Ruth G. Lowry

The effect of a pedometer-based community walking intervention "Walking for Wellbeing in the West" on physical activity levels and health outcomes: a 12-week randomized controlled trial

BackgroundRecent systematic reviews have suggested that pedometers may be effective motivational tools to promote walking. However, studies tend to be of a relatively short duration, with small clinical based samples. Further research is required to demonstrate their effectiveness in adequately powered, community based studies.ObjectiveUsing a randomized controlled trial design, this study assessed the impact of a 12-week graduated pedometer-based walking intervention on daily step-counts, self-reported physical activity and health outcomes in a Scottish community sample not meeting current physical activity recommendations.MethodSixty-three women and 16 men (49.2 years ± 8.8) were randomly assigned to either an intervention (physical activity consultation and 12-week pedometer-based walking program) or control (no action) group. Measures for step-counts, 7-day physical activity recall, affect, quality of life (n = 79), body mass, BMI, % body fat, waist and hip circumference (n = 76), systolic/diastolic blood pressure, total cholesterol and HDL cholesterol (n = 66) were taken at baseline and week 12. Analyses were performed on an intention to treat basis using 2-way mixed factorial analyses of variance for parametric data and Mann Whitney and Wilcoxon tests for non-parametric data.ResultsSignificant increases were found in the intervention group for step-counts (p < .001), time spent in leisure walking (p = .02) and positive affect (p = .027). Significant decreases were found in this group for time spent in weekday (p = .003), weekend (p = .001) and total sitting (p = .001) with no corresponding changes in the control group. No significant changes in any other health outcomes were found in either group. In comparison with the control group at week 12, the intervention group reported a significantly greater number of minutes spent in leisure time (p = .008), occupational (p = .045) and total walking (p = .03), and significantly fewer minutes in time spent in weekend (p = .003) and total sitting (p = .022).ConclusionA pedometer-based walking program, incorporating a physical activity consultation, is effective in promoting walking and improving positive affect over 12 weeks in community based individuals. The discussion examines possible explanations for the lack of significant changes in health outcomes. Continued follow-up of this study will examine adherence to the intervention and possible resulting effects on health outcomes.

Walking on prescription: The utility of a pedometer pack for increasing physical activity in primary care

OBJECTIVE This study used a multi-method approach to examine the effectiveness of a pedometer-based intervention delivered by health professionals for increasing walking. METHODS Pedometer packs were distributed to 374 patients who undertook a 12-week walking programme. Changes in walking were assessed at three months (using self-reported step-counts [n=139] and questionnaire data [n=104]) and at six months (using patient questionnaire data [n=112]). Qualitative data were collected at both time points to identify underlying mechanisms. RESULTS After 12 weeks patients had increased their step-counts by 4532 steps/day (p<.001) and at six months were achieving 2977 more steps/day (equivalent to around 30 min/day) than at baseline. Over half the patients reported achieving this target on at least 5 days/week. Qualitative data indicated that the pedometer pack was perceived to be most effective when patients were ready to change and when ongoing support was made available. CONCLUSION These findings support the use of pedometer-based interventions in primary care and suggest that the pedometer pack could lead to sustainable changes in walking. Further investigation, using a randomised controlled trial design, is warranted. PRACTICE IMPLICATIONS Provision of social support and accurate identification of patient readiness to change are important considerations in future implementation of the intervention.

Using pedometers as motivational tools: are goals set in steps more effective than goals set in minutes for increasing walking?

Abstract Background Pedometers are popular devices that measure walking steps. There has been a recent surge in promoting the pedometer as a motivational tool to increase walking. However, little empirical evidence exists to support this suggestion. Objective To examine the effectiveness of a pedometer as a motivational tool to increase walking. Methods 50 participants (7 men and 43 women, mean age (SD) 40.16 (8.81) years, range 25–61 years) were randomly assigned to either an intervention group who followed a four-week walking programme with goals set in steps (using an open pedometer for feedback) or a comparison group who followed an equivalent four-week walking programme with goals set in minutes. Participants had step-counts recorded at baseline, weeks 1, 2, 3, 4, and at weeks 16 and 52 for follow-up. Results Both groups significantly increased step- counts from baseline to week 4 with no significant difference between groups. However, a significantly greater number of participants in the intervention group (77%) compared with the comparison group (54%) achieved their week 4 goals (p=0.03). There was no significant change in step-counts from week 4 to week 16. There was a significant decrease from week 16 to week 52. Conclusion In the short term, both goals set in minutes and goals set in steps using a pedometer may be effective at promoting walking. In the long term, additional support may be required to sustain increases in walking.

