international Journal von Behavioral Nutrition und Physical task volume 8, Article number: 79 (2011) cite this article

Physical activity guidelines native around ns world are frequently expressed in terms des frequency, duration, und intensity parameters. Objective surveillance using pedometers and accelerometers supplies a new opportunity kommen sie measure and communicate physical activity in terms von steps/day. Various step-based versions or translations von physical activity guidelines are emerging, mirroring public interest bei such guidance. However, there appears kommen sie be a vast discrepancy in the specific values that room being communicated. It makes sense that step-based recommendations have to be harmonious with existing evidence-based public health guidelines that acknowledge that "some physical activity zu sein better than none" while keeping a emphasis on time spent bei moderate-to-vigorous physical task (MVPA). Thus, die purpose des this evaluation was to update ours existing knowledge des "How plenty of steps/day space enough?", and to notify step-based recommendations consistent with existing physical task guidelines. Normative säule indicate that gesund adults commonly take bolzen 4,000 und 18,000 steps/day, and that 10,000 steps/day is reasonable weil das this population, although there are significant "low active populations." Interventions demonstrate incremental increases on the order of 2,000-2,500 steps/day. The results des seven various controlled forschung demonstrate the there is a strong relationship between cadence and intensity. Further, regardless of some inter-individual variation, 100 steps/minute represents a reasonable floor worth indicative von moderate strongness walking. Multiply this cadence über 30 minute (i.e., typical of a täglich recommendation) produces a minimales of 3,000 steps that zu sein best offered as a heuristic (i.e., guiding) value, but these steps must it is in taken over and above habitual activity levels zu be a true expression des free-living steps/day that deshalb includes recommendations weil das minimal amounts des time bei MVPA. Computed steps/day translations des time in MVPA that so include estimates des habitual activity levels equate zu 7,100 kommen sie 11,000 steps/day. A direct estimate von minimal amounts des MVPA accumulated an the course of objectively monitored free-living behaviour ist 7,000-8,000 steps/day. A scale that spans a vast range von incremental increases in steps/day und is congruent with public wellness recognition that "some physical activity ist better than none," yet still incorporates step-based translations of recommended amounts des time in MVPA might be useful in research und practice. The full range des users (researchers zu practitioners to the general public) des objective monitoring tools that administer step-based outputs require great reference data und evidence-based recommendations kommen sie be may be to design effective health and wellness messages congruent through public health and wellness physical task guidelines, guide behaviour change, und ultimately measure, track, und interpret steps/day.

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Around the world, physical activity guidelines room written und promoted by government and non-governmental agencies to provide direction zum recommended amounts von physical task required kommen sie benefit health, basically answering die question "how much is enough?" these guidelines are frequently expressed bei terms of frequency, duration, and intensity parameters and are based on decades of epidemiological and intervention research that has practically exclusively relied on self-reported physical task behaviours. Die recent release des the U.S. Physical activity Guidelines <1> acknowledges that "some physical activity zu sein better 보다 none" while keeping a focus on time spent in moderate-to-vigorous physical task (MVPA). The entwickeln of target monitoring of physical activity using pedometer und accelerometer modern technology offers an opportunity to extend guidelines to include recommendations weil das objectively monitored parameters reflective des time spent an MVPA in the context of free-living behaviour.

The charme generated by accelerometers space robust and can be downloaded und converted into time spent an various intensities des physical activity und inactivity by applying welcomed accelerometer-specific reduced points (i.e., intensity-linked activity counts that stand for a proprietary digitized integration des a movement event und its acceleration). Although die importance von these data an terms des studying frequency und duration von intensity-specific activity is unquestionable, accelerometers generally are relatively expensive and require additional personnel time und expertise kommen sie manage und manipulate the data to have these end points. In contrast, pedometers are inexpensive, easy kommen sie use, and the action output ist readily easily accessible (i.e., digitally presented on screen) und easily interpretable as an indicator von overall volume of physical activity. The output des pedometers and accelerometers zu sein clearly associated <2>. Back accelerometers room now deshalb being used zu capture and describe action data bei nationally representative surveys <3>, pedometers are more likely to be used bei public health and clinical applications and adopted von the general public due zu their loved one low cost, practicality, and interpretability.

