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Abstract

A recommendation to walk 10,000 steps/day is widely promoted among populations. This study aimed to review scientific evidence of 10,000 steps walking. English language articles between years 2000-2016 were searched from online databases; MEDLINE, CINAHL, and Google Scholar. The search terms were " 10000 steps walking " AND " adults ". Seventeen primary studies were reviewed. The studies supported benefits of 10,000 steps/day on body compositions, blood pressure and serum lipid levels. A 10,000 steps/day walking was considered as an alternative recommendation on physical activity for public health which comparable with 150 minutes/week of moderate-intensity physical activity. Various approaches included prize reinforcement, using a step counter (pedometer), family-and community-based interventions could increase a number of steps. Applying any interventions to achieve the recommendation should consider about accessibility, appropriate duration, and continuity of those approaches.
Mini-Review 241
http://www.jhealthres.org J Health Res
vol.31 no.3 June 2017
EVIDENCE BEHIND 10,000 STEPS WALKING
Apichai Wattanapisit1, *, Sanhapan Thanamee2
1 School of Medicine, Walailak University, Nakhon Si Thammarat, 80161, Thailand
2 Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
ABSTRACT:
A recommendation to walk 10,000 steps/day is widely promoted among populations. This study aimed
to review scientific evidence of 10,000 steps walking. English language articles between years 2000-
2016 were searched from online databases; MEDLINE, CINAHL, and Google Scholar. The search terms
were “10000 steps walking” AND “adults”. Seventeen primary studies were reviewed. The studies
supported benefits of 10,000 steps/day on body compositions, blood pressure and serum lipid levels. A
10,000 steps/day walking was considered as an alternative recommendation on physical activity for
public health which comparable with 150 minutes/week of moderate-intensity physical activity.
Various approaches included prize reinforcement, using a step counter (pedometer), family- and
community-based interventions could increase a number of steps. Applying any interventions to
achieve the recommendation should consider about accessibility, appropriate duration, and continuity
of those approaches.
Keywords: Health benefits; Walking; 10,000 steps walking
DOI: Received: August 2016; Accepted: October 2016
INTRODUCTION
“Walking is man’s best medicine” is a quote
of Hippocrates [1]. It is also one of the effective
physical activities to reduce risks of non-
communicable diseases (NCDs) and to increase
health benefits [2, 3]. Globally, physical activity
guidelines recommend adults should participate in
regular physical activity (PA) which based on type,
intensity and duration of activities [4, 5]. Walking
can be a moderate-intensity PA which beneficial
to health [6]. Alternatively, step-based walking
recommendations from around the world are
emerging, and they are different in terms of amount
of steps per day or steps per week [7]. The numbers
of walking steps are translated as 1) ‘sedentary
lifestyle index’ (<5,000 steps/day); 2) ‘low active’
(5,000-7,499 steps/day); 3) ‘somewhat active
(7,500-9,999 steps/day); 4) ‘active’ (≥10,000
steps/day); and 5) ‘highly active’ (>12,500 steps/day)
[8]. As a physically active level, a 10,000 steps/day
walking becomes a commonly-acknowledged
* Correspondence to: Apichai Wattanapisit
E-mail: apichai.wa@wu.ac.th
goal for daily fitness across the world through media
[9, 10]. The target of achieving 10,000 steps/day
is widely recognised in Japan [8]. The 10,000
steps/day walking is approximately equivalent to
300 and 400 kcal/day of energy expenditure
(depending on walking speed and body size) [11].
The weekly energy expenditure from 10,000
steps/day for more than 3 days a week is comparable
with energy use of 30 minutes of moderate-intensity
PA on most days of the week which met a threshold
associated with significant reductions in
cardiovascular-related mortality (1,000 kcal/week)
[12-14].
According to the emerging evidence regarding
PA guidelines, moderate- to vigorous-intensity PA
(MVPA) is recommended to maintain and improve
cardiovascular functions; also reduce health-related
risks [4, 5]. The step-based walking is considered as
an appropriate approach to increase participation in
health-related PA [15]. However, the benefits of and
recommendations on a step-based walking approach
or 10,000 steps walking are still controversial.
This study reviewed the current evidence
toward benefits, recommendations on the step-based
walking and interventions to reach and maintain the
Cite this article as:
Wattanapisit A, Thanamee S. Evidence behind 10,000 steps walking. J Health Res. 2017; 31(3): 241-8.
DOI:
242
J Health Res
vol.31 no.3 June 2017 http://www.jhealthres.org
Figure 1 Searching results
daily goal of 10,000 steps per day. This review
consisted of both experimental and observational
studies to fulfil the gap of knowledge of the 10,000
steps walking. The findings of this study might be
the additional information and an alternative
recommendation on PA among adult populations.
METHODS
The online databases were searched from
MEDLINE, CINAHL, and Google Scholar on 20th
April 2016. The keywords comprised “10000 steps
walking” AND “adults”. Only English language
articles between years 2000-2016 were reviewed.
Secondary studies, including systematic and
narrative reviews, were excluded.
The 49 articles were found from the online
databases. Twenty-eight articles were excluded
based on titles and abstracts. Four systematic
reviews and narrative reviews were excluded. A
total of 17 articles were assessed (Figure 1).
RESULTS
Relevant studies
The relevant studies were shown in Table 1.
Benefits of 10,000 steps walking
Many studies investigated benefits of 10,000
steps walking on body compositions. A study in
adults, aged 20 to 70, represented a 3 cm loss in
waist circumference after 6 months of a 10,000
steps/day walking programme [22]. A longer
programme (9 months) showed significant
improvements in body weight (-2.4 kg), body mass
index (BMI) (-0.8 kg/m2), percentage body fat
(-1.9%), fat mass (-2.7 kg), waist circumference
(-1.8 cm), and hip circumference (-1.9 cm) [27].
