a level lower than currently recommended to improve cardiovascular risk factors and functional capacity . Design : 12 week r and omised controlled trial . Setting : Northern Irel and Civil Service ; home-based walking . Participants : 106 healthy , sedentary 40 to 61 year old adults of both sexes . Interventions : Participants were r and omly allocated to a walking programme ( 30 minutes brisk walking three days a week ( n = 44 ) or five days a week ( n = 42 ) ) or a control group ( n = 20 ) . Participants could choose to walk in bouts of at least 10 minutes . They used pedometers to record numbers of steps taken . Intention to treat analysis of changes within groups was done using paired t tests ; extent of change ( baseline to 12 week measurements ) was compared between groups using analysis of variance and Gabriel ’s post hoc test . Main outcome measures : Blood pressure , serum lipids , body mass index , waist : hip ratio , and functional capacity ( using a 10 m shuttle walk test ) . Main results : 89 % ( 93/106 ) completed the study . Systolic blood pressure and waist and hip circumferences fell significantly both in the three day group ( 5 mm Hg , 2.6 cm , and 2.4 cm , respectively ) and in the five day group ( 6 mm Hg , 2.5 cm , and 2.2 cm ) ( p<0.05 ) . Functional capacity increased in both groups ( 15 % ; 11 % ) . Diastolic blood pressure fell in the five day group ( 3.4 mm Hg , p<0.05 ) . No changes occurred in the control group . Conclusions : This study provides evidence of benefit from exercising at a level below that currently recommended in healthy sedentary adults . Further studies are needed of potential longer term health benefits for a wider community from low levels of exercise OBJECTIVE To investigate the link between a reduction in blood pressure ( BP ) and daily exercise . DESIGN Cross-sectional and longitudinal clinical intervention study with exercise education . SUBJECTS 43 overweight Japanese men aged 32 - 59 years ( BMI , 29.0+/-2.3 kg/m2 ) at baseline . Among the participants , a r and omly selected 23 overweight men ( BMI , 28.5+/-1.7 ) were further enrolled into the 10 months exercise program . MEASUREMENTS BP was measured every week and steps per day were also recorded every day throughout the observation period . Fat distribution was evaluated by visceral fat ( V ) and subcutaneous fat ( S ) areas measured with computed tomography ( CT ) scanning at umbilical level , at before , 5 months and after intervention . Anthropometric parameters were also measured at same point .  Aerobic exercise level , muscle strength , flexibility and calorie intake and insulin resistance ( HOMA index ) were investigated at before and after the study . RESULTS In a cross sectional analysis , systolic BP ( SBP ) and diastolic BP ( DBP ) were significantly correlated with body composition . In a second longitudinal analysis , SBP was significantly reduced at 2 months and DBP was also reduced at 3 months , and almost maintained until the end of the observation period . Increasing daily walking was observed in 3 months and maintained until 10 months . Body composition , aerobic exercise level , muscle strength , flexibility and insulin resistance were significantly improved . There was positive correlation between DeltaDBP and Deltavisceral fat area ( 1 - 5 , 5 - 10 , 1 - 10 months ) . By stepwise multiple regression analysis , only Deltavisceral fat area was independently related to DeltaDBP at a significant level ( 1 - 10 months : DeltaDBP=-0.608 + 0.105Deltavisceral fat area , r2=0.227 , P=0.0334 ) . CONCLUSION The present study indicated daily exercise lowers BP and visceral fat area is the critical factor for BP change BACKGROUND Although exercise parameters such as intensity and format have been shown to influence exercise participation rates and physiological outcomes in the short term , few data are available evaluating their longer-term effects . The study objective was to determine the 2-year effects of differing intensities and formats of endurance exercise on exercise participation rates , fitness , and plasma HDL cholesterol levels among healthy older adults . METHODS AND RESULTS Higher-intensity , group-based exercise training ; higher-intensity , home-based exercise ; and lower-intensity , home-based exercise were compared in a 2-year r and omized trial . Participants were 149 men and 120 postmenopausal women 50 to 65 years of age who were sedentary and free of cardiovascular disease . Recruitment was achieved through a r and om digit-dial community telephone survey and media promotion . All exercise occurred in community setting s. For higher-intensity exercise training , three 40-minute endurance training sessions per week were prescribed at 73 % to 88 % of peak treadmill heart rate . For lower-intensity exercise , five 30-minute endurance training sessions per week were prescribed at 60 % to 73 % of peak treadmill heart rate . Treadmill exercise performance , lipoprotein levels and other heart disease risk factors , and exercise adherence were evaluated at baseline and across the 2-year period . Treadmill exercise test performance improved for all three training conditions during year 1 and was successfully maintained during year 2 , particularly for subjects in the higher-intensity , home-based condition . Subjects in that condition also showed the greatest year 2 exercise adherence rates ( P < .003 ) . Although no significant increases in HDL cholesterol were observed during year 1 , by the end of year 2 subjects in the two home-based training conditions showed small but significant HDL cholesterol increases over baseline ( P < .01 ) . The increases were particularly pronounced for subjects in the lower-intensity condition , whose exercise prescription required more frequent exercise sessions per week . For all exercise conditions , increases in HDL cholesterol were associated with decreases in waist-to-hip ratio in both men and women ( P < .04 ) . CONCLUSIONS While older adults can benefit from initiating a regular regimen of moderate-intensity exercise in terms of improved fitness levels and small improvements in HDL cholesterol levels , the time frame needed to achieve HDL cholesterol change ( 2 years ) may be longer than that reported previously for younger population s. Frequency of participation may be particularly important for achieving such changes . Supervised home-based exercise regimens represent a safe , attractive alternative for achieving sustained participation BACKGROUND Inactivity is a leading contributor to chronic health problems . Here , we examined the effects of a pedometer-based physical activity intervention ( Prince Edward Isl and -First Step Program , PEI-FSP ) on activity and specific health indices in 106 sedentary workers . METHODS Participants were recruited from five workplaces where most jobs were moderately-highly sedentary . Using subjects as their own control , physical activity ( pedometer-determined steps per day ) was compared before and after a 12-week intervention . Changes in body mass index ( BMI ) , waist girth , resting heart rate , and blood pressure were evaluated . RESULTS The PEI-FSP was completed by 59 % of participants . Steps per day increased from 7,029 + /- 3,100 ( SD ) at baseline to a plateau of 10,480 + /- 3,224 steps/day by 3.96 + /- 3.28 weeks of the intervention . The amount that participants were able to increase their steps per day was not related to their baseline BMI . On average , participants experienced significant decreases in BMI , waist girth , and resting heart rate . Reductions in waist girth and heart rate were significantly related to the increase in steps per day . In contrast , reductions in BMI were predicted by the initial steps per day . CONCLUSIONS The PEI-FSP increased physical activity in a sedentary population . Importantly , those with a higher BMI at baseline achieved relatively similar increases in their physical activity as participants with a lower BMI
target: No significant changes in any other health outcomes were found in either group .
background: Background : Recent systematic review s have suggested that pedometers may be effective motivational tools to promote walking .
  However , studies tend to be of a relatively short duration , with small clinical based sample s. Further research is required to demonstrate their effectiveness in adequately powered , community based studies .
  Objective : Using a r and omized controlled trial design , this study assessed the impact of a 12-week graduated pedometer-based walking intervention on daily step-counts , self-reported physical activity and health outcomes in a Scottish community sample not meeting current physical activity recommendations .