The various und emerging step-based references from around ns world are catalogued in Table 1 und reflect publicly interest an such guidance. As can be checked out from the table, there appears zu be a large discrepancy in the range of step-based referrals that room being communicated. However internationally, similar frequency-, duration-, and intensity-based public health and wellness guidelines room endorsed: 30 minute (at mal up zu 60 minutes) per day (or 150-210 minutes/week) bei MVPA, typically in minimal 10 minute bouts <4–9>. These extensively accepted, evidence-based adult public wellness physical task guidelines were initially formulated in terms of preventing morbidity and mortality. Together framed, this frequency-, duration-, und intensity- based guidelines imply that die recommended dose of physical activity should it is in taken over and above a baseline level (of lower intensity activities) that has actually never been explicitly described, and may in fact be transforming as a result des societal trends, which further complicates die issue. Public health and wellness guidelines <1> deshalb now zustand that, especially zum inactive adults, "some physical activity ist better 보다 none," and this recognition sets ns stage for bei expanded yet blieb compatible step-based blog post that so accommodates encourage amounts von time bei MVPA.

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Table 1 Government/agency/professional organization step-based recommendations from around die world

In order to avoid being interpreted as simply one more source des confusion and disagreement, it provides sense that any kind of step-based recommendation must be harmonious v existing physical activity guidelines. They space "not intended to supplant currently public health recommendations, however rather supplement them" <10>. However, over there is in opportunity zu posit a pistole number of steps/day deswegen that both habitual task levels (taken an the course of free-living und not necessarily of at least moderate intensity) und suggested increments an physical activity that fulfill frequency-, duration-, and intensity-based parameters room considered in the recommended "dose." die question "How plenty of steps/day space enough?" has been previously reviewed <11, 12>. The literature related to objective monitoring of physical activity is growing at a significant rate and it is again time zu address this question. The purpose of this review therefore was to update und identify gaps bei the evidence zu inform step-based recommendations congruent with existing physical activity guidelines und otherwise to extend guidelines kommen sie include recommendations zum "How numerous steps/day room enough?"

In February 2010, ns Public health and wellness Agency of Canada (PHAC) commissioned a literary works review designed zu identify how plenty of steps are about equivalent to public wellness guidelines in children/adolescents, adults, und older adults/special populations. A skilled librarian identified 1,594 articles by conducting a search des English language literature published because 2000 an CINAHL, ERIC, MEDLINE, PsycINFO, SocINDEX, and SPORTDiscus using ns keywords (pedomet* or acceleromet*) und step* and ((physical activity) or walk*). This list was reduced to 837 posts once duplicates, staying non-English language articles, dissertations, non-peer the evaluation articles, und those obviously notfall dealing v step-defined human being physical task were removed. Abstracts zum this diminished list des articles were at first read über the erste author to identify relevant articles and electronic copies of these were assembled utilizing Endnote X3 (Thomson Reuters, new York). Added articles were figured out from article reference lists. Relevant content was tabulated and/or summarized by the zuerst author. Choose researchers native around die world with experience in collecting objectively monitored step data were invited zu identify any absent literature (including recognized in-press articles), critically review die report, edit check and verify assembled data, und intellectually contribute über participating an the writing von a series von consensus records (children/adolescents <13>, adults, und older adults/special populaces <14>) intended to provide step-based recommendations congruent with public health guidelines (given the limitations detailed below). This particular review is focused on healthy adults around 20-65 years von age, although ns upper limit was not rigid (as driven von the identified literature), und living without impairment or chronic illness. The child/adolescent <13> und older adult/special populations <14> literature ist reviewed separately. No various other inclusion criteria were provided other than relevance to die question at hand.

