title: Using pedometers to increase physical activity in overweight and obese women: a pilot study Physical activity is associated with a low prevalence of musculoskeletal disorders in the Royal Norwegian Navy: a cross sectional study Effects of exercise adherence on physical function among overweight older adults with knee osteoarthritis. Pedometer-driven Walking for Chronic Low Back Pain: A Feasibility Randomized Controlled Trial Promoting Physical Activity for Persons With Diabetes Efficacy of a progressive walking program and glucosamine sulphate supplementation on osteoarthritic symptoms of the hip and knee: a feasibility trial Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. The feasibility of using pedometers and brief advice to increase activity in sedentary older women – a pilot study Pedometer measures of free-living physical activity: comparison of 13 models. Pedometer-Based Internet-Mediated Intervention For Adults With Chronic Low Back Pain: Randomized Controlled Trial The Back 2 Activity Trial: education and advice versus education and advice plus a structured walking programme for chronic low back pain Veterans walk to beat back pain: study rationale, design and protocol of a randomized trial of a pedometer-based Internet mediated intervention for patients with chronic low back pain Effects of an exercise and manual therapy program on physical impairments, function and quality-of-life in people with osteoporotic vertebral fracture: a randomised, single-blind controlled pilot trial Effects of an adapted physical activity program in a group of elderly subjects with flexed posture: clinical and instrumental assessment A four-week walking exercise programme in patients with knee osteoarthritis improves the ability of dual-task performance: a randomized controlled trial The effect of pedometer use in combination with cognitive and behavioral support materials to promote physical activity. The effectiveness of a work style intervention and a lifestyle physical activity intervention on the recovery from neck and upper limb symptoms in computer workers Leisure-time physical activity levels and changes in relation to risk of hip fracture in men and women. Effectiveness of a pedometer-based program using a socio-cognitive intervention on physical activity and quality of life in a setting of cardiac rehabilitation. Validity of 10 electronic pedometers for measuring steps, distance, and energy cost. A home-based pedometer-driven walking program to increase physical activity in older adults with osteoarthritis of the knee: a preliminary study. Effect of physical exercise interventions on musculoskeletal pain in all body regions among office workers: a one-year randomized controlled trial. Effects of recreational physical activity and back exercises on low back pain and psychological distress: findings from the UCLA Low Back Pain Study. Enhancement of daily physical activity increases physical fitness of outclinic COPD patients: results of an exercise counseling program. Brisk walking, fitness, and cardiovascular risk: a randomized controlled trial in primary care.
abstract: Background Most public health guidelines recommend that adults participate in 30 minutes of moderate intensity physical activity on most days of the week . Establishing new ways to achieve these targets in sedentary population s need to be explored . This research evaluated whether the daily use of pedometers could increase physical activity and improve health outcomes in sedentary overweight and obese women . Methods Twenty six overweight and obese middle-aged women were r and omized into two groups : The control group was not able to record their steps daily , whilst the pedometer group , were asked to record the number of steps on a daily basis for 12 weeks . Results Our data showed that the pedometer group significantly increased their steps/day , by 36 % , at the end of the 12 weeks , whereas the control group 's physical activity levels remained unchanged . There was no significant difference in weight or body fat composition in the pedometer group compared to the control group . However , there was a significant decrease in systolic blood pressure in the pedometer group ( 112.8 ± 2.44 mm Hg ) compared to the control group ( 117.3 ± 2.03 mm Hg ) ( p = 0.003 ) . Conclusion In conclusion , this pilot study shows that the combination of having step goals and immediate feedback from using a pedometer was effective in increasing physical activity levels in sedentary overweight and obese women . Trial registration Background Despite considerable knowledge about musculoskeletal disorders ( MSD ) and physical , psychosocial and individual risk factors there is limited knowledge about physical activity as a factor in preventing MSD . In addition , studies of physical activity are often limited to either leisure activity or physical activity at work . Studies among military personnel on the association between physical activity at work and at leisure and MSD are lacking . This study was conducted to find the prevalence of MSD among personnel in the Royal Norwegian Navy and to assess the association between physical activity at work and at leisure and MSD . Methods A question naire about musculoskeletal disorders , physical activity and background data ( employment status , age , gender , body mass index , smoking , education and physical stressors ) was completed by 2265 workers ( 58 % ) 18 to 70 years old in the Royal Norwegian Navy .  