Improvements of blood pressure were the
benefits which found in several studies. According
to a study among university students, a 6-week
10,000 steps/day walk could significantly reduce
systolic blood pressure (SBP) (120.00±15.62 mmHg
versus 111.75±9.80 mmHg; P=0.04) and diastolic
blood pressure (DBP) (79.00±8.23 mmHg versus
71.56±8.34 mmHg; P=0.04) [26]. Soroush et al. also
showed a significance of blood pressure
improvement (SBP and DBP decreased 5.57 and
4.03 mmHg every 3 months, respectively) among
adults aged 20 to 65 years after the 6 months of
10,000 steps/day walking [21].
For bone health, a 10,000-step daily walk was
sufficient to maintain bone mineral density (BMD)
in 49 to 64 years old adults [29]. Several studies
found significant improvements in blood tests [24,
27, 30]. High-density lipoprotein (HDL) increased
significantly (3 mg/dl) after a 36-week-10,000
steps/day walking [27]. This finding, an increase in
HDL, was similarly found in older Australians, aged
55 to 85 years [30]. Even a low-intensity exercise
which consisted of walking 10,000 steps three times
per week with any walking speed for 8 weeks could
elevate HDL and reduce low-density lipoprotein
(LDL) [24].
MEDLINE
CINAHL
Google Scholar
“10000 steps walking” AND
“adults”
49 articles were published
between 2000 and 2016
17 research articles were
reviewed
28 articles were excluded based
on titles and abstracts
4 articles were review articles
243
Table 1 Relevant studies
Titles
Author(s)
Year of
publication
Study design
Sample size
Summary
1. A pilot randomised controlled trial evaluating motivationally
matched pedometer feedback to increase physical activity
behaviour in older adults [16]
Strath et al.
2011
Randomised
controlled trial
81
A pedometer feedback intervention with
individually matched motivational messaging
was an effective intervention strategy to
increase PA behaviour.
2. Short-term effects of using pedometers to increase daily physical
activity in smokers: a randomised trial [17]
Kovelis et al.
2012
Randomised
controlled trial
76
Physically inactive smokers improved their
daily physical activity level by using a
pedometer.
3. A randomised study of reinforcing ambulatory exercise in older
adults [18]
Petry et al.
2013
Randomised
controlled trial
45
The participants in the reinforcement
condition walked an average of about 2,000
more steps/day than participants in the
control condition.
4. A randomised controlled trial of continuous activity, short bouts,
and a 10,000 step guideline in inactive adults [19]
Samuels et al.
2011
Randomised
controlled trial
43
A 10,000 steps/day recommendation could
increase the largest step counts compared to
a continuous 30 minutes/day and an
accumulating the total of 30 minutes/day
recommendation.
5. Effects of "10,000 steps Ghent": a whole-community intervention
[20]
De Cocker et al.
2007
Non-randomised
controlled
1,682
Multiple strategies using a central theme of
10,000 steps/day could increase PA levels.
6. Effects of a 6-month walking study on blood pressure and
cardiorespiratory fitness in U.S. and Swedish adults: ASUKI Step
Study [21]
Soroush et al.
2013
Non-randomised
controlled
355
Walking more than 10,000 steps/day
approached a significance for changes in
systolic blood pressure.
7. U.S. cohort differences in body composition outcomes of a
6-month pedometer-based physical activity intervention: the
ASUKI Step Study [22]
Walker et al.
2014
Non-randomised
controlled
142
A 10,000 steps/day walking programme
changed the body composition measures.
8. Maintaining high activity levels in sedentary adults with a
reinforcement-thinning schedule [23]
Andrade et al.
2014
Non-randomised
controlled
61
Monitoring plus reinforcement-thinning
schedule could increase the number of
walking steps.
9. Low-intensity exercise exerts beneficial effects on plasma lipids
via PPARγ [24]
Butcher et al.
2008
Non-randomised
controlled
34
The exercise programme (walking) could
significantly decrease total cholesterol and
increase high-density lipoprotein (HDL).
Table 1 Relevant studies (cont.)
Titles
Author(s)
Year of
publication
Study design
Sample size
Summary
10. The effect of two different health messages on physical activity
levels and health in sedentary overweight, middle-aged women
[25]
Pal et al.
2011
Non-randomised
controlled
32
A 10,000 steps/day guideline was more
effective than a 30 minutes/day walking for
increasing the number of steps.
11. UNISTEP (university students exercise and physical activity)
study: a pilot study of the effects of accumulating 10,000 steps on
health and fitness among university students [26]
Tully et al.
2011
Non-randomised
controlled
31
A 10,000 steps/day walking might be an
appropriate intervention in sedentary
university students to increase PA.
12. Effects of a 10,000 steps per day goal in overweight adults [27]
Schneider et al.
2006
Before-and-after
interventional
56
A 10,000 steps/day walking resulted in
weight loss over 36 weeks in previously
sedentary, overweight/obese adults.
13. Walking to meet physical activity guidelines in knee
osteoarthritis: is 10,000 steps enough? [28]
White et al.
2013
Cohort
1,788
The analysis supported 7,910 steps/day (for
men) and 9,040 steps/day (for women) as
optimal steps/day cut-points, and 100
steps/minute was considered as a moderate-
intensity PA.
14. Maintaining femoral bone density in adults: how many steps per
day are enough? [29]
Bowyer et al.
2011
Cohort
105
A walking speed greater than 1.32 m/s for
10,000 steps/day was sufficient to maintain
a healthy bone mineral density.
15. How many steps are enough? Dose-response curves for
pedometer steps and multiple health markers in a community-
based sample of older Australians [30]
Ewald et al.
2014
Cross-sectional
2,458
Most of the health benefit was achieved by
8,000 steps/day.
16. Steps per day required for meeting physical activity guidelines in
Japanese adults [31]
Cao et al.
2014
Cross-sectional
940
A 7,700-8,000 steps/day walking was
comparable with 150 minutes/week MVPA.
17. Achieving the daily step goal of 10,000 steps: the experience of a
Canadian family attached to pedometers [32]
Choi et al.
2007
Cross-sectional
4
‘Get off the chair’ was emphasised to meet
the daily step goals.
