RT Journal A1 Bravata DM, Smith-Spangler C, Sundaram V, et al T1 Using pedometers to increase physical activity and improve health: A systematic review JF JAMA JO JAMA YR 2007 FD November 21 VO 298 IS 19 SP 2296 OP 2304 DO 10.1001/jama.298.19.2296 UL http://dx.doi.org/10.1001/jama.298.19.2296 AB Context  Without detailed evidence of their effectiveness, pedometers have recently become popular as a tool for motivating physical activity.Objective  To evaluate the association of pedometer use with physical activity and health outcomes among outpatient adults.Data Sources  English-language articles from MEDLINE, EMBASE, Sport Discus, PsychINFO, Cochrane Library, Thompson Scientific (formerly known as Thompson ISI), and ERIC (1966-2007); bibliographies of retrieved articles; and conference proceedings.Study Selection  Studies were eligible for inclusion if they reported an assessment of pedometer use among adult outpatients, reported a change in steps per day, and included more than 5 participants.Data Extraction and Data Synthesis  Two investigators independently abstracted data about the intervention; participants; number of steps per day; and presence or absence of obesity, diabetes, hypertension, or hyperlipidemia. Data were pooled using random-effects calculations, and meta-regression was performed.Results  Our searches identified 2246 citations; 26 studies with a total of 2767 participants met inclusion criteria (8 randomized controlled trials [RCTs] and 18 observational studies). The participants' mean (SD) age was 49 (9) years and 85% were women. The mean intervention duration was 18 weeks. In the RCTs, pedometer users significantly increased their physical activity by 2491 steps per day more than control participants (95% confidence interval [CI], 1098-3885 steps per day, P < .001). Among the observational studies, pedometer users significantly increased their physical activity by 2183 steps per day over baseline (95% CI, 1571-2796 steps per day, P < .0001). Overall, pedometer users increased their physical activity by 26.9% over baseline. An important predictor of increased physical activity was having a step goal such as 10 000 steps per day (P = .001). When data from all studies were combined, pedometer users significantly decreased their body mass index by 0.38 (95% CI, 0.05-0.72; P = .03). This decrease was associated with older age (P = .001) and having a step goal (P = .04). Intervention participants significantly decreased their systolic blood pressure by 3.8 mm Hg (95% CI, 1.7-5.9 mm Hg, P < .001). This decrease was associated with greater baseline systolic blood pressure (P = .009) and change in steps per day (P = .08).Conclusions  The results suggest that the use of a pedometer is associated with significant increases in physical activity and significant decreases in body mass index and blood pressure. Whether these changes are durable over the long term is undetermined.