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26 June 2019

Short-term pedometer interventions produce significant health benefits several years later

Adults who participated in short-term pedometer-based walking trials experienced health benefits several years later, according to research from King’s.

Walking with pedometer


Researchers have followed up pedometer-based walking trials in adults and found long-term health benefits for the participants four years later.   

In the original clinical trials, called PACE-UP and PACE-LIFT, led by Professor Tess Harris of St George’s, University of London, groups of primary care patients were given pedometers, 12-week walking programmes based on effective behaviour change techniques, and physical activity diaries. The patients in PACE-UP were predominantly inactive 45 to 75-year olds, while in PACE-LIFT the patients were 60-75 years old. In both groups, the intervention patients were found to have increased their activity levels 12 months later and 3-4 years later, compared to patients in a control group.

Participants in the intervention groups showed significantly fewer cardiovascular events, including heart attacks and strokes, as well as suffering fewer fractures, compared with those in the control groups in the studies.

In a follow-up study, researchers sought to link trial data with participants’ primary care records to evaluate the intervention effects from both trials on longer-term health outcomes. They looked at the electronic primary care data records for 1001 PACE-UP and 296 PACE-LIFT participants. They found that there were significantly fewer new cardiovascular events and fractures in intervention participants at 4 years. Approximately 60 people needed to receive the walking intervention to prevent one cardiovascular event and approximately 28 to prevent one fracture.

Last year, research led by Professor of Health Economics Julia Fox-Rushby, from the School of Population Health, predicted that posting pedometers to 45-75 year olds would be a cost-effective health measure in the long term, but raised concerns about the quality of long-term data. Professor Fox-Rushby said the new research has provided “added confidence” to these predictions.       

It is never too late to start exercising – our work was aimed at 45-75 year olds who were not walking much. Encouraging use of pedometers or step-counting to increase brisk walking is a great investment for those commissioning services to improve public health.

Julia Fox-Rushby, Professor of Health Economics


Effect of pedometer-based walking interventions on long-term health outcomes: prospective 4-year follow-up of two randomised controlled trials using routine primary care data can be read here on PLOS Medicine.