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Recommendations on 10,000 steps walking
among adult population
As the global recommendations on PA, adults
should have at least 150 minutes/week of MVPA [5].
To compare with the time-based recommendations,
Cao et al. investigated the optimal steps per day
needed to meet the current PA recommendations by
using accelerometer-based monitoring [31]. This
study recruited 940 adults (460 men and 480
women), aged between 20 and 69 years, in Japan.
The analysis consisted of linear regression analysis,
and the results showed overall population needed
7,716 steps/day to meet the recommendation, 150
minutes/week of MVPA [31]. Men needed a slightly
lower number of steps per day to meet the
recommendation compared with women (7,523
steps/day versus 7,905 steps/day) [31]. According to
the study of Cao et al., 10,000 steps/day walking
extended beyond the recommended number of steps.
To meet the PA recommendations, in terms of
quality, walking at greater than 100 steps/minute
was considered as a moderate-intensity PA [28]. For
quantity, although both step-based and time-based
goals could elevate the number of walking steps, a
step-based achievement was more effective than a
time-based achievement to reach a 10,000 steps/day
goal. The studies showed that a 10,000 steps/day
goal could increase more walking steps compared to
30 minutes/day recommendations [19, 25].
Interventions to reach and maintain 10,000 steps
walking
Meeting a 10,000-step per day goal in public
health needed specific interventions. Previous studies
investigated outcomes of prize reinforcement
systems, including monetary prize; gift cards; food
items; and clothing, for increasing steps per day to
10,000 steps [18, 23]. One study recruited sedentary
adults, aged 18 years and over, and the participants
were encouraged to achieve 10,000 steps/day over
12 weeks of the programme. The subjects who
participated in the prize reinforcement system had
the potential to maintain a higher rate of ambulatory
activities compared to the control group [23]. In
sedentary older adults with mild to moderate
hypertension, the prize reinforcement interventions
showed the similar trend that the programme could
increase the participants’ walking steps compared to
the control group after a 12-week intervention [18].
Using a pedometer as objective monitoring
could have a positive effect in increasing walking
steps to reach a level of 10,000 steps/day. This
approach represented a positive finding that using a
pedometer in inactive cigarette smokers for 1 month
could significantly increase steps/day of the
participants from 7,670 (6,159-9,402) steps/day
to 10,310 (9,483-11,110) steps/day (P<0.001) [17].
To increase effectiveness of using a pedometer,
individualised motivational feedback and
motivational feedback plus telephone feedback
could increase on average 1,684 steps/day (P<0.001)
and 2,013 steps/day (P<0.001), respectively,
compared to using only a pedometer after a 12-week
intervention [16].
An intervention, ‘get off the chair’ campaign,
for a whole family, including walking at brisk pace;
grocery shopping, window shopping in a shopping
centre; going to an entertainment centre; and
attending parties might be an effective approach to
increase daily steps [32]. For a community-based
intervention, multiple strategies consisted of local
media campaign, environmental approaches,
pedometer sale and loan services, and local PA
projects were implemented in Ghent, Belgium, and
its results showed an 8% increase in the number of
people reaching 10,000 steps/day after one year
intervention [20].
DISCUSSION
The recent studies found a wide range of 10,000
steps/day walking benefits. Body compositions,
blood pressure, and lipid profiles were commonly
positive findings in those studies. Benefits of
interventions were found in various age groups
from young to older adults. Moreover, a 10,000
steps/day walking at greater than 100 steps/minute
could be an appropriate level to achieve the current
PA recommendations. Recommendations regarding
10,000 steps goal should specify the exact number
of steps rather than the amount of time. The evidence
supported interventions included prize reinforcement,
using a pedometer with or without individualised
feedback, encouraging to increase steps/day
in family, and multistrategy community-based
intervention were effective schemes to reach and
maintain 10,000 steps walking.
Walking was considered as a popular,
acceptable, and accessible PA among populations
[15, 33]. Many studies showed positive outcomes of
10,000-step/day walking in sedentary or physically
inactive populations [24, 26]. Additionally, in
general populations, many benefits on health were
found [21, 22, 34]. On the other hand, increasing PA
raised musculoskeletal injury risks [35], however,
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walking was a low-risk PA (minor injury and low
injury rates) [36].
Reaching the step-based recommendation
might need an instrument such as pedometer to
measure the objective data [37]. Using a pedometer,
especially a traditional pedometer, was limited by
several factors [38, 39]. Presently, smartphone
pedometer applications could be substitutions of
traditional pedometers in the free-living setting [40].
Nevertheless, accuracy among different smartphone
pedometer applications was still controversial [41].
The key to success of any 10,000 steps/day
interventions might include an appropriate duration
and continuity of interventions. The previous studies
showed that the number of steps per day decreased
by time after interventions [18, 23]. Increasing
accessibility to interventions, such as building PA
friendly environment, also was a supportive factor
to achieve the goal [20].
Barriers to achieving 10,000 steps per day
included several layers based on the social
ecological model [42]. Functional limitations and
low self-efficacy were individual barriers. For
environmental issues, lack of perceive and actual
environmental supports for walking were also
obstacles. In addition, unsupportive regional and
community policies could be considered as barriers
to achieve the 10,000 steps walking [43].
The strengths of this study were the coverage of
recently primary evidence and comparison between
a 10,000 steps/day approach and time-based PA
recommendations. However, this study was a
narrative review which not summarised statistics of
all studies. Another weakness was using the
expansive search terms which leading to nonspecific
and missing data.
In summary, a 10,000 steps/day walk should be
promoted to populations, especially in physically
inactive populations. Beyond the scope of this study,
any health promotion campaigns in the future should
consider behavioural and motivational aspects to
meet this step-based goal [44].
CONCLUSIONS
The recent studies support benefits of 10,000
steps/day on body compositions, blood pressure and
serum lipid levels. A 10,000 steps/day walking is
considered as an alternative recommendation on PA
for public health. Various approaches included prize
reinforcement, using a pedometer, family- and
community-based interventions can increase a
number of steps to meet the step-based goal.
