AGS: Pedometer Steps Up Physical Activity

SEATTLE, May 7 -- Giving older type 2 diabetic patients a pedometer and a goal to meet may be enough to get them moving, researchers said.

Patients with diabetes 55 and older who were provided with a pedometer and the target of 10,000 steps a day increased their weekly calorie expenditure by nearly twice as much as controls, found Eugene Licht, B.S., a student at Weill Cornell Medical College in New York, and colleagues.

Moderate high-intensity exercise was also about eight times more frequent after patients received pedometers, they reported here at the American Geriatrics Society meeting.

"The importance of increased physical activity in improving diabetes management in minority elders cannot be overstated," Licht and colleagues said.

A previous small study had shown pedometers to be effective in increasing physical activity but did not focus on older adults, who comprise 40% of the type 2 diabetes population.

So, the researchers randomized 28 African-American and Hispanic patients with type 2 diabetes to receive standard diabetes education alone or with a pedometer and instruction in its use.

The diabetes education program consisted of four one-hour classes.

The mean age was 60 in the control group and 64 in the pedometer group. Patients were matched for ethnicity and gender between groups (both had predominantly women). Patients had fairly well-controlled diabetes with an average hemoglobin A1c of 7.1% and 7.3%, respectively.

Frequency of physical activity was measured using the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire.

Although patients were given the goal of 10,000 steps a day, they averaged 7,013 per day over the six-month follow-up.

Among the findings at six months, the investigators reported:

• More total calories per week expended on average in the pedometer group (4,593 versus 3,931).
• More increase in total calories per week expended over baseline in the pedometer group (2,235 versus 1,216).
• Greater calories per week expended in moderate-high intensity activity in the pedometer group (1,918 versus 1,691).
• More increase in calories per week expended in moderate-high intensity exercise compared with baseline for the pedometer group (1,400 versus 935).
• Higher frequency of all physical activity (18.3 versus 12.5 episodes per week).
• Increase in frequency of physical activity for the pedometer group over baseline, but decrease for the control group from baseline (change +4.8 versus -0.3).
• Greater frequency of moderate-high intensity physical activity for the pedometer group (7.3 versus 2.3).
• Far greater increase in moderate high-intensity exercise frequency from baseline for the pedometer group (change 5.7 versus 0.7).

The study shows pedometers to be effective in increasing core energy expenditure as well as more strenuous exercise, Licht said.

In talking to the patients in the study, who all came from an urban area, patients accomplished this primarily by walking for errands they normally would have taken the bus for, he said.

"It made them pay attention," he said.

Although it is not clear how the findings would generalize to a less urban population, he said they likely would be similar for a non-minority population.

The next step is enrolling more patients and looking at clinical outcomes, he said.