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Open Access Highly Accessed Review

How many steps/day are enough? For older adults and special populations

Catrine Tudor-Locke12*, Cora L Craig23, Yukitoshi Aoyagi4, Rhonda C Bell5, Karen A Croteau6, Ilse De Bourdeaudhuij7, Ben Ewald8, Andrew W Gardner9, Yoshiro Hatano10, Lesley D Lutes11, Sandra M Matsudo1213, Farah A Ramirez-Marrero14, Laura Q Rogers15, David A Rowe16, Michael D Schmidt1718, Mark A Tully19 and Steven N Blair20

Author Affiliations

1 Walking Behaviour Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA

2 Canadian Fitness and Lifestyle Research Institute, 201-185 Somerset Street West Ottawa, ON, K2P 0J2, Canada

3 School of Public Health, Edward Ford Building (A27), University of Sydney, Sydney, NSW 2006, Australia

4 Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaecho, Tokyo Itabashi, Tokyo 173, Japan

5 Department of Agricultural, Food and Nutritional Science, 4-10 Agriculture/Forestry Centre University of Alberta, Edmonton, Alberta, T6G 2P5, Canada

6 Department of Exercise, Health, and Sport Sciences, University of Southern