Applying any interventions to achieve the
recommendation should consider about
accessibility, appropriate duration, and continuity of
those approaches.
CONFLICT OF INTERESTS
The authors declare that there is no conflict of
interests regarding the publication of this article.
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... The average daily steps for Waves 1, 2, 3, and 4 are 16,861, 13,205, 14,736, and 13,297, respectively. There were three female participants with average daily steps fewer than 10,000 steps-a conventional threshold for inactive lifestyle [43,44]-in Wave 1, five females and two males with average daily steps fewer than 10,000 steps in Wave 2, and four females in Wave 3 and six females in Wave 4 with average daily steps fewer than 10,000. Table 2 summarizes the size of activity space and counts of daily steps by gender for each wave. ...
... Our findings are consistent with the previous studies on labor division in Lao PDR [50]. Surprisingly, despite walking being the most frequent travel mode in the study area, there are still a few participants with daily steps fewer than 10,000, an important indicator for an active lifestyle [43,44]. One explanation, as shown in Table 4, is that both male and female participants spent more than one-third of their day on sedentary or lowlevel physical activities, such as chatting, resting, drinking or eating. ...
Article
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Background Southeast Asia is experiencing a health transition, where non-communicable diseases (NCD) are exceeding communicable diseases. Despite NCDs accounting for roughly 60–85% of deaths in the region, many developing Southeast Asian countries are beginning to address the impacts of a physically inactive lifestyle for the first time. Our study aims to bridge this gap by objectively measuring physical activity in rural Lao PDR to reveal the association among physical activity, activity space, and seasonal variation. Methods Multiple waves of survey data were collected in Songkhon District, Lao PDR between March 2010 and March 2011. Adults aged between 18 and 65 were recruited ( n = 48). A portable GPS recorded participants’ activity and farmland locations and an accelerometer recorded participants’ physical activity level and daily steps for seven consecutive days. Using a directional distribution tool in ArcGIS 10.5, the activity space area of each participant in each wave was calculated. Concurrently, participants recorded time spent on each daytime activity. Linear mixed models with the fixed effects as the observations from different waves and the random effects as individual participants were developed to identify factors associated with areas of activity space and counts of daily steps, respectively. Results A total of 48 respondents aged between 19 and 57 took part in the study. Half of the participants were females. Walking was found to be the most frequent travel mode. Females were physically less active, with a smaller activity space, and were more overweight than the males in the study. Participants were physically less active during the off-farming seasons. Conclusions Findings contribute to the surveillance of risk factors needed to create healthy living environments. Our research is also one of the first to use empirical evidence demonstrating seasonal variations of rural residents’ activities in mainland Southeast Asia.
... Steps were used as one of the assessment types for determining SB in 11 studies. The consensus is that taking 10,000 steps per day is necessary for health (Wattanapisit et al., 2017). Dixon-Ibarra et al. (2013) showed that 10% (n=4) of 18-49year-old adults with ID and 3% (n=1) of 50+-year-old adults with ID achieved the recommended 10,000 steps per day however the sample size who attained this level of activity is small so not generalisable and does conjure up the question if this level of steps is attainable for all those with ID.. Another study showed that 3 people (15%) had >= 10,000 steps/day, while several had <5000 steps per day, which according to some experts is indicative of a sedentary lifestyle. ...
Article
This literature review was designed to establish the effects of sedentary behaviour on the physical health of adults with an intellectual disability. Sedentary behaviour is defined as any waking behaviour characterized by an energy expenditure of ≤1.5 METs while in a sitting, lying or reclining posture. An extensive search was executed in six databases: EMBASE, Medline, CINAHL, PsycINFO, ASSIA and Web of Science. Following screening, 18 articles remained for inclusion in the review. A thematic analysis using the Braun and Clarke six step process resulted in the identification of seven broad health areas. Studies showed a prevalence of obesity, multimorbidity and metabolic syndrome as well as elevated levels of sedentary behaviour in adults with an intellectual disability. This literature review demonstrated that sedentary behaviour could be a contributor to the poor health which is common in adults with an intellectual disability. However to date the body of evidence does not confirm a cause-and-effect relationship.
... Participants were discharged from hospitals after critical care admissions and significant deconditioning, and step counts were well below those of active adults (8000 to 10,000 steps per day) [32,33] and those found to be associated with a decreased risk of all-cause mortality [34]. Capturing this trajectory of improvement via the smartwatches provided data that suggest physiological recovery and are reassuring for patients with severe illness. ...
Article
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Background: As a sequelae of the COVID-19 pandemic, a large cohort of critical illness survivors have had to recover in the context of ongoing societal restrictions. Objective: To employ smartwatches (Fitbit Charge 3) to assess changes in step count and heart rate of critical care survivors following admission with COVID-19; use these devices within a remote multidisciplinary team (MDT) setting to support patient recovery, and report on our experience of this. Methods: A prospective multi-centre observational trial in eight UK critical care units. 50 participants with moderate or severe lung injury as a result of confirmed COVID-19 disease were recruited at discharge from critical care and given a smartwatch (Fitbit Charge 3) between April-June 2020. Data collected included step count and daily resting heart rate (HR). A subgroup of the overall cohort at one site, the'MDT site'(n=19), had their smartwatch data used to inform a regular MDT meeting. The use of a patient feedback questionnaire and direct feedback from the MDT was used to report our experience. Participants that did not upload smartwatch data were excluded from analysis. Results: From the 50 participants recruited, 35 (70%) used and uploaded data from their smartwatch during the 1 year period. At the MDT site 74% (n=14/19) of users uploaded data from compared with 68% (n=21) at the control sites. The overall cohort recorded a mean increase of 4359 (3488) steps per day in the first month following discharge, to 7914(4146) steps at 1 year (P=.003). HR reduced from a mean of 79 (7) beats per minute in the first month to 69 (4) at one year following discharge (P<.001). The MDT subgroup increased mean step count by more than the control group (176% vs 42%, +5474 vs +2181 steps, P=.04) over the 1 year. Of smartwatch users at the MDT site compared with control sites, 71% (n=10/14) vs 48% (n=10/21) strongly agreed that their Fitbit motivated them to recover and 86% (n=12/14) vs 48% (n=10/21) strongly agreed they aimed increase their activity levels over time. Conclusions: This is the first study to report 1-year recovery of patients who survived COVID-19 critical illness using smartwatch technology and report their use within the post critical care MDT. Future work could explore the role of smartwatches as part of a randomised controlled trial to assess clinical and economic effectiveness. International registered report: RR2-https://doi.org/10.12968/ijtr.2020.0102.