Identified themes emerged as the literature was reviewed und provide a structure weil das the remainder des this article: 1) normative data (i.e., expected values); 2) incremental changes expected native interventions; 3) controlled studies that determine precise step-based conversions of timed behaviour; 4) computer a action translation des duration- and intensity-based physical task guidelines (e.g., steps/day associated with time spent bei MVPA); 5) straight measured steps/day indicative des minimal time bei MVPA taken under free-living conditions; and, 6) steps/day relevant with various health outcomes. Essentially, each section represents a "mini-review." at times ns search strategie was exhaustive and the precise number of articles identified ist presented under ns appropriate heading listed below (e.g., regulated studies). Exceptions occur in the case of identified existing review articles (e.g., normative data, interventions). The findings of these evaluate were merely summarized herein and select original posts are referred zu only zu make details points. Wherein appropriate, einzelheiten of forschung are presented in tables; inconsistencies in reporting within and across tables (e.g., instrument brand, model, etc.) reflect underlying reporting inconsistencies between original articles.

Normative säule (expected values)

An beforehand review of 32 lernen published bolzen 1980 und 2000 <15> suggested that gesund younger adult (approximately 20-50 years of age) take it 7,000-13,000 steps/day. Many more studies des step-defined physical activity measured using pedometers and accelerometers are released today, including a much more recent review article des adult normative data. Special, Bohannon <16> offered a meta-analytic approach kommen sie summarize and present steps/day taken von healthy adults (18+ years of age). Forty-two forschung published between 1983 and 2004 to be identified. Report values zum adults under 65 years of age ranged from around 5,400 steps/day (in a U.S. Sample of multiethnic women mean age 54.2 year <17>) kommen sie 18,000 steps/day (in a sample of Amish males mean period 34 year <18>). Excluding ns Amish sample, overall mean steps/day was 9,448 (95% CI = 8,899-9,996). Die NHANES accelerometer säule were adjusted to facilitate interpretation on a pedometer-based scale, because accelerometers typically detect much more steps than pedometers <19, 20>. Ns findings show that, on average, U.S. Adult take roughly 6,500 steps/day <3>, not too different from two other U.S. Estimates based upon pedometer data: Colorado (≅6,800 steps/day) <21> and South Carolina (≅5,900 steps/day) <22>. A an ext recent article reported the U.S. Adult average about 5,100 steps/day when measured von a pedometer <23>. An contrast, other representative samples show that Japanese world aged 15+ year take an average of approximately 7,200 steps/day <24>, west Australians aged 18+ years take roughly 9,600 steps/day <25>, Belgian adults aged 25-75 year take roughly 9,600 steps/day <26>, und Swiss adult aged 25-74 years of age take about 8,900 steps/day (women) and 10,400 steps/day (men) <27>. Despite differences in instrumentation used, the ability kommen sie compare results across forschung that schutz used research-quality pedometers ist reasonably an excellent <28>.

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In 2004 Tudor-Locke and Bassett <11> introduced die concept of a graduated action index for healthy adults: 1) 12> and an 2009 the original "sedentary" level (i.e., 3>. Ns utility of this graduated action index has actually been assessed an terms of discriminating individuals von body mass table of contents (BMI) <29> und reflecting increased cardiometabolic risk <30> (reviewed bei more detail below). Thus, step-based estimates von U.S. Adults" habitual physical activity would divide the population as "low active" according zu this currently step-defined physical activity scale <11, 12>.

Sixteen free-living gesund adult forschung (Table 2) were established that reported die percentage des their samples achieving stated step-defined cut points, including using cut points damit verbundenen with die graduated action index described above. Five used 10,000 steps/day as in exclusive cut suggest (no other reduced point was considered). Eight reported using the graduated action index originally proposed von Tudor-Locke und Bassett <11>. Two studies of South african samples that also made use of the graduated action index to be excluded from Table 1 since their lower age limits extended into adolescence <31, 32>, beyond the scope von this specific review. Noticeable patterns indigenous Table 1 include: younger adult are more likely zu achieve 10,000 steps/day, U.S. Samples are much more likely to take Table 2 Studies of free-living behaviour reporting percent von participants meeting choose step-defined cut points in adults
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Table 3 managed study draft that oase informed "how plenty of steps/day are enough?" in adults
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Table 5 studies that have attempted zu set steps/day reduced points bei adults relative to time spent in MVPA or power expended
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