High Versus Low Theoretical Fidelity Pedometer Intervention Using Social-Cognitive Theory on Steps and Self-Efficacy

Purpose: This study was designed to compare a low versus high theoretical fidelity pedometer intervention applying social-cognitive theory on step counts and self-efficacy. Method: Fifty-six public university employees participated in a 10-week randomized controlled trial with 2 conditions that varied in theoretical fidelity. Participants in the high theoretical fidelity condition wore a pedometer and participated in a weekly group walk followed by a meeting to discuss cognitive-behavioral strategies targeting self-efficacy. Participants in the low theoretical fidelity condition met for a group walk and also used a pedometer as a motivational tool and to monitor steps. Step counts were assessed throughout the 10-week intervention and after a no-treatment follow-up (20 weeks and 30 weeks). Self-efficacy was measured preintervention and postintervention. Results: Participants in the high theoretical fidelity condition increased daily steps by 2,283 from preintervention to postintervention, whereas participants in the low fidelity condition demonstrated minimal change during the same time period (p = .002). Individuals attending at least 80% of the sessions in the high theoretical fidelity condition showed an increase of 3,217 daily steps (d = 1.03), whereas low attenders increased by 925 (d = 0.40). Attendance had minimal impact in the low theoretical fidelity condition. Follow-up data revealed that step counts were at least somewhat maintained. For self-efficacy, participants in the high, compared with those in the low, theoretical fidelity condition showed greater improvements. Conclusion: Findings highlight the importance of basing activity promotion efforts on theory. The high theoretical fidelity intervention that included cognitive-behavioral strategies targeting self-efficacy was more effective than the low theoretical fidelity intervention, especially for those with high attendance.     

Can sit-to-stand muscle power explain the ability to perform functional tasks in adults with severe obesity?

This study examined the relationship between sit-to-stand (STS) power and physical function in adults with severe obesity. Thirty-eight adults (age: 44 ± 12 years; body mass index [BMI]: 45.2 ± 7.8 kg/m²) completed evaluations of STS power, strength and functional performance. STS power was measured with a wearable inertial sensor, strength was assessed with the isometric mid-thigh pull, and function was measured with the timed up-and-go (TUG), six-minute walk test (6MWT) and 30-s chair STS. Power and strength (normalised to body mass) entered regression models in addition to age, gender, BMI and physical activity (daily step count). Power displayed large univariate associations with TUG (r = 0.50) and 30-s chair STS (r = 0.67), and a moderate association with 6MWT (r = 0.49). Forward stepwise regression revealed that power independently contributed to TUG (β = ?0.40, p = 0.010), 30-s chair STS (β = 0.67, p < 0.001) and 6MWT performance (β = 0.27, p = 0.007). Power also appeared to be a superior determinant of function compared with strength. Power generated via the STS transfer largely underpins the ability to perform functional tasks in adults with severe obesity, although intervention studies are required to investigate a potentially causal relationship.     

Validity of Self-Reported Pedometer Steps per Day in College Students

The purpose of this article was to examine the validity of self-reported pedometer steps/day. Forty-seven participants were provided a New Lifestyles NL-2000 (NL-2000; Lees Summit, MO, USA) pedometer and a physical activity (PA) diary for 3 weeks, but not informed of the data-storing capabilities. For weeks 2 and 3, each participant was given a step goal of 3,000 steps/day above week 1 average. A 2 × 3 repeated measures analysis of variance (ANOVA) was used to examine differences between reported steps/day. Bland–Altman plots assessed the mean bias and limits of agreement between reporting methods. Mean self-reported and NL-2000 steps/day were 9,264 ± 3,555 and 8,971 ± 3,590 steps/day (n = 26, p > .05). Mean biases were 216 ± 1,753 (week 1), –506 ± 1,355 (week 2), and –590 ± 1,360 (week 3) steps/day. Negative mean bias values indicate higher self-reported steps/day. Mean steps/day were similar between recording methods, but large differences were observed among individuals, suggesting self-reported steps/day may be valid for PA research at the population level, but not the individual level.     