... Among tertiary level students, female students were found to have less engagement in physical activities compared to male students [20][21][22], as the female students often had lower motivation compared to male students [23]. This could potentially explain their failure in achieving the target of 10,000 steps daily, approximately similar to 150 minutes/week of moderate-intensity physical activity as recommended in several studies [24][25][26][27]. ...
Article
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Introduction The decreasing level of physical activity among female undergraduates is worrying as it is associated with the increased risk of non-communicable diseases. Thus, this study aimed to identify the motivations, barriers and preferences towards exercise among female undergraduates in Malaysia. Methods A non-probability purposive sampling was used for the recruitment process. The inclusion criteria of the participants were registered female undergraduates and aged between 18–30 years old. A semi-structured in-depth interview was used to collect topic-related information from the participants and signed consents were obtained prior to the interview. The interview questions were on respondents’ understanding of exercise, motivation and barriers to exercise, and exercise preferences. The recruitment process was conducted until the data was saturated. All interviews were audio recorded and manually transcribed verbatim. NVivo 11 was used to conduct the inductive analysis of the data to develop themes for motivation and barriers to exercise. For exercise preferences, four predetermined themes were used. Findings A total of 26 respondents participated in this study. Eight themes were found for motivation to exercise, with the most common themes being maintaining or improving appearance, health benefits and togetherness. For barriers of exercising, five themes were found, and the most common ones were disliking exercise and no motivation. For exercise preferences, most respondents preferred a structured exercise program with flexibility in terms of when and where the exercise could be conducted. Light or moderate intensity exercise for 10–30 minutes with a frequency of 1–2 times a week was desired the most among the respondents. Conclusion In conclusion, personal and environmental factors play important roles in motivating or hampering female undergraduates to exercise, and a structured program was the preferred mode of exercise of these respondents. A new exercise module was designed based on this needs assessment with a 70% acceptance rate among the participants. These findings can help the future development of more exercise modules tailored to female university students.
... The general goal of walking 10,000 steps daily has been widely adopted by the fitness industry, fitness tracking devices and the population in general (Brody & Burn, 2015). Notably, peer reviewed evidence also indicates positive health benefit for body composition, lipid levels and blood pressure improvements (Wattanapisit & Thanamee, 2017) occur with this level of activity. ...
Article
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The aim of this study was to assess changes in mental health and wellbeing measures across a 50-day physical activity workplace program. The secondary aims assessed the relationship between demographic and pre-program physical activity self-reported variables, mental health, wellbeing and program engagement measures. The study utilized a naturalistic longitudinal design with a study population of 2903 people. Participants were engaged in the 10,000 step daily physical activity program for 50-days and measures of engagement were tracked. 1320 participants provided full pre/post-program data across a range of standardized mental health and wellbeing measures alongside demographic and program engagement measures. For individuals providing pre and post program data there was a significant reduction in anxiety (18.2%, p = .008), stress (13.0%, p = .014) and sleep related impairment (6.9%, p < .001) alongside a significant improvement in overall wellbeing (6.7%, p = .001). The data further showed no significant mental health differences were identified between individuals who recorded below versus equal to or above 10,000 steps. Regression analyses indicated numerous group and personal variables impacted mental health, wellbeing and program engagement. The study highlights improvements in a range of mental health and wellbeing scores occurred over the 50-day activity program for people who complete the program. Finally, the study identified a range of protective and risk factors for mental health benefits of these programs and level of engagement. Whilst there were similarities in the pre-program mental health and wellbeing scores of those who completed and those lost to follow-up, further research is required to better characterize and understand this group.
... This activity will involve users pointing their smartphone camera at nearby points of interest and then the developed AI model will infer the object as shown in Figure 2. If the correct object is scanned above the 85% threshold accuracy then the location has been found and the user earns a point. 1) Physical activity: The app uses the phone's built in accelerometer to calculate and display the number of steps taken by the user while playing the game to encourage physical activity as many people aim to walk 10,000 steps each day [32]. To ensure players are walking towards the hidden locations, as they approach a location text in the center of the screen will alert the user that they are getting closer, encouraging them to continue walking in order to find the location. ...
Conference Paper
An exergame is a genre of gaming that combinesexercising with digital game play. The ubiquity of mobile devicesmake them ideal platforms for these games to promote physicalactivities. Advances in Internet of Things (IoT) technologiesincluding Bluetooth Low Energy (BLE) beacons can be utilisedfor proximity detection to promote physical activities and the useof Artificial Intelligence (AI) in the form of object recognitioncan accelerate engagement with location-based pervasive games.Therefore, we have designed, implemented, and tested a casualexergame in the form of a treasure hunt that provides theapproximate location of nearby points of interest in real-timewithin the vicinity of Bluetooth beacons. The system exploits thesignal strength of the BLE beacons to measure proximity whichmakes it suitable for outdoor and indoor functioning where GPSsignals are not accessible. Our preliminary results show that IoTtechnology can be successfully utilised for proximity detectionwith sufficient accuracy. In addition the adoption of AI andCamera challenges has offered an active gaming experience andmediated playful experiences for large spaces.
... The participants were also asked to walk around 7000 steps per day at the beginning of the program, gradually increasing to >10,000 steps towards the end of the intervention. There is sufficient evidence to prove that such an approach is beneficial to health [28]. ...
