Table 3.

Health-Related Outcomes in Studies Using Pedometers

Study detailsa	Intervention	Outcome measures	Health outcomes resultsb	Downs and Black scorec
Bjørgaas et al.40 Norway I RCT	N = 70; subjects with T2DM randomized pedometer or no-pedometer group to determine if pedometer increases walking or increases beneficial health-related effects; 6-month intervention	Steps/day Oxygen uptake VO2peak HbA1c, serum creatine, lipids Body weight Blood pressure Fasting plasma glucose Cholesterol, HDL, triglycerides	↔ Steps/day, no increase (p = .65) ↔ Oxygen uptake VO2peak + Body weight, HbA1c, fasting blood glucose, triglycerides, and diastolic blood pressure ↔ HDL cholesterol (no improvement) − Compliance, no diary or not enough data; mean number of pedometer days recorded per month varied between 5.4 and 5.9	22
Tudor-Locke et al.37 Canada I RCT	N = 47; effectiveness of 16-week physical activity intervention (24-week follow-up): the First Step Program for adults with T2DM; examined if increased physical activity was related to improvements in cardiovascular health, glycemic control, and lipid profiles	Steps/day BMI Heart rate and blood pressure Blood glucose Total cholesterol HDL/LDL cholesterol Triglycerides HbA1c	− Compliance; recording daily steps in calendars began at 100% and dropped to 88% when group meetings were discontinued, then stabilized at 58% during the last 4 weeks + First Step Program group, approximately 3000 steps/day from baseline (p < .01) ↔ BMI and body weight (both groups) + Waist girth (improvement) ↔ Other indicators of cardiovascular fitness, glycemia or lipids (between groups)	22
Richardson et al.38 USA I RCT (pilot)	N = 30 (35 randomized); T2DM; 6-week study comparing two goal-setting strategies: (1) lifestyle goals targeting total daily accumulated steps and (2) structured goals targeting bout steps defined as walking that lasts for 10 min or longer at a pace of 60 steps/min, to determine which strategy was most effective in increasing bout steps	Increase in steps taken during previously defined bouts using automated Internet-based uploading-enhanced pedometers Satisfaction and adherence	+ Daily bout steps (in both groups); across groups, the average daily bout steps increased by 1921 ± 2729 + Satisfaction with the program (lifestyle goal group); all participants enjoyed tracking their steps with the pedometer + Adherence (lifestyle goal group more likely to use pedometer)	21
Araiza et al.41 USA I RCT	N = 30; effectiveness of accumulation of daily steps (10,000/day) for improving metabolic outcomes in patients with T2DM; 6-week intervention; the active group (N = 15) instructed to walk at least 10,000 steps/day, 5 or more days/week for 6 weeks	BMI, % body fat, waist circumference Blood pressure, resting energy expenditure HbA1c, fructosamine, fasting plasma glucose, insulin, and lipids Total radical antioxidant parameter, MDAd, plasminogen activator inhibitor 1 (PAI-1), homocysteine, lipoprotein (a) Serum total cholesterol, HDL-C, triglycerides	+ Active group increased steps/day (p = .002). ↔ Control group, no change in activity levels (p > .05) ↔ BMI, % body fat, HbA1c, blood pressure, or waist circumference, both groups (p > .05) + Measured REEd; active group (p = .014)	19

^aStudy details are listed according to level of evidence and in order of quality assessment score (Downs and Black). Study levels: I = RCT; II = cohort; III = case control; IV = case series.

^b↔ indicates no difference in health outcomes; + indicates improvements in health outcomes; and – indicates decline in health outcomes.

^cDowns and Black score ranges were given corresponding quality levels: excellent (26–28) and good (20–25). Studies that scored either in the fair (15–19) or poor (≤14) ranges were excluded, except where it was the only available evidence.

^dMDA, malondialdehyde; REE, resting energy expenditure