Multiple logistic regression with 95 % confidence intervals was used to assess the relationship between physical activity and musculoskeletal disorders . Results A total of 32 % of the workers reported musculoskeletal disorders often or very often in one or more parts of the body in the past year . The most common musculoskeletal disorders were in the lower back ( 15 % often or very often ) , shoulders ( 12 % often or very often ) and neck ( 11 % often or very often ) . After adjustment for confounders , physical activity was inversely associated with musculoskeletal disorders for all body sites except elbows , knees and feet . Conclusion The one-year prevalence of musculoskeletal disorders among workers in the Royal Norwegian Navy was rather low . A physically active lifestyle both at work and at leisure was associated with fewer musculoskeletal disorders  among personnel in the Royal Norwegian Navy . Prospect i ve studies are necessary to confirm the cause and effect in this association OBJECTIVE To determine whether high exercise adherence improved physical function among older adults with knee osteoarthritis ( OA ) who were overweight or obese . METHODS Associations between  exercise adherence , changes in 6-minute walking distance in meters , and self-reported disability ( Western Ontario and McMaster Universities Osteoarthritis Index function subscale ) after 6 and 18 months were examined among an Arthritis , Diet , and Activity Promotion Trial sub sample ( n = 134 ) using multiple linear regression models . RESULTS Higher exercise adherence was associated with greater improvements in 6-minute walking distance after 6 and 18 months and in disability after 6 months . Pain and body mass index ( BMI ) contributed , to some extent , to explaining the link between exercise adherence  and changes in physical performance and self-reported disability . CONCLUSION Higher exercise adherence is associated with improved physical function in overweight and obese older adults with knee OA . This indicates that promoting adherence is clinical ly relevant when prescribing exercise regimens that also focus on decreasing pain and BMI Objectives : To evaluate the feasibility of an RCT of a pedometer-driven walking program and education/advice to remain active compared with education/advice only for treatment of chronic low back pain ( CLBP ) . Methods : Fifty-seven participants with CLBP recruited from primary care were r and omly allocated to either : ( 1 ) education/advice ( E , n=17 ) or ( 2 ) education/advice plus an 8-week pedometer-driven walking program ( EWP , n=40 ) . Step targets , actual daily step counts , and adverse events were recorded in a walking diary over the 8 weeks of intervention for the EWP group only . All other outcomes ( eg , functional disability using the Oswestry Disability Question naire ( ODQ ) , pain scores , physical activity ( PA ) measurement etc . ) were recorded at baseline , week 9 ( immediately post-intervention ) , and 6 months in both groups . Results : The recruitment rate was 22 % and the dropout rate was lower than anticipated ( 13 % to 18 % at 6 mo ) . Adherence with the EWP was high , 93 % ( n=37/40 ) walked for ≥6 weeks , and increased their steps/day ( mean absolute increase in steps/d , 2776 , 95 % confidence interval [ CI ] , 1996 - 3557 ) by 59 % ( 95 % CI , 40.73%-76.25 % ) from baseline . Mean percentage adherence with weekly step targets was 70 % ( 95 % CI , 62%-77 % ) . Eight ( 20 % ) minor-related adverse events were observed in 13 % ( 5/40 ) of the participants . The EWP group participants demonstrated an 8.2 % point improvement ( 95 % CI , −13 to −3.4 ) on the ODQ at 6 months compared with 1.6 % points ( 95 % CI , –9.3 to 6.1 ) for the E group ( between group d=0.44 ) . There was also a larger mean improvement in pain ( d=0.4 ) and a larger increase in PA ( d=0.59 ) at 6 months in EWP . Discussion : This preliminary study demonstrated that a main RCT is feasible . EWP was safe and produced a real increase in walking ; CLBP function and pain improved , and participants perceived a greater improvement in their PA levels . These improvements require confirmation in a fully powered RCT Purpose The purpose of this study was to evaluate the effectiveness of a  self-help physical activity program  for persons with type 2 diabetes . Effectiveness was measured by cardiovascular indicators , hemoglobin A1C , anthropometric indicators , and activity levels . Methods This intervention study included 53 individuals with type 2 diabetes . Participants were r and omly assigned . Participants in the intervention group attended the usual Diabetes Self-Management Education Program ( DSMEP ) and received a copy of the book , Manpo-kei ; a concise h and out summarizing the key points of Manpo-kei ; and a pedometer . Participants not assigned to the intervention attended the usual DSMEP only . Data collection was completed at the beginning of the study and 3 months later using a lifestyle and diabetes question naire , a physical activity question naire , and cardiovascular and anthropometric measures . Results Those who participated in the intervention demonstrated a significant decrease in hemoglobin A1C , weight , and body fat . In addition , they increased their number of daily steps as measured by the pedometer . The control group also demonstrated a significant decrease in hemoglobin A1C and weight . Both groups demonstrated increases in their regular weekly activity . At the end of the study period , the intervention group had a significantly lower diastolic blood pressure than the control group . Conclusions Pedometers can be a helpful strategy to motivate persons with diabetes