Article
Full-text available
A wearable activity tracker (WAT) incorporated with behavioral change techniques (BCTs) increases physical activity in younger adults; however, its effectiveness with frail older adults is unknown. The feasibility and preliminary effects of a WAT-based exercise intervention to increase physical activity levels in frail older adults was investigated in this pilot study involving 40 community-dwelling frail older adults. The experimental group received a 14-week WAT-based group exercise intervention and a 3-month follow-up, while the control group only received similar physical training and all BCTs. The recruitment rate was 93%, and the average attendance rate was 85.2% and 82.2% in the WAT and control groups, respectively, establishing feasibility. Adherence to wearing the WAT was 94.2% and 92% during the intervention and follow-up periods, respectively. A significant interaction effect between time and group was found in all physical assessments, possibly lasting for 3 months post-intervention. However, no significant difference between groups was observed in any daily activity level by the ActiGraph measurement. The majority of the WAT group’s ActiGraph measurements reverted to baseline levels at the 1-month follow-up. Thus, the WAT-based exercise program has potential for employment among community-dwelling frail older adults, but sustaining the effects after the intervention remains a major challenge.
... The results highlight the importance of physical activity as a target for diabetes prevention, and the potential for policy interventions that promote walking to reduce the burden and costs of diabetes. Other studies have demonstrated the benefits of walking on blood pressure, serum lipid levels, and weight loss [28]. Physical activity targets have been established around the world, for example, member states of the World Health Organization have agreed to a 10% relative reduction in the prevalence of insufficient physical activity, defined as less than 150 min of moderate-intensity activity per week, by 2025 [6]. ...
Article
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Promoting adequate levels of physical activity in the population is important for diabetes prevention. However, the scale needed to achieve tangible population benefits is unclear. We aimed to estimate the public health impact of increases in walking as a means of diabetes prevention and health care cost savings attributable to diabetes. We applied the validated Diabetes Population Risk Tool (DPoRT) to the 2015/16 Canadian Community Health Survey for adults aged 18–64, living in the Greater Toronto and Hamilton area, Ontario, Canada. DPoRT was used to generate three population-level scenarios involving increases in walking among individuals with low physical activity levels, low daily step counts and high dependency on non-active forms of travel, compared to a baseline scenario (no change in walking rates). We estimated number of diabetes cases prevented and health care costs saved in each scenario compared with the baseline. Each of the three scenarios predicted a considerable reduction in diabetes and related health care cost savings. In order of impact, the largest population benefits were predicted from targeting populations with low physical activity levels, low daily step counts, and non active transport use. Population increases of walking by 25 min each week was predicted to prevent up to 10.4 thousand diabetes cases and generate CAD 74.4 million in health care cost savings in 10 years. Diabetes reductions and cost savings were projected to be higher if increases of 150 min of walking per week could be achieved at the population-level (up to 54.3 thousand diabetes cases prevented and CAD 386.9 million in health care cost savings). Policy, programming, and community designs that achieve modest increases in population walking could translate to meaningful reductions in the diabetes burden and cost savings to the health care system.
Article
Background : Sedentary behaviour (SB), which is characterised by low levels of energy expenditure, has been linked to increased cardio-metabolic risks, obesity and mortality, as well as cancer risk. No firm guidelines are established on safe levels of SB. Adults with an intellectual disability (ID) have poorer health than their counterparts in the general population with higher rates of multi-morbidity, inactivity, and obesity. The reasons for this health disparity are unclear however it is known that SB and overall inactivity contribute to poorer health. There is no clear picture of the levels of SB among individuals with ID therefore SB levels in this vulnerable population need to be examined. The aim of this systematic review is to investigate the prevalence of sedentary behaviour in adults with an ID. Methods : The PRISMA-P framework was applied to identify high quality articles. An extensive search was carried out in four databases and grey literature sources . In total, 1,972 articles were retrieved of which 48 articles went forward for full review after duplicate removal and screening by title and abstract. The National Institute of Health’s quality assessment tools were used to assess article quality. Two reviewers independently assessed each article. An excel spreadsheet was created to guide the data extraction process. The final review included 25 articles. A meta-analysis was completed using REVMAN. Results : Different SB assessment types were identified in studies. These included steps, time, questionnaires, and screen time. Studies were heterogeneous. Observed daily steps per individual ranged from 44 to above 30,000, with an average of approximately 6,500 steps. Mean daily time spent in SBs was more than 60% of available time, with observed screen time of more than 3 hours. Conclusion : There is a high prevalence of SB in adults with an intellectual disability. [Registration no: Index CRD42020177225].
Article
Background : Sedentary behaviour (SB), which is characterised by low levels of energy expenditure, has been linked to increased cardio-metabolic risks, obesity and mortality, as well as cancer risk. No firm guidelines are established on safe levels of SB. Adults with an intellectual disability (ID) have poorer health than their counterparts in the general population with higher rates of multi-morbidity, inactivity, and obesity. The reasons for this health disparity are unclear however it is known that SB and overall inactivity contribute to poorer health. There is no clear picture of the levels of SB among individuals with ID therefore SB levels in this vulnerable population need to be examined. The aim of this systematic review is to investigate the prevalence of sedentary behaviour in adults with an ID. Methods : The PRISMA-P framework was applied to identify high quality articles. An extensive search was carried out in four databases and grey literature sources . In total, 1,972 articles were retrieved of which 48 articles went forward for full review after duplicate removal and screening by title and abstract. The National Institute of Health’s quality assessment tools were used to assess article quality. Two reviewers independently assessed each article. An excel spreadsheet was created to guide the data extraction process. The final review included 25 articles. A meta-analysis was completed using REVMAN. Results : Different SB assessment types were identified in studies. These included steps, time, questionnaires, and screen time. Studies were heterogeneous. Observed daily steps per individual ranged from 44 to above 30,000, with an average of approximately 6,500 steps. Mean daily time spent in SBs was more than 60% of available time, with observed screen time of more than 3 hours. Conclusion : There is a high prevalence of SB in adults with an intellectual disability. [Registration no: Index CRD42020177225].
