Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults

Guidance for Prescribing Exercise

Carol Ewing Garber, Ph.D., FACSM, (Chair); Bryan Blissmer, Ph.D.; Michael R. Deschenes, Ph.D., FACSM; Barry A. Franklin, Ph.D., FACSM; Michael J. Lamonte, Ph.D., FACSM; I-Min Lee, M.D., Sc.D., FACSM; David C. Nieman, Ph.D., FACSM; David P. Swain, Ph.D., FACSM.

Disclosures

Med Sci Sports Exerc. 2011;43(7):1334-1359. 

In This Article

Can Steps Per Day be Used to Prescribe Exercise?

Pedometers are popular and effective for promoting physical activity[366] and modest weight loss,[308] but they provide an inexact index of exercise volume.[26,368] They are limited in that the "quality" (e.g., speed, grade, duration) of steps often cannot be determined. A goal of 10,000 steps per day is often cited, but even fewer steps may meet contemporary exercise recommendations.[367] For example, recent data from "America on the Move"[27] showed those individuals who reported "exercising strenuously" on 3 d·wk−1 (duration of exercise not ascertained), a level that probably meets current recommendations, accumulated a mean of 5486 ± 231 SEM steps per day. People reporting 4 d·wk−1 of "strenuous exercise" accumulated 6200 ± 220 steps per day, and 7891 ± 540 steps per day were reported by those "exercising strenuously" on 6–7 d·wk−1. In a randomized trial evaluating different doses of physical activity on fitness levels, initially sedentary women who engaged in a new program of physical activity meeting current exercise recommendations averaged about 7000 steps per day.[187] Two meta-analyses of pedometer use showed that participants in randomized clinical trials increased their daily steps on average by about 2000 steps per day, equal to walking approximately 1 mile·d−1, and few of the most sedentary subjects achieved the goal of 10,000 steps per day.[51,193] In participants with elevated blood pressure, an increase of 2000 steps per day was associated with a modest decrease in systolic blood pressure (~4 mm Hg), independent of changes in body mass index, suggesting that fewer than 10,000 steps per day may provide health benefits. Recent work to determine step count cut points corresponding to moderate-intensity walking demonstrated that 100 steps per minute is a very rough approximation of moderate-intensity exercise.[242] Because of the substantial errors of prediction using either step counts or this algorithm to estimate energy expenditure,[204,242,368] it may be prudent to use both steps per minute combined with currently recommended durations of exercise for exercise prescription (e.g., 100 steps per minute for 30 min per session).[242,368]

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