to increase physical activity . However , it appears that attendance at DSMEP alone may be enough to increase physical activity for persons with type 2 diabetes Introduction Management of osteoarthritis ( OA ) includes the use of non-pharmacological and pharmacological therapies . Although walking is commonly recommended for reducing pain and increasing physical function in people with OA , glucosamine sulphate has also been used to alleviate pain and slow the progression of OA . This study evaluated the effects of a progressive walking program and glucosamine sulphate intake on OA symptoms and physical activity participation in people with mild to moderate hip or knee OA . Methods Thirty-six low active participants ( aged 42 to 73 years ) were provided with 1500 mg glucosamine sulphate per day for 6 weeks , after which they began a 12-week progressive walking program , while continuing to take glucosamine . They were r and omized to walk 3 or 5 days per week and given a pedometer to monitor step counts . For both groups , step level of walking was gradually increased to 3000 steps/day during the first 6 weeks of walking , and to 6000 steps/day for the next 6 weeks . Primary outcomes included physical activity levels , physical function ( self-paced step test ) , and the WOMAC Osteoarthritis Index for pain , stiffness and physical function . Assessment s were conducted at baseline and at 6- , 12- , 18- , and 24-week follow-ups . The Mann Whitney Test was used to examine differences in outcome measures between groups at each assessment , and the Wilcoxon Signed Ranks Test was used to examine differences in outcome measures between assessment s. Results During the first 6 weeks of the study ( glucosamine supplementation only ) , physical activity levels , physical function , and total WOMAC scores improved ( P < 0.05 ) . Between the start of the walking program ( Week 6 ) and the final follow-up ( Week 24 ) , further improvements were seen in these outcomes ( P < 0.05 ) although most improvements were seen between Weeks 6 and 12 . No significant differences were found between walking groups . Conclusions In people with hip or knee OA , walking a minimum of 3000 steps ( ~30 minutes ) , at least 3 days/week , in combination with glucosamine sulphate , may reduce OA symptoms . A more robust study with a larger sample is needed to support these preliminary findings .Trial Registration Australian Clinical Trials Registry ACTRN012607000159459 OBJECTIVE The Arthritis , Diet , and Activity Promotion Trial ( ADAPT ) was a r and omized , single-blind clinical trial lasting 18 months that was design ed to determine whether long-term exercise and dietary weight loss are more effective , either separately or in combination , than usual care in improving physical function , pain , and mobility in older overweight and obese adults with knee osteoarthritis ( OA ) . METHODS Three hundred sixteen community-dwelling overweight and obese adults ages 60 years and older , with a body mass index of > or = 28 kg/m(2 ) , knee pain , radiographic evidence of knee OA , and self-reported physical disability , were r and omized into healthy lifestyle ( control ) , diet only , exercise only , and diet plus exercise groups . The primary outcome was self-reported physical function as measured with the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) . Secondary outcomes included weight loss , 6-minute walk distance , stair-climb time , WOMAC pain and stiffness scores , and joint space width . RESULTS Of the 316 r and omized participants , 252 ( 80 % ) completed the study .  Adherence was as follows : for healthy lifestyle , 73 % ; for diet only , 72 % ; for exercise only , 60 % ; and for diet plus exercise , 64 % . In the diet plus exercise group , significant improvements in self-reported physical function ( P < 0.05 ) , 6-minute walk distance ( P < 0.05 ) , stair-climb time ( P < 0.05 ) , and knee pain ( P < 0.05 ) relative to the healthy lifestyle group were observed . In the exercise group , a significant improvement in the 6-minute walk distance ( P < 0.05 ) was observed . The diet-only group was not significantly different from the healthy lifestyle group for any of the functional or mobility measures . The weight-loss groups lost significantly ( P < 0.05 ) more body weight ( for diet , 4.9 % ; for diet plus exercise , 5.7 % ) than did the healthy lifestyle group ( 1.2 % ) . Finally , changes in joint space width were not different between the groups . CONCLUSION The combination of modest weight loss plus moderate exercise provides better overall improvements in self-reported measures of function and pain and in performance measures of mobility in older overweight and obese adults with knee OA compared with either intervention alone 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 PURPOSE The purpose of this study was to compare the step values of multiple br and s of pedometers over a 24-h period . The following 13 electronic pedometers were assessed in the study : Accusplit Alliance 1510 ( AC ) , Freestyle Pacer Pro ( FR ) , Colorado on the Move ( CO ) , Kenz Lifecorder ( KZ ) , New-Lifestyles NL-2000 ( NL ) , Omron HJ-105 ( OM ) , Oregon Scientific PE316CA ( OR ) , Sportline 330 ( SL330 ) and 345 ( SL345 ) , Walk4Life LS 2525 ( WL ) , Yamax Skeletone EM-180 ( SK ) , Yamax Digi-Walker SW-200 ( YX200 ) , and the Yamax Digi-Walker SW-701 ( YX701 ) . METHODS Ten males ( 39.5 + /- 16.6 yr , mean + /- SD ) and 10 females ( 43.3 + /- 16.6 yr ) ranging in BMI from 19.8 to 35.4 kg.m-2 wore two pedometers for a 24-h period . The criterion