Article
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[Purpose] The effectiveness of a smartphone pedometer application was compared with that of a traditional pedometer for improving the physical activity and weight status of community-dwelling older adults. [Subjects and Methods] This study had a nonequivalent pretest-posttest control group design. Ninety-seven older adults (mean age ± SD, 60.1 ± 5.5 years) joined the smartphone pedometer group and underwent a 2-week walking intervention based on a smartphone pedometer application. Fifty-four older adults (mean age ± SD, 65.3 ± 8.7 years) joined the traditional pedometer group and underwent a 2-week walking intervention based on a traditional pedometer. The participants’ physical activity was evaluated using the International Physical Activity Questionnaire–Short Form, and their weight status was quantified by calculating the body mass index. The daily pedometer count was also documented. [Results] No significant time, group, or time-by-group interaction effects were found for any of the outcome variables. However, trends of improvement in physical activity and body mass index were seen only in the smartphone pedometer group. [Conclusion] A smartphone pedometer application might be more favorable than a traditional pedometer in improving physical activity and body mass index in community-dwelling older adults. However, further experimental studies are necessary to confirm the results.
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This study examines the accuracy of three popular, free Android-based pedometer applications (apps), namely, Runtastic (RT), Pacer Works (PW), and Tayutau (TY) in laboratory and free-living settings. Forty-eight adults (22.5 ± 1.4 years) completed 3-min bouts of treadmill walking at five incremental speeds while carrying a test smartphone installed with the three apps. Experiment was repeated thrice, with the smartphone placed either in the pants pockets, at waist level, or secured to the left arm by an armband. The actual step count was manually counted by a tally counter. In the free-living setting, each of the 44 participants (21.9 ± 1.6 years) carried a smartphone with installed apps and a reference pedometer (Yamax Digi-Walker CW700) for 7 consecutive days. Results showed that TY produced the lowest mean absolute percent error (APE 6.7%) and was the only app with acceptable accuracy in counting steps in a laboratory setting. RT consistently underestimated steps with APE of 16.8% in the laboratory. PW significantly underestimated steps when the smartphone was secured to the arm, but overestimated under other conditions (APE 19.7%). TY was the most accurate app in counting steps in a laboratory setting with the lowest APE of 6.7%. In the free-living setting, the APE relative to the reference pedometer was 16.6%, 18.0%, and 16.8% for RT, PW, and TY, respectively. None of the three apps counted steps accurately in the free-living setting.
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This study examined sources of variability in habitual physical activity of children, and the minimum number of days required for estimating children's habitual physical activity levels using pedometers. A total of 31 children wore two pedometers during five weekdays and four weekend days. A two random facet completely crossed design was conducted with two-way analysis of variances across weekdays, weekends, and weekdays and weekend days combined. Moderate/high generalizability coefficients were estimated across all days. Primary sources of variability were variance components of the person and person by day interaction. Minimum numbers of days required for estimating habitual physical activity levels using a pedometer were five during weekdays. However, estimating habitual physical activity levels during weekends, and weekdays and weekend days combined was impractical.
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Background Physical activity (PA) offers numerous benefits to health and well-being, but most adults are not sufficiently physically active to afford such benefits. The 10,000 steps campaign has been a popular and effective approach to promote PA. The Transtheoretical Model posits that individuals have varying levels of readiness for health behavior change, known as Stages of Change (Precontemplation, Contemplation, Preparation, Action, and Maintenance). Few validated assessment instruments are available for determining Stages of Change in relation to the PA goal of 10,000 steps per day. The purpose of this study was to assess the criterion-related validity of the SoC-Step, a brief 10,000 steps per day Stages of Change instrument. Methods Participants were 504 Australian adults (176 males, 328 females, mean age = 50.8 ± 13.0 years) from the baseline sample of the Walk 2.0 randomized controlled trial. Measures included 7-day accelerometry (Actigraph GT3X), height, weight, and self-reported intention, self-efficacy, and SoC-Step: Stages of Change relative to achieving 10,000 steps per day. Kruskal-Wallis H tests with pairwise comparisons were used to determine whether participants differed by stage, according to steps per day, general health, body mass index, intention, and self-efficacy to achieve 10,000 steps per day. Binary logistic regression was used to test the hypothesis that participants in Maintenance or Action stages would have greater likelihood of meeting the 10,000 steps goal, in comparison to participants in the other three stages. Results Consistent with study hypotheses, participants in Precontemplation had significantly lower intention scores than those in Contemplation (p = 0.003) or Preparation (p < 0.001). Participants in Action or Maintenance stages were more likely to achieve ≥10,000 steps per day (OR = 3.11; 95 % CI = 1.66,5.83) compared to those in Precontemplation, Contemplation, or Preparation. Intention (p < 0.001) and self-efficacy (p < 0.001) to achieve 10,000 steps daily differed by stage, and participants in the Maintenance stage had higher general health status and lower body mass index than those in Precontemplation, Contemplation and Preparation stages (p < 0.05). Conclusions This brief SoC-Step instrument appears to have good criterion-related validity for determining Stages of Change related to the public health goal of 10,000 steps per day. Trial registration Australian New Zealand Clinical Trials Registry reference: ACTRN12611000157976 World Health Organization Universal Trial Number: U111-1119-1755 Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2539-y) contains supplementary material, which is available to authorized users.
