Short-term and long-term effects of a self-managed physical activity program using a pedometer for chronic respiratory disease: a randomized controlled trial.
Daigo Kato, Kunio Dobashi, Makoto Fueki and 3 others
PMID 28603350WHAT IT FOUND
Elderly chronic respiratory patients who used a pedometer and diary, without step targets, increased steps and had better 3-month walking distance, leg strength and quality of life than controls.
Breathlessness also improved within the diary group. Long-term group differences were less clear.
Key findings
01Patients using a pedometer and diary, with no step target, increased daily steps from 8,220.0 ± 4,155.1 in the initial 2 months to 9,151.8 ± 5,179.8 in the final 2 months.
02At 3 months, the pedometer and diary group showed significant improvement in mMRC, 6-minute walking test, and CS-30, while the control group showed no significant improvement.
03Between-group differences were significant for changes in 6-minute walking distance, CS-30, and SGRQ at 3 months, and for body weight and BMI changes at 6 months.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was small: 33 patients were recruited, 25 completed 3 months, and 17 completed 6 months. Sixteen patients dropped out, including eight for disease progression, two for hospitalization, and six for lack of motivation or personal reasons. Two Diary group patients were excluded because their diaries were incomplete. The control group did not record steps, so daily activity between groups was not compared. The paper does not name a primary outcome, so it is unclear which result should be treated as the main question. After 6 months, most between-group differences were not significant, and the authors suggest this may relate to the small remaining sample. The participants were older adults with chronic respiratory disease attending a Japanese hospital, so results may not apply to younger patients or other settings. Allocation concealment and blinding of outcome assessors are not described.
Declared interests
The authors declared no conflicts of interest. The funding source is not stated in the supplied text.
The easy way to misread this
Do not conclude that the pedometer alone caused every improvement or that the effect is proven long-term. The intervention included a pedometer, diary, and instructions, the control group did not record steps, and after 6 months most between-group differences were not significant.