title: A systematic review of studies using pedometers as an intervention for musculoskeletal diseases.
abstract: BACKGROUND
  Physical activity (PA) plays an important role in the prevention and management of a number of chronic conditions.
  
  
  OBJECTIVE
  to investigate the evidence for effectiveness of pedometer-driven walking programs to promote physical activity among patients with musculoskeletal disorders (MSDs).
  
  
  METHODS
  A comprehensive systematic review was performed using 11 electronic databases up to 20 February 2014. Keywords and MeSH terms included "musculoskeletal disorders", "walking", and "pedometer". Randomized controlled trials, published in English, that examined the effects of a pedometer-based walking intervention to increase physical activity levels and improve physical function and pain in patients with musculoskeletal disorders were included.
  
  
  RESULTS
  Of the 1996 articles retrieved, seven studies ranging in date of publication from 1998 to 2013 met the inclusion criteria, allowing data extraction on 484 participants with an age range of 40 to 82 years. Interventions lasted from 4 weeks to 12 months and the results across studies showed significant increases in step count (p < 0.05) following the intervention. Across these studies, there was a mean increase in PA of 1950 steps per day relative to baseline. Four studies reported improved scores for pain and/or physical function at the intervention completion point relative to controls.
  
  
  CONCLUSIONS
  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. Further research should include larger sample sizes, and longer intervention durations are required to support the role of pedometer walking interventions as a long term intervention for management of musculoskeletal disorders.
authors.affiliation: School of Physiotherapy, University of Otago, Dunedin, New Zealand. almsu521@student.otago.ac.nz.
authors.forename: Suliman
authors.initials: S
authors.lastname: Mansi
authors.forename: Stephan
authors.initials: S
authors.lastname: Milosavljevic
authors.forename: G David
authors.initials: GD
authors.lastname: Baxter
authors.forename: Steve
authors.initials: S
authors.lastname: Tumilty
authors.forename: Paul
authors.initials: P
authors.lastname: Hendrick
mesh_terms: D056044:Actigraphy / Q000295:instrumentation*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D020127:Recovery of Function; D013997:Time Factors; D014159:Transducers; D016896:Treatment Outcome; D016138:Walking