How many steps/day are enough? For older adults and special populations

Abstract

Older adults and special populations (living with disability and/or chronic illness that may limit mobility and/or physical endurance) can benefit from practicing a more physically active lifestyle, typically by increasing ambulatory activity. Step counting devices (accelerometers and pedometers) offer an opportunity to monitor daily ambulatory activity; however, an appropriate translation of public health guidelines in terms of steps/day is unknown. Therefore this review was conducted to translate public health recommendations in terms of steps/day. Normative data indicates that 1) healthy older adults average 2,000-9,000 steps/day, and 2) special populations average 1,200-8,800 steps/day. Pedometer-based interventions in older adults and special populations elicit a weighted increase of approximately 775 steps/day (or an effect size of 0.26) and 2,215 steps/day (or an effect size of 0.67), respectively. There is no evidence to inform a moderate intensity cadence (i.e., steps/minute) in older adults at this time. However, using the adult cadence of 100 steps/minute to demark the lower end of an absolutely-defined moderate intensity (i.e., 3 METs), and multiplying this by 30 minutes produces a reasonable heuristic (i.e., guiding) value of 3,000 steps. However, this cadence may be unattainable in some frail/diseased populations. Regardless, to truly translate public health guidelines, these steps should be taken over and above activities performed in the course of daily living, be of at least moderate intensity accumulated in minimally 10 minute bouts, and add up to at least 150 minutes over the week. Considering a daily background of 5,000 steps/day (which may actually be too high for some older adults and/or special populations), a computed translation approximates 8,000 steps on days that include a target of achieving 30 minutes of moderate-to-vigorous physical activity (MVPA), and approximately 7,100 steps/day if averaged over a week. Measured directly and including these background activities, the evidence suggests that 30 minutes of daily MVPA accumulated in addition to habitual daily activities in healthy older adults is equivalent to taking approximately 7,000-10,000 steps/day. Those living with disability and/or chronic illness (that limits mobility and or/physical endurance) display lower levels of background daily activity, and this will affect whole-day estimates of recommended physical activity.

Recovery of ambulation activity across the first six months post-stroke

“…The current sample of stroke survivors engaged in ambulation activity similar to that reported in sedentary older adults 24 and below required levels for health benefits 5 . Recommendations for daily activity suggest a minimum of 30 minutes of moderate intensity activity per day, spread across bouts of at least 10 minutes in duration, with a range of 75 to 150 minutes per week in 'vigorous' or high intensity activity 25 .…”

“…For example, after stroke, daily step counts are reported to range from 1400 3 to 6195 4 steps/day, indicating that the overall volume of activity after stroke is mostly below that required for general health benefits (i.e. 10,000 steps per day) 5 . However, observation of change in ambulation activity behaviours from the subacute (24 hours to 6-months post-stroke) to the chronic phase (> 6-months post-stroke) of stroke recovery is limited and variable 4,6,7 .…”

Relacao entre o nivel de atividade fisica estimado pelo Baltimore Activity Scale for Intermittent Claudication e a pedometria em pacientes com claudicacao intermitente

“…Patients received instructions about how to use the device correctly. Mean number of steps taken was analyzed for three periods: all the days of the week, weekdays and weekends 17 . In a subsample of 25 patients, the reproducibility of pedometer data was evaluated seven days later, and the intraclass correlation coefficient was r=0.72.…”

Association between Walking and Cardiovascular Risk Factors in University Employees

“…The simplest and most achievable form of physical activity for everyone is walking. Daily steps can be accumulated by doing household chores and working in the office (Tudor-Locke et al, 2011). Walking has been promoted, in part, by the growing popularity of pedometers and pedometer-linked health promotion messages.…”