Article
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Regular physical activity (PA) enhances health and is an important factor in disease prevention and longevity. The 2008 U.S. Physical Activity Guidelines recommends that all healthy adults attain at least 150 minutes per week of moderate intensity aerobic PA (e.g., brisk walking) to maintain and promote PA. This study determined the effects of a 6-month pedometer-based worksite walking intervention with participants focusing on a goal of achieving 10,000 steps per day, on body composition in adults with a wide range of body mass index (BMI) values and compares the changes with outcomes of similar studies. The design was a single group, quasi-experimental study. All participants received a pedometer and were asked to register the daily number of steps. Men and women (n = 142; age = 41 ± 11.5 years; BMI = 27.2 ± 7.25 kg.m(-2)) received body composition measures at 1, 3, and 6 months. A multilevel growth modeling approach was used to explore change over time and to predict change by steps, age, gender, and fat category categorized as normal and overweight/obese. Significant individual differences in linear slopes and change over time were observed for waist circumference (WC) (-3.0 cm) only in unconditional model (t = -0.67, P = 0.02). A 3.0 cm loss in WC shows that a 10,000 step per day walking program has the potential to influence changes in body composition measures that are correlated with adverse health outcomes. While significant changes did occur there are some limitations. The analysis did not consider the data regarding completing of 10,000 steps per day and other potential factors that could influence the results. Compliance to the walking dose and initial physical activity and body composition levels are important to consider when studying body composition changes in such programs.
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Objective To assess the health benefits of outdoor walking groups. Design Systematic review and meta-analysis of walking group interventions examining differences in commonly used physiological, psychological and well-being outcomes between baseline and intervention end. Data sources Seven electronic databases, clinical trial registers, grey literature and reference lists in English language up to November 2013. Eligibility criteria Adults, group walking outdoors with outcomes directly attributable to the walking intervention. Results Forty-two studies were identified involving 1843 participants. There is evidence that walking groups have wide-ranging health benefits. Meta-analysis showed statistically significant reductions in mean difference for systolic blood pressure −3.72 mm Hg (−5.28 to −2.17) and diastolic blood pressure −3.14 mm Hg (−4.15 to −2.13); resting heart rate −2.88 bpm (−4.13 to −1.64); body fat −1.31% (−2.10 to −0.52), body mass index −0.71 kg/m2 (−1.19 to −0.23), total cholesterol −0.11 mmol/L (−0.22 to −0.01) and statistically significant mean increases in VO2max of 2.66 mL/kg/min (1.67–3.65), the SF-36 (physical functioning) score 6.02 (0.51 to 11.53) and a 6 min walk time of 79.6 m (53.37–105.84). A standardised mean difference showed a reduction in depression scores with an effect size of −0.67 (−0.97 to −0.38). The evidence was less clear for other outcomes such as waist circumference fasting glucose, SF-36 (mental health) and serum lipids such as high-density lipids. There were no notable adverse side effects reported in any of the studies. Conclusions Walking groups are effective and safe with good adherence and wide-ranging health benefits. They could be a promising intervention as an adjunct to other healthcare or as a proactive health-promoting activity.
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This study aimed to determine the optimal number of steps per day needed to meet the current physical activity guidelines in a large population sample of Japanese adults. An accelerometer-based activity monitor (Kenz Lifecorder) was used to simultaneously measure moderate-to vigorous-intensity physical activity (MVPA) and step counts in 940 Japanese adults (480 women) aged 20-69 y. The step count per day equivalents to two different physical activity recommendations (23 MET-h/wk and 150 min/wk of MVPA) were derived using linear regression analysis and receiver operating characteristic (ROC) methodology. Linear regression analysis showed that daily step counts correlated with weekly PAEE(r = 0.83) and daily minutes of MVPA (r = 0.83). Linear regression analysis also showed that 23MET-h/wk of MVPA is equivalent to 11,160steps/d, and 150 min/wk of MVPA is equivalent to 7,716 steps/d. ROC analysis yielded similar findings: 10,225 steps/dare required to accumulate≥23 MET-h/wk of MVPA and 7,857 steps/d are needed to meet the recommendation of ≥150 min/wk of MVPA. The findings suggest that 10,000-11,000and 7,700-8,000steps/d represent the optimal thresholds for accumulating ≥ 23 MET-h/wk of MVPA and ≥ 150 min/wk of MVPA, respectively, for Japanese adults.
Article
Objective: To conduct a systematic review and meta-analysis of randomised control trials that examined the effect of walking on risk factors for cardiovascular disease. Methods: Four electronic databases and reference lists were searched (Jan 1971-June 2012). Two authors identified randomised control trials of interventions ≥ 4 weeks in duration that included at least one group with walking as the only treatment and a no-exercise comparator group. Participants were inactive at baseline. Pooled results were reported as weighted mean treatment effects and 95% confidence intervals using a random effects model. Results: 32 articles reported the effects of walking interventions on cardiovascular disease risk factors. Walking increased aerobic capacity (3.04 mL/kg/min, 95% CI 2.48 to 3.60) and reduced systolic (-3.58 mm Hg, 95% CI -5.19 to -1.97) and diastolic (-1.54 mm Hg, 95% CI -2.83 to -0.26) blood pressure, waist circumference (-1.51 cm, 95% CI -2.34 to -0.68), weight (-1.37 kg, 95% CI -1.75 to -1.00), percentage body fat (-1.22%, 95% CI -1.70 to -0.73) and body mass index (-0.53 kg/m(2), 95% CI -0.72 to -0.35) but failed to alter blood lipids. Conclusions: Walking interventions improve many risk factors for cardiovascular disease. This underscores the central role of walking in physical activity for health promotion.
Article
Physical inactivity is a leading cause of mortality. Reinforcement interventions appear to be useful for increasing activity and preventing adverse consequences of sedentary lifestyles. This study evaluated a reinforcement-thinning schedule for maintaining high activity levels. Sedentary adults (N = 77) were given pedometers and encouraged to walk ≥10,000 steps per day. Initially, all participants earned rewards for each day they walked ≥10,000 steps. Subsequently, 61 participants were randomized to a monitoring-only condition or a monitoring-plus-reinforcement-thinning condition, in which frequencies of monitoring and reinforcing walking decreased over 12 weeks. The mean (± SD) percentage of participants in the monitoring-plus-reinforcement-thinning condition who met walking goals was 83% ± 24% and was 55% ± 31% for participants in the monitoring-only condition, p < .001. Thus, monitoring plus reinforcement thinning maintained high rates of walking when it was in effect; however, groups did not differ at a 24-week follow-up. Monitoring plus reinforcement thinning, nevertheless, hold potential to extend benefits of reinforcement interventions at low costs.