pedometer ( YX200 ) was worn on the left side of the body , and a comparison pedometer was worn on the right . Steps counted by each device were recorded at the end of the day for each of the thirteen pedometers . RESULTS Subjects took an average of 9244 steps.d-1 . The KZ , YX200 , NL , YX701 , and SL330 yielded mean values that were not significantly different from the criterion . The FR , AC , SK , CO , and SL345 significantly underestimated steps ( P < 0.05 ) and the WL , OM , and OR significantly overestimated steps ( P < 0.05 ) when compared with the criterion . In addition , some pedometers underestimated by 25 % whereas others overestimated by 45 % . CONCLUSION The KZ , YX200 , NL , and YX701 appear to be suitable for most research purpose s. Given the potential for pedometers in physical activity research , it is necessary that there be consistency across studies in the measurement of " steps per day . Background Chronic pain , especially back pain , is a prevalent condition that is associated with disability , poor health status , anxiety and depression , decreased quality of life , and increased health services use and costs . Current evidence suggests that exercise is an effective strategy for managing chronic pain . However , there are few clinical programs that use generally available tools and a relatively low-cost approach to help patients with chronic back pain initiate and maintain an exercise program . Objective The objective of the study was to determine whether a pedometer-based , Internet-mediated intervention can reduce chronic back pain-related disability . Methods A parallel group r and omized controlled trial was conducted with 1:1 allocation to the intervention or usual care group . 229 veterans with nonspecific chronic back pain were recruited from one Department of Veterans Affairs ( VA ) health care system . Participants r and omized to the intervention received an uploading pedometer and had access to a website that provided automated walking goals , feedback , motivational messages , and social support through an e-community ( n=111 ) . Usual care participants ( n=118 ) also received the uploading pedometer but did not receive the automated feedback or have access to the website . The primary outcome was measured using the Rol and Morris Disability Question naire ( RDQ ) at 6 months ( secondary ) and 12 months ( primary ) with a difference in mean scores of at least 2 considered clinical ly meaningful . Both a complete case and all case analysis , using linear mixed effects models , were conducted to assess differences between study groups at both time points . Results Baseline mean RDQ scores were greater than 9 in both groups . Primary outcome data were provided by approximately 90 % of intervention and usual care participants at both 6 and 12 months . At 6 months , average RDQ scores were 7.2 for intervention participants compared to 9.2 for usual care , an adjusted difference of 1.6 ( 95 % CI 0.3 - 2.8 , P=.02 ) for the complete case analysis and 1.2 ( 95 % CI -0.09 to 2.5 , P=.07 ) for the all case analysis . A post hoc analysis of patients with baseline RDQ scores ≥4 revealed even larger adjusted differences between groups at 6 months but at 12 months the differences were no longer statistically significant . Conclusions Intervention participants , compared with those receiving usual care , reported a greater decrease in back pain-related disability in the 6 months following study enrollment . Between-group differences were especially prominent for patients reporting greater baseline levels of disability but did not persist over 12 months . Primarily , automated interventions may be an efficient way to assist patients with managing chronic back pain ; additional support may be needed to ensure continuing improvements . Trial Registration Clinical Trials.gov NCT00694018 ; http:// clinical trials.gov/ct2/show/NCT00694018 ( Archived by WebCite at http://www.webcitation.org/6IsG4Y90E ) Background Current evidence supports the use of exercise-based treatment for chronic low back pain that encourages the patient to assume an active role in their recovery . Walking has been shown it to be an acceptable type of exercise with a low risk of injury . However , it is not known whether structured physical activity programmes are any more effective than giving advice to remain active . Methods / Design The proposed study will test the feasibility of using a pedometer-driven walking programme , as an adjunct to a st and ard education and advice session in participants with chronic low back pain . Fifty adult participants will be recruited via a number of different sources . Baseline outcome measures including self reported function ; objective physical activity levels ; fear-avoidance beliefs and health-related quality of life will be recorded . Eligible participants will be r and omly allocated under strict , double blind conditions to one of two treatments groups . Participants in group A will receive a single education and advice session with a physiotherapist based on the content of the ' Back Book ' . Participants in group B will receive the same education and advice session . In addition , they will also receive a grade d pedometer-driven walking programme prescribed by the physiotherapist . Follow up outcomes will be recorded by the same research er , who will remain blinded to group allocation , at eight weeks and six months post r and omisation . A qualitative exploration of participants ' perception of walking will also be examined by use of focus groups at the end of the