Validation of a one-day self-report questionnaire for physical activity assessment in healthy adults

Abstract

A self-report physical activity scale (PAS) has previously been developed to document physical activity (MET-hours) undertaken by adults during an average weekday. The current study aimed to validate the PAS over 24 hours via pedometer determinations of physical activity in healthy, active adults, and to determine possible influences of gender and body mass status on this relationship. One-hundred and seven healthy university students (age 18–41 years) wore a pedometer (Yamax DigiWalker SW-700) during the waking hours of an average weekday followed by successful completion of the PAS. Relationships between the PAS and pedometer measures (steps taken and energy expenditure) were examined by Pearson's correlation coefficients. Significant (P<0.05) gender and body mass status differences were examined by two-way analysis of variance with Tukey post-hoc tests. Participants reported 48.0±10.4 MET-hours of activity, completed 11,506±4195 steps, and expended 499±227 kcal during an average weekday. Physical activity measures, except energy expenditure, were similar across groups by gender and body mass status. The total number of MET-hours was significantly associated with pedometer steps taken (r=0.375–0.568, P<0.01), and this relationship varied by gender and to a lesser extent by body mass status. The results of the current study show that the self-reported physical activity of healthy active adults was in line with the popular recommended dose of daily physical activity (10,000 steps per day) and was not influenced by gender or body mass status. Furthermore, over an average weekday, the PAS provided a simple, quick, and valid method to document physical activity undertaken by young healthy active adults that is comparable to pedometer readings.     

An integrated curriculum approach to increasing habitual physical activity in deprived South Asian children

Integrating physical activity (PA) within a school curriculum is a promising approach for increasing PA in children. To date, no research has examined its effectiveness in increasing the low levels of PA witnessed in deprived South Asian (SA) children. The study aims to ascertain whether an integrated school-based curriculum and pedometer intervention could increase PA in children from deprived SA backgrounds. Following ethical approval and informed consent, 134 deprived SA children (63 boys, 71 girls, control (n?=?40, mean age?=?11.12 years, SD?=?0.32 years) and intervention (n?=?94, mean age?=?9.48 years, SD?=?0.62 years)) from a primary school in England, UK, completed a 6-week integrated PA intervention based on virtually walking from their school (middle of the country) to the coast and back (March–July 2013). Habitual PA was determined at baseline and post 6 weeks intervention for both groups, and determined weekly during the intervention in the experimental group. The results indicated that average daily steps were significantly higher at post 6 weeks compared to baseline for the intervention group (intervention mean change?=?8694 steps/day, SD?=?7428 steps/day vs. control mean change?=??1121 steps/day, SD?=?5592 steps/day, 95% CI of difference, 6726–7428 steps/day, P?=?.001, d?=?1.76). In addition, significant decreases in BF% and waist circumference were observed in the intervention group post 6 weeks (mean change for BF%?=??4.5%, mean change for WC?=??1.7?cm, P?=?.001). School-based integrated curriculum and pedometer interventions provide a feasible and effective mechanism for increasing habitual PA in primary school children from deprived SA backgrounds.     

Carbohydrate intake and training efficacy – a randomized cross-over study

Carbohydrate (CHO) availability during endurance exercise seems to attenuate exercise-induced perturbations of cellular homeostasis and might consequently diminish the stimulus for training adaptation. Therefore, a negative effect of CHO intake on endurance training efficacy seems plausible. This study aimed to test the influence of carbohydrate intake on the efficacy of an endurance training program on previously untrained healthy adults. A randomized cross-over trial (8-week wash-out period) was conducted in 23 men and women with two 8-week training periods (with vs. without intake of 50g glucose before each training bout). Training intervention consisted of 4x45 min running/walking sessions/week at 70% of heart rate reserve. Exhaustive, ramp-shaped exercise tests with gas exchange measurements were conducted before and after each training period. Outcome measures were maximum oxygen uptake (VO_2max) and ventilatory anaerobic threshold (VT). VO_2max and VT increased after training regardless of CHO intake (VO_2max: Non-CHO 2.6 ± 3.0 ml*min^?1*kg^?1 p = 0.004; CHO 1.4 ± 2.5 ml*min^?1*kg^?1 p = 0.049; VT: Non-CHO 4.2 ± 4.2 ml*min^?1*kg^?1 p < 0.001; CHO 3.0 ± 4.2 ml*min^?1*kg^?1 p = 0.003). The 95% confidence interval (CI) for the difference between conditions was between +0.1 and +2.1 ml*min^?1*kg^?1 for VO_2max and between ?1.2 and +3.1 for VT. It is concluded that carbohydrate intake could potentially impair the efficacy of an endurance training program.     