Where is the Theoretical Basis for Understanding and Measuring the Environment for Physical Activity

Researchers are beginning to explore environmental correlates to further the field of physical activity research. Before interventions and experimental investigations can be undertaken, it is necessary to identify specific environmental features that are consistent correlates of physical activity. There has been a plethora of research measuring such cross-sectional associations since this field came to the fore in 2003. This paper posits that it is time for researchers to evaluate the state of knowledge, and suggests that future developments in this field focus on the theoretical bases for (i) measurement of the environment and (ii) understanding the links between perceptions of the environment and behaviour through psychological theories of cognition. Key theories considered include social ecology and the theory of planned behaviour. It is suggested that with a continued absence of a common conceptual framework, vocabulary and measurement tools the majority of studies may remain at a correlates stage. In highlighting issues with current methodologies, this commentary encourages more grounded theoretical approaches to the study of the environment and physical activity.

The Validity of Consumer-Level Activity Monitors in Healthy Older Adults in Free-Living Conditions

Consumer-level activity monitors, such as Fitbit and Misfit devices, are a popular and low-cost means of measuring physical activity. This study aims to compare the accuracy of step counts from two consumer-level activity monitors against two reference devices in healthy, community-dwelling older adults in free-living conditions. Twenty-five older adults (aged 65-84) simultaneously wore 5 devices (e.g., Misfit Shine and Fitbit Charge HR) over 7 consecutive days. All consumer-level activity monitors positively correlated with reference devices (p < .001). There was also substantial to near perfect agreement between all consumer-level activity monitors and reference devices. Compared to the ActiGraph GT3X+, the waist-worn Misfit Shine displayed the highest agreement amongst the devices worn (ICC = 0.96, 95% 0.91 to 0.99). The wrist-worn devices showed poorer agreement to reference devices. Future research needs to consider that not all consumer-level activity monitors are equal in terms of accuracy, design, and function.

Older adults’ satisfaction of wearing consumer-level activity monitors

There is a growing body of evidence to suggest that consumer-level activity monitors are a valid means of measuring physical activity in older adults. Understanding whether older adults are satisfied with wearing these activity monitors is an important step to ensuring that devices can be successfully implemented in clinical and research settings. Twenty-five older adults (mean age = 72.5 years, standard deviation = 4.9) wore two consumer-level activity monitors (Misfit Shine and Fitbit Charge HR) for seven consecutive days. After the week, participants were asked for their views and satisfaction of wearing each device, measured in part by the Quebec User Evaluation of Satisfaction with assistive Technology. Participants were generally satisfied with most aspects of the devices, though they were significantly more satisfied with the Misfit Shine. Participants were critical about their ability to adjust the fit of both the Misfit Shine and Fitbit Charge HR. Interestingly, the perceived satisfaction with the device was not associated with participants’ consideration of wearing the device again. Future research needs to consider whether the design of consumer-level activity monitors are best suited for older adults.

Rock drumming enhances motor and psychosocial skills of children with emotional and behavioural difficulties.

Objectives: Drumming may have therapeutic and learning benefits but there exists little causal evidence regarding the benefits for children with emotional and behavioral difficulties (EBD) such as Autistic Spectrum Disorder. Methods: Six EBD pupils (EBD Drum) and six peers (Peer Drum) were given 2, 30-min rock drumming lessons per week, over 5 weeks. Six matched individuals received no drumming instruction (3 = EBD Control; 3 = Peer Control). An exploratory, mixed-methods analysis was used to explore quantitative changes in skills and qualitative perspectives of the teaching staff. All pupils were tested two times (pretest and posttest) on drumming ability and Motor skills (Movement Assessment Battery for Children, version 2). Teacher’s rating of social behavior (Strength and Difficulties Questionnaire; SDQ) was tested two times (pretest and retention). Results: Significant differences in total SDQ difficulties between the four groups (χ2(3) = 8.210, p = 0.042) and the hyperactivity subscale (χ2(3) = 10.641, p = 0.014) were observed. The EBD Drum group had greater reductions in total difficulties compared to the Peer Drum (p = 0.009) group and specifically greater reductions in hyperactivity compared to Peer Drum (p = 0.046) and the EBD Control (p = 0.006) group. In follow-up interviews, staff spoke positively about changes in pupil’s attitudes toward learning and social confidence. Conclusions: The positive changes to social and behavioral skills reported in this pilot study are similar to those recorded for other music modalities.

Sport coaches’ experiences of athlete injury: the development and regulation of guilt

Abstract This study sought to examine coaches’ experiences of guilt in the specific context of athlete injury. In-depth, semi-structured interviews were utilised to generate data. Our analysis suggested that not only was guilt a commonly felt emotion, but was also one that that the participants attempted to regulate. The coaches’ stories were primarily, although not exclusively, interrogated using the psychological theorising concerning trauma-related guilt. We conclude the paper by making connections to, and from, the coaches’ experiences of guilt with existing critiques of the prevailing deontological approach used to define what it means to be a ‘good’ sport coach. Here, we suggest that dominant perspectives in coach education may be instrumental in entrenching coaches’ experience of guilt.