intervention . As a feasibility study , treatment effects will be represented by point estimates and confidence intervals . The assessment of participant satisfaction will be tabulated , as will adherence levels and any recorded difficulties or adverse events experienced by the participants or therapists . This information will be used to modify the planned interventions to be used in a larger r and omised controlled trial . Discussion This paper describes the rationale and design of a study which will test the feasibility of using a structured , pedometer-driven walking programme in participants with chronic low back pain . Trial Registration [ IS RCT N67030896 Background Chronic back pain is a significant problem worldwide and may be especially prevalent among patients receiving care in the U.S. Department of Veterans Affairs healthcare system . Back pain affects adults at all ages and is associated with disability , lost workplace productivity , functional limitations and social isolation . Exercise is one of the most effective strategies for managing chronic back pain . Yet , there are few clinical programs that use low cost approaches to help patients with chronic back pain initiate and maintain an exercise program . Methods / Design We describe the design and rationale of a r and omized controlled trial to assess the efficacy of a pedometer-based Internet mediated intervention for patients with chronic back pain . The intervention uses an enhanced pedometer , website and e-community to assist these patients with initiating and maintaining a regular walking program with the primary aim of reducing pain-related disability and functional interference . The study specific aims are : 1 ) To determine whether a pedometer-based Internet-mediated intervention reduces pain-related functional interference among patients with chronic back pain in the short term and over a 12-month timeframe . 2 ) To assess the effect of the intervention on walking ( measured by step counts ) , quality of life , pain intensity , pain related fear and self-efficacy for exercise . 3 ) To identify factors associated with a sustained increase in walking over a 12-month timeframe among patients r and omized to the intervention . Discussion Exercise is an integral part of managing chronic back pain but to be effective requires that patients actively participate in the management process . This intervention is design ed to increase activity levels , improve functional status and make  exercise programs more accessible for a broad range of patients with chronic back pain . Trial Registration Background This r and omised , single-blind controlled pilot trial aim ed to determine the effectiveness of a physiotherapy program , including exercise and manual therapy , in reducing impairments and improving physical function and health-related quality of life in people with a history of painful osteoporotic vertebral fracture . Methods 20 participants were r and omly allocated to an intervention ( n = 11 ) or control ( n = 9 ) group . The intervention group attended individual sessions with an experienced clinician once a week for 10 weeks and performed daily home exercises with adherence monitored by a self-report diary . The control group received no treatment . Blinded assessment was conducted at baseline and 11 weeks . Question naires assessed self-reported changes in back pain , physical function , and health-related quality of life . Objective measures of thoracic kyphosis , back and shoulder muscle endurance ( Timed Loaded St and ing Test ) , and function ( Timed Up and Go test ) were also taken . Results Compared with the control group , the intervention group showed significant reductions in pain during movement ( mean difference ( 95 % CI ) -1.8 ( -3.5 to -0.1 ) ) and at rest ( -2.0 ( -3.8 to -0.2 ) ) and significantly greater improvements in Qualeffo physical function ( -4.8 ( -9.2 to -0.5 ) ) and the Timed Loaded St and ing test ( 46.7 ( 16.1 to 77.3 ) secs ) . For the perceived change in back pain over the 10 weeks , 9/11 ( 82 % ) participants in the intervention group rated their pain as ' much better ' compared with only 1/9 ( 11 % ) participants in the control group . Conclusion Despite the modest sample size , these results support the benefits of exercise and manual therapy in the clinical management of patients with osteoporotic vertebral fractures , but need to be confirmed in a larger sample .Trail registration Background Flexed posture commonly increases with age and is related to musculoskeletal impairment and reduced physical performance . The purpose of this clinical study was to systematic ally compare the effects of a physical activity program that specifically address the flexed posture that marks a certain percentage of elderly individuals with a non specific exercise program for 3 months . Methods Participants were r and omly divided into two groups : one followed an Adapted Physical Activity program for flexed posture and the other one completed a non-specific physical activity protocol for the elderly .  