Effect of Weight Training with Pelvic Floor Muscle Training in Elderly Women with Urinary Incontinence

Purpose: To determine if weight training combined with pelvic floor muscle training is more efficient than pelvic floor muscle training alone for the treatment of urinary incontinence (UI) symptoms in elderly women. Method: This was a two-arm, parallel, randomized controlled trial. Twenty-six women with stress UI participated in the study. The intervention group (IG) underwent training with moderate intensity weights combined with pelvic floor muscle training, whereas the control group (CG) only underwent pelvic floor muscle training. Intervention occurred twice a week over 12 weeks. The International Consultation on Incontinence Questionnaire–Short Form was used as the main measure. Scores of zero defined the absence of symptoms. The absence of symptoms was evaluated at 4 weeks, 12 weeks, and 1 month after the end of treatment. Moreover, activities related to UI and the use and change of daily protection were investigated. Results: The rate of absence of symptoms was significantly higher in IG after 4 weeks (58.3%) compared to CG (14.8%). The relative risk was 4.1 (95% confidence interval [CI] [1.08, 16.06]). Although no intention-to-treat analysis was performed, there was no difference in the evaluations after the interventions. Conclusion: Compared to pelvic floor muscle training alone, the combination of weight training and pelvic floor muscle training provided earlier improvement of UI in elderly women.     

Daily steps in midlife and older adults: relationship with demographic, self-rated health, and self-reported physical activity

The relationship between average daily step counts and age, body mass index (BMI), self-reported physical activity (PA) level, and perceived health was determined in 85 middle-aged and older adults who wore a pedometer for 7 consecutive days. Average daily steps were significantly (p < .05) correlated with BMI (r = -.26), age (r = -.44) and perceived health (r = .53) but not with self-reported PA level (r = .19). The adjusted percentage of participants classified as meeting the PA recommendation in < or = 5,000, 5,001-9,999, and > or = 10,000 steps/day categories ranged from 53 to 61%. These findings support previous evidence in younger populations suggesting that the recommended minimal level of health-related PA may be achieved despite not accumulating 10,000 steps/day.     

The effects of goal variation on adult physical activity behaviour

The purposes of this study were to examine the effects of varying levels of goals on increasing daily steps and the frequency of goal achievement among middle-aged adults. Ninety-six adults participated in a randomised control study. Participants were randomly assigned to five different step goal groups: (1) Easy (n = 19), (2) Medium (n = 19), (3) Difficult (n = 19), (4) Do-your-best (n = 19), and (5) No goal (n = 20) based on previous research. The participants wore a pedometer and were asked to reach a pre-established goal during the experimental period. In order to examine the effectiveness of the goal difficulty, (a) an average number of steps taken by different goal conditions and (b) the number of days meeting the assigned goal were tested. A one-way ANCOVA revealed significant step count differences among goal groups. Post hoc analyses indicated that the change in step count in both the Medium and Difficult goal groups was significantly greater than the remaining groups. However, there was no significant difference between the medium and difficult goal conditions. In addition, a one-way ANOVA indicated that there were no significant differences in the frequency of goal achievement among the Easy, Medium, and Difficult goal groups. Results suggest that when promoting physical activity through increasing step counts, researchers and clinicians should design goals that are specific and challenging.     

