Effect of pedometer use and goal setting on walking and functional status in overweight adults with multimorbidity: a crossover clinical trial.
BACKGROUND
Walking can improve functional status, and a pedometer and goal setting can increase walking and, potentially, gait speed. The efficacy of pedometer use and goal setting for increasing step counts among overweight and obese adults with multiple comorbid conditions has not been evaluated.


METHODS
We recruited and randomly assigned obese or overweight adults with multimorbidity to immediate pedometer use with goal setting or delayed pedometer use, using a crossover design. The primary outcome of interest was step count, with secondary outcomes of gait speed and grip strength, with comparison between the intervention and delayed pedometer groups.


RESULTS
Mean (standard deviation [SD]) age of the 130 participants was 63.4 (15.0) years. At 2 months, mean (SD) steps for the immediate pedometer use group (n=64) was 5,337 (3,096), compared with 4,446 (2,422) steps in the delayed pedometer group (n=66) (P=0.08). Within-group step count increased nonsignificantly, by 179 steps in the immediate pedometer group and 212 steps in the delayed pedometer group after 2 months of intervention, with no significant difference between the groups. Gait speed significantly increased by 0.08 m/s (P<0.05) and grip strength significantly increased by 1.6 kg (P<0.05) in the immediate pedometer group.


CONCLUSIONS
Pedometer use and goal setting did not significantly increase step count among overweight and obese adults with multimorbidity. The absolute step count was lower than many reported averages. Gait speed and grip strength increased with immediate pedometer use. The use of pedometers and goal setting may have an attenuated response in this population.
Division of Primary Care Internal Medicine.
Paul Y
PY
Takahashi
Division of Primary Care Internal Medicine.
Stephanie M
SM
Quigg
Division of Primary Care Internal Medicine.
Ivana T
IT
Croghan
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
Darrell R
DR
Schroeder
Division of Primary Care Internal Medicine.
Jon O
JO
Ebbert
D056044:Actigraphy / Q000295:instrumentation; D000368:Aged; D015897:Comorbidity; D018592:Cross-Over Studies; D015444:Exercise; D005260:Female; D000072936:Fitness Trackers / Q000706:statistics & numerical data*; D005684:Gait; D006040:Goals; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D018670:Monitoring, Ambulatory / Q000295:instrumentation; D009042:Motivation; D053580:Muscle Strength; D009765:Obesity / Q000503:physiopathology / Q000628:therapy*
chronic disease; gait speed; grip strength; muscle strength; obesity; pedometer; physical activity