A multidimensional clinical assessment was performed at baseline and at 3 months including anthropometric data , clinical profile , measures of musculoskeletal impairment and disability . The instrumental assessment of posture was realized using a stereophotogrammetric system and a specific biomechanical model design ed to describe the reciprocal position of the body segments on the sagittal plane in a upright posture . Results The Adapted Physical Activity program determined a significant improvement in several key parameters of the multidimensional assessment in comparison to the non-specific protocol : decreased occiput-to-wall distance , greater lower limb range of motion , better flexibility of pectoralis , hamstrings and hip flexor muscles , increased spine extensor muscles strength . Stereophotogrammetric analysis confirmed a reduced protrusion of the head and revealed a reduction in compensative postural adaptations to flexed posture characterized by knee flexion and ankle dorsiflexion in the participants of the specific program . Conclusion The Adapted Physical Activity program for flexed posture significantly improved postural alignment and musculoskeletal impairment of the elderly . The stereophotogrammetric evaluation of posture was useful to measure the global postural alignment and especially to analyse the possible compensatory strategies at lower limbs in flexed posture Objective : To investigate whether a four-week walking exercise programme in patients with knee osteoarthritis improves the ability of dual-task performance in older adults with knee osteoarthritis . Design : A r and omized controlled trial with two groups : a walking group and a control group . Subjects : Forty older adults with knee osteoarthritis , 20 participants in each group . Intervention : The walking intervention was design ed to increase the number of steps walked daily . The walking group was instructed to increase their number of steps to 3000 steps more than before the intervention . Main outcome measures : Dual-task performance was computed by an automaticity index : the walking velocity under single-task condition/under dual-task conditions × 100 ( % ) , defined as automaticity . The nearer to 100 % automaticity , the better the dual-task performance . Decrease of the Trail Making Test ( TMT ) performance was defined as ΔTMT . ΔTMT was calculated as the difference between times ( part B – part A ) as a measure of executive function . In addition , functional ability was measured by the Japanese Knee Osteoarthritis Measure . Results : The walking group improved significantly in automaticity ( P < 0.001 , from 75.2 ( 7.6 ) to 86.9 ( 10.4 ) , ΔTMT ( P < 0.001 , from 63.4 ( 43.1 ) to 48.3 ( 29.6 ) ) and Japanese Knee Osteoarthritis Measure score ( P < 0.001 , from 54.4 to 51.9 ) compared with before the intervention , while the control group displayed no significant differences . Conclusions : We found that walking exercise improves executive function and dual-task performance 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 Abstract This study assessed the effectiveness of a single intervention targeting work style and a combined intervention targeting work style and physical activity on the recovery from neck and upper limb symptoms . Computer workers with frequent or long‐term neck and upper limb symptoms were r and omised into the work style group ( WS , n = 152 ) , work style and physical activity group ( WSPA , n = 156 ) , or usual care group ( n = 158 ) . The WS and WSPA group attended six group meetings . All meetings focused on behavioural change with regard to body posture , workplace adjustment , breaks and coping with high work dem and s ( WS and WSPA group ) and physical activity ( WSPA group ) . Pain , disability at work , days with symptoms and months without symptoms were measured at baseline and after 6 ( T1 ) and 12 months ( T2 ) . Self‐reported recovery was assessed at T1/T2 . Both interventions were ineffective in improving recovery . The work style intervention but not the combined intervention was effective in reducing all pain measures . These effects were present in the neck/shoulder , not in the arm/wrist/h and . For the neck/shoulder , the work style intervention group also showed an increased recovery‐rate . Total physical activity increased in all study groups but no differences between groups were observed . To conclude , a group‐based work style intervention focused on behavioural change was effective in improving recovery from neck/shoulder symptoms and reducing pain on the long‐term . The combined intervention was ineffective in increasing total physical activity . Therefore we can not draw conclusions on the effect of increasing physical activity on the recovery from neck and upper limb symptoms The authors prospect ively studied the effect of leisure-time physical activity level on  hip fracture risk  along with the influence of within-subject changes in activity levels , while taking possible confounding by other health behaviors and poor health into account . Analyses were based on pooled data from three population studies conducted in Copenhagen , Denmark . Among 13,183 women and 17,045 men , 1,121 first hip fractures were identified during follow-up . In comparison with being sedentary , the relative risk ( RR ) of hip fracture associated with being moderately physically active 2 - 4 hours per week was 0.72 ( 95 % confidence interval ( CI ) : 0.59 , 0.89 ) in women and 0.75 ( 95 % CI : 0.55 , 1.03 ) in men after adjustment for confounders . Being in the most active leisure activity category did not decrease the risk of hip fracture further . Adjustment for poor health affected the risk estimates only modestly . Subjects who , during follow-up , reduced their physical activity level from the highest or the intermediate activity level to a sedentary level had a higher risk of hip fracture than did those who remained moderately physically active at the intermediate level ( multivariate adjusted RR = 2.19 , 95 % CI : 1.00 , 4.84 and RR = 1.89 , 95 % CI : 1.21 , 2.95 , for reduction from the highest and intermediate levels , respectively ) . There was no evidence of a fracture-protective effect from increasing physical activity . In conclusion , moderate levels of physical activity appear to provide protection against later hip fracture . Decline in the physical activity level over time is an important risk factor for hip fracture BACKGROUND Physical activity contributes to improve health and quality of life . However , the prevalence of sedentary lifestyle is elevated after an acute coronary syndrome . METHODS A r and omized controlled trial was performed to evaluate the impact of a pedometer-based program associated with a socio-cognitive intervention on physical activity behaviour , cardiovascular risk factors , and quality of life during the year after an acute coronary syndrome event . During hospitalization , we r and omized 32 patients to an experimental group and 33 patients to a usual care group . The experimental intervention included 6 consultations with a clinical nurse specialist during 12 months . RESULTS Groups characteristics were comparable . At baseline , the percentage of participants considered in the active range category was similar between groups ( 31 % vs 41 % ; P = 0.915 ) . However , the proportion of participants who were still active was greater in the experimental group than in the usual care group at 6 , 9 , and 12 months follow-up ( 75 % vs 41 % ; 68 % vs 36 % , and 83 % vs 55 % , respectively ; P < 0.05 ) . After 12 months , changes in overall quality of life and in health and the functioning scores were different between groups ( interaction effects [ groups by time ] P = 0.048 and P = 0.036 , respectively ) . CONCLUSIONS The use of a pedometer concomitantly with a socio-cognitive intervention improves adherence to physical activity and quality of life during the year after an acute coronary syndrome event . This finding is relevant because physical activity and quality of life are a great concern in preventive cardiology . These results support applying this innovative approach in cardiac rehabilitation programs PURPOSE This study examined the effects of walking speed on the accuracy and reliability of 10 pedometers : Yamasa Skeletone ( SK ) , Sportline 330 ( SL330 ) and 345 ( SL345 ) , Omron ( OM ) , Yamax Digiwalker SW-701 ( DW ) , Kenz Lifecorder ( KZ ) , New Lifestyles 2000 ( NL ) , Oregon Scientific ( OR ) , Freestyle Pacer Pro ( FR ) , and Walk4Life LS 2525 ( WL ) . METHODS Ten subjects ( 33 + /- 12 yr ) walked on a treadmill at various speeds ( 54 , 67 , 80 , 94 , and 107 m x min-1 ) for 5-min stages . Simultaneously , an investigator determined  steps by a h and counter and  energy expenditure  ( kcal ) by indirect calorimetry . Each br and was measured on the right and left sides . RESULTS Correlation coefficients between right and left sides exceeded 0.81 for all pedometers except OR ( 0.76 ) and SL345 ( 0.57 ) . Most pedometers underestimated steps at 54 m x min-1 , but accuracy for step counting improved at faster speeds . At 80 m x min-1 and above , six models ( SK , OM , DW , KZ , NL , and WL ) gave mean values that were within + /- 1 % of actual steps . Six pedometers displayed the distance traveled . Most of them estimated mean distance to within + /- 10 % at 80 m x min-1 but overestimated distance at slower speeds and underestimated distance at faster speeds . Eight pedometers displayed kilocalories , but except for KZ and NL , it is unclear whether this should reflect net or gross kilocalories . If one assumes they display net kilocalories , the general trend was an overestimation of kilocalories at every speed . If one assumes they display gross kilocalorie , then seven of the eight pedometers were accurate to within + /-30 % at all speeds . CONCLUSION In general , pedometers are most accurate for assessing steps , less accurate for assessing distance , and even less accurate for assessing kilocalories 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 This study investigated effects of physical exercise on  musculoskeletal pain symptoms in all regions of the body , as well as on other musculoskeletal pain in association with neck pain . A single blind r and omized controlled trial testing a one-year exercise intervention was performed among 549 office workers ;  specific neck/shoulder resistance training , all-round physical exercise , or a reference intervention . Pain symptoms were determined by question naire screening of twelve selected body regions . Case individuals were identified for each body region as those reporting pain intensities at baseline of 3 or more ( scale of 0 - 9 ) during the last three months . For neck cases specifically , the additional number of pain regions was counted . Intensity of pain decreased significantly more in the neck , low back , right elbow and right h and in cases of the two exercise groups compared with the reference group ( P<0.0001 - 0.05 ) . The additional number of pain regions in neck cases decreased in the two exercise groups only ( P<0.01 - 0.05 ) . In individuals with no or minor pain at baseline , development of pain was minor in all three groups . In conclusion , both specific resistance training and all-round physical exercise for office workers caused better effects than a reference intervention in relieving musculoskeletal pain symptoms in exposed regions of the upper body OBJECTIVES We sought to estimate the effects of recreational physical activity and back exercises on  low back pain , related disability , and psychological distress among patients r and omized to chiropractic or medical care in a managed care setting . METHODS Low back pain patients ( n=681 ) were r and omized and followed for 18 months . Participation in recreational physical activities , use of back exercises , and low back pain , related disability , and psychological distress were measured at baseline , at 6 weeks , and at 6 , 12 , and 18 months . Multivariate logistic regression modeling was used to estimate adjusted associations of physical activity and back exercises with concurrent and subsequent pain , disability , and psychological distress . RESULTS Participation in recreational physical activities was inversely associated -- both cross-sectionally and longitudinally -- with low back pain , related disability , and psychological distress . By contrast , back exercise was positively associated -- both cross-sectionally and longitudinally -- with low back pain and related disability . CONCLUSIONS These results suggest that individuals with low back pain should refrain from specific back exercises and instead focus on nonspecific physical activities to reduce pain and improve psychological health OBJECTIVE To investigate whether a 12-week pedometer-based exercise counseling strategy is feasible and effectively enhances daily physical activity in outclinic Chronic Obstructive Pulmonary Disease ( COPD ) patients who do not participate in a rehabilitation program in a controlled way . METHODS 35 outclinic COPD patients ( 21 males , mean age 62 years , GOLD I-III , mean FEV(1)% predicted 64.7 ) were r and omized for a 12-week individual pedometer-based exercise counseling program promoting daily physical activities or usual care .  Daily physical activity ( DigiWalker SW-200 ) , physical fitness , health-related quality of life , self-efficacy , fatigue , depression and motivation to be physically active were assessed before and after the intervention . RESULTS After the intervention , COPD patients in the exercise counseling group showed a significant increase in their mean number of steps/day ( from 7087 to 7872 ) , whereas the usual care group showed a decrease ( from 7539 to 6172 ) . Significant differences favoring the exercise counseling group were demonstrated in arm strength , leg strength , health-related quality of life and intrinsic motivation to be physically active . CONCLUSION Our study shows that a 12-week pedometer-based exercise counseling strategy is feasible and effectively enhances daily physical activity , physical fitness , health-related quality of life and intrinsic motivation in outclinic COPD patients who do not participate in a rehabilitation program . PRACTICE IMPLICATION S The feasibility of our exercise counseling strategy is good and patients were motivated to participate STUDY OBJECTIVE To examine the effects of 30 min of self-paced , non-supervised , brisk walking , 5 days per week on the health and fitness of people aged 50 - 65 years . DESIGN R and omized controlled trial . Members of the intervention group ( n = 21 ) were directed to walk briskly for 30 min , 5 days per week , for 12 weeks . Individuals were given the choice to complete the 30 min of walking in one session or in shorter bouts of no less than 10 min . They were asked to record in a diary the time spent walking and the number of steps taken during a single walk using a pedometer . Participants in the  control group ( n = 10 ) were asked to maintain their habitual lifestyle and not change their activity or dietary habits . Measurements of body mass index ( BMI ) , waist/hip ratio ( WHR ) , blood pressure , functional capacity , total cholesterol , triglyceride , and lipoprotein subfractions were taken before and after the program . Changes in 10-year risk estimate for coronary heart disease and stroke were calculated using Framingham risk equations . SETTING Three urban general practice s patients : 31 healthy , sedentary 50- to 65-year-old participants recruited following contact by their general practitioner . MAIN RESULTS The mean time spent walking by the intervention group was 27.72 ( + /-9.79 ) min/day : their adherence to the protocol was 90.3 % . Significant decreases in systolic and diastolic blood pressure , reduction in stroke risk , and increased functional capacity were found within the walking group between baseline and 12-week measurements . No changes were found in these parameters within the control group . Significant reductions in 10-year risk of CHD were observed in both groups . No significant changes were found in lipid levels or anthropometric measurements in either group . CONCLUSIONS The study provides evidence for the benefit to fitness and cardiovascular risk of the " 30-min brisk walking , 5 days a week " message to people aged 50 - 65 years who participated in an unsupervised home-based walking program . Further study to overcome the problem of poor recruitment and determine the minimum effective dose of exercise to improve cardiovascular risk prediction scores is required
target: Conclusion This study provides strong evidence for the effectiveness of pedometer walking interventions in increasing PA levels for patients with MSDs .
  Our findings suggest that a combination of interventions is likely to be the most effective strategy to maximize health benefits in the short term .
background: Background Physical activity ( PA ) plays an important role in the prevention and management of a number of chronic conditions .
  Aim : to investigate the evidence for effectiveness of pedometer-driven walking programs to promote physical activity among patients with musculoskeletal disorders ( MSDs ) .