Focus Groups to Explore the Perceptions of Older Adults on a Pedometer-Based Intervention

Focus group methodology was used to explore in depth the perceptions of older adults who had participated in a 12-week pedometer-based intervention. Nineteen women and 8 men, ages 55–86 years, volunteered to take part in the focus groups following participation in the intervention. Four focus groups of six to eight participants were scheduled at primary sites in the southern Maine area. Analysis of the data revealed four specific topical areas: (a) factors that led to increases in daily step count, (b) factors that hindered increases in daily step count, (c) benefits of pedometer intervention program, and (d) recommendations on how to improve older adults' physical activity. Overall, focus group participants found this intervention to be beneficial and recommended its expansion to other groups.     

Reliability and concurrent validity of a motor skill competence test among 4- to 12-year old children

The purpose of this study was to examine the test-retest reliability, internal consistency and concurrent validity of the Athletic Skills Track (AST). During a regular PE lesson, 930 4- to 12-year old children (448 girls, 482 boys) completed two motor skill competence tests: (1) the Körperkoordination-Test für Kinder (KTK) and (2) an age-related version of the AST (age 4–6 years: AST-1, age 6–9 years: AST-2, and age 9–12 years: AST-3). The test-retest reliability of the AST was high (AST-1: ICC = 0.881 (95% CI: 0.780–0.934); AST-2: ICC = 0.802 (95% CI: 0.717–0.858); and AST-3: ICC = 0.800 (95% CI: 0.669–0.871). The internal consistency, concerning the three age-bands of the AST was above the acceptable level of Cronbach’s α > 0.70 (AST-1: α = 0.764; AST-2: α = 0.700; and AST-3: α = 0.763). There was a moderate to high correlation between the time to complete the AST, and the age- and gender-related motor quotients of the KTK (AST-1: r = ?0.747, p = 0.01; AST-2: r = ?0.646, p = 0.01; and AST-3: r = ?0.602, p = 0.01). The Athletic Skills Track is a reliable and valid assessment tool to assess motor skill competence among 4- to 12-year old children in the PE setting.     

Accuracy of three Android-based pedometer applications in laboratory and free-living settings

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.     

Flexibility training in preadolescent female athletes: Acute and long-term effects of intermittent and continuous static stretching

This study compared the acute and long-term effects of intermittent and continuous static stretching training on straight leg raise range of motion (ROM). Seventy-seven preadolescent female gymnasts were divided into a stretching (n = 57), and a control group (n = 20). The stretching group performed static stretching of the hip extensors of both legs, three times per week for 15 weeks. One leg performed intermittent (3 × 30 s with 30 s rest) while the other leg performed continuous stretching (90 s). ROM pre- and post-stretching was measured at baseline, on weeks 3, 6, 9, 12, 15 and after 2 weeks of detraining. ROM was increased during both intermittent and continuous stretching training, but remained unchanged in the control group. Intermittent stretching conferred a larger improvement in ROM compared to both continuous stretching and control from week 3, until the end of training, and following detraining (p = 0.045 to 0.001 and d = 0.80 to 1.41). During detraining, ROM after the intermittent protocol decreased (p = 0.001), while it was maintained after the continuous protocol (p = 0.36). Acute increases in ROM following the intermittent stretching were also larger than in the continuous (p = 0.038). Intermittent stretching was more effective than continuous, for both long-term and acute ROM enhancement in preadolescent female athletes.     

Influence of a proprioceptive training on functional ankle stability in young speed skaters – a prospective randomised study

The influence of a 12-week-proprioceptive training on functional ankle stability was investigated in young speed skaters. Twenty-eight speed skaters were randomly divided into an intervention (n = 14) and into a control group (n = 14). A 15-min circle training was performed 5 times per week over a 12-week period. Measurements were taken prior to the training, after 6 and 12 weeks of training. Kinaesthesia was evaluated with the Isomed2000 in all movements of the ankle joint. Dynamic balance was tested with the Biodex Stability System at the stable level 8 and at the unstable level 2, measuring the overall stability index, the anterior/posterior and the medial/lateral scores. Static single-leg stance was evaluated using the Kistler force platform. Kinaesthesia of the intervention group improved significantly for plantarflexion of the right foot (P = 0.001) after 12 weeks. Dynamic balance showed significant differences in the intervention group after 12 weeks in comparison with the first measurement for each foot in the overall stability index, the anterior/posterior and the medial/lateral scores (P ≤ 0.017, respectively) at the unstable level 2. Functional ankle stability improved in terms of dynamic balance after 12 weeks of proprioceptive training. Therefore, inclusion of proprioceptive exercises in the daily training programme is recommended for young speed skaters.     

Computerized Agility Training Improves Change-of-Direction and Balance Performance Independently of Footwear in Young Adults

Understanding the effects of training in different footwear on sporting performance would be useful to coaches and athletes. Purpose: This study compared the effects of computerized agility training using 3 types of footwear on change-of-direction and balance performance in young adults. Method: Thirty recreationally active young adults (M_age = 22.8 ± 3.1 years; M_height = 1.71 ± 0.7 m; M_bodymass = 73.4 ± 10.3 kg) were randomly assigned to a 6-week computerized agility training intervention in 1 of 3 footwear groups (n = 10/group): barefoot, minimal footwear, or traditional shoes. Participants had no previous barefoot or minimal-footwear training experience. Dependent variables included change-of-direction test time to completion, Star Excursion Balance Test, and single-leg stability evaluation. Testing was performed at the start of the training program, after 2 weeks, after 4 weeks, and at the end of the training program. Results: No group or time interactions were found for any of the dependent variables. Time main effects were observed for the performance measures of change of direction, Star Excursion, and single-leg-with-eyes-open stability evaluation. Participants improved in all 3 tests as early as 2 weeks into the intervention, with improvements continuing through the entire 6-week intervention. Conclusions: The lack of interaction and footwear effects suggests that agility and balance improvements during foot agility training are independent of footwear in a recreationally active young-adult population. Computerized agility training improves change-of-direction and balance performance within 2 weeks of training implementation. Future studies should consider footwear training effects in different populations, including frail older adults and athletes.     

Lifesource XL-18 pedometer for measuring steps under controlled and free-living conditions

The primary aim was to examine the criterion and construct validity and test–retest reliability of the Lifesource XL-18 pedometer (A&D Medical, Toronto, ON, Canada) for measuring steps under controlled and free-living activities. The influence of body mass index, waist size and walking speed on the criterion validity of XL-18 was also explored. Forty adults (35–74 years) performed a 6-min walk test in the controlled condition, and the criterion validity of XL-18 was assessed by comparing it to steps counted manually. Thirty-five adults participated in the free-living condition and the construct validity of XL-18 was assessed by comparing it to Yamax SW-200 (YAMAX Health & Sports, Inc., San Antonio, TX, USA). During the controlled condition, XL-18 did not significantly differ from criterion (P > 0.05) and no systematic error was found using Bland–Altman analysis. The accuracy of XL-18 decreased with slower walking speed (P = 0.001). During the free-living condition, Bland–Altman analysis revealed that XL-18 overestimated daily steps by 327 ± 118 than Yamax (P = 0.004). However, the absolute percent error (APE) (6.5 ± 0.58%) was still within an acceptable range. XL-18 did not differ statistically between pant pockets. XL-18 is suitable for measuring steps in controlled and free-living conditions. However, caution may be required when interpreting the steps recorded under slower speeds and free-living conditions.     

Randomized controlled trial of effectiveness of pedometers on general practitioners' attitudes to engagement in and promotion of physical activity

Abstract

Pedometers have been identified as a tool for health professionals to promote physical activity. This study, which aimed to evaluate the effectiveness of wearing a pedometer on general practitioners' attitudes to promoting physical activity, was a pragmatic, multi-centred, randomized controlled trial within a primary care trust in England. The participants were 102 general practitioners (GPs). Eighty-five (48 males, 37 females) of the GPs completed pre and post questionnaires, 43 of whom were in the intervention group. Statistical analysis revealed no significant changes between the control and intervention groups for attitude to engage in physical activity (t ₈₃ = 1.13, CI ?0.362 to 0.099) or attitude to promote physical activity in their patients (t ₈₃ = 1.7, CI ?0.593 to 0.045). A higher volume of walking was significantly correlated with a more positive attitude to engage in physical activity (r = 0.58, P < 0.01) but not with a more positive attitude to promoting physical activity. Wearing a pedometer had no significant effect on GPs' attitudes to engaging in physical activity or promoting physical activity in their patients.     

Sport-specific biomechanical responses to an ACL injury prevention programme: A randomised controlled trial

Anterior cruciate ligament (ACL) injury prevention programmes have not been as successful at reducing injury rates in women’s basketball as in soccer. This randomised controlled trial (ClinicalTrials.gov #NCT02530333) compared biomechanical adaptations in basketball and soccer players during jump-landing activities after an ACL injury prevention programme. Eighty-seven athletes were cluster randomised into intervention (6-week programme) and control groups. Three-dimensional biomechanical analyses of drop vertical jump (DVJ), double- (SAG-DL) and single-leg (SAG-SL) sagittal, and double- (FRONT-DL) and single-leg (FRONT-SL) frontal plane jump landing tasks were tested before and after the intervention. Peak angles, excursions, and joint moments were analysed using two-way MANCOVAs of post-test scores while controlling for pre-test scores. During SAG-SL the basketball intervention group exhibited increased peak knee abduction angles (p = .004) and excursions (p = .003) compared to the basketball control group (p = .01) and soccer intervention group (p = .01). During FRONT-SL, the basketball intervention group exhibited greater knee flexion excursion after training than the control group (p = .01), but not the soccer intervention group (p = .11). Although women’s soccer players exhibit greater improvements in knee abduction kinematics than basketball players, these athletes largely exhibit similar biomechanical adaptations to ACL injury prevention programmes.     

Comparison of different theoretical models estimating peak power output and maximal oxygen uptake in trained and elite triathletes and endurance cyclists in the velodrome

Abstract

The primary objective of this study was to examine the relationship between heart rate intensity and pedometer step counts in adolescents. To determine cardiorespiratory fitness, 106 participants (47 boys, 59 girls, mean age 14.2 years, s = 0.8) completed the Queen's College Step Test and were classified as having low, moderate or high cardiorespiratory fitness. Adolescents also completed a 10-min treadmill trial while wearing a pedometer and heart rate monitor. The participants were instructed to maintain their heart rate between 65 and 75% of their maximum heart rate while running or walking on a treadmill. A heart rate of 65–75% maximum was associated with 146 steps per minute (s = 22) in boys and 137 steps per minute (s = 22) in girls. Results of analysis of variance indicated that there was a main effect for level of fitness (F _2,102 = 9.36, P < 0.001). The correlation between mean steps per minute and estimated maximum oxygen consumption was statistically significant (r = 0.44, P < 0.001). The results from this study suggest that a step rate of 130 steps per minute is equal to 65–75% maximum heart rate in low-fit adolescents and achieving 130 steps per minute could be used as an initial goal to improve fitness.     

Evaluation of an extra-curricular school sport programme promoting lifestyle and lifetime activity for adolescents

Abstract

The purpose of this study was to evaluate the impact of an extra-curricular school sport programme to promote physical activity among adolescents. One hundred and sixteen students (mean age 14.2 years, s = 0.5) were assigned to an intervention (n = 50) or comparison group (n = 66). The 8-week intervention involved structured exercise activities and information sessions. Four days of pedometer monitoring and time spent in non-organized physical activity and sedentary behaviours were measured at baseline and post-test. At baseline, participants were classified using steps per day as low-active (girls <11,000, boys <13,000) or active (girls ≥ 11,000, boys ≥ 13,000) and the effects of the intervention were assessed using these subgroups. Adolescents in the intervention group classified as low-active at baseline increased their step counts across the 8-week intervention (baseline: 7716 steps/day, s = 1751; post-test: 10,301 steps/day, s = 4410; P < 0.05) and accumulated significantly more steps (P < 0.05) than their peers in the comparison group (baseline: 8414 steps/day, s = 2460; post-test: 8248 steps/day, s = 3674; P = 0.879). The results of the present study provide further evidence that physical activity monitoring using pedometers is an effective strategy for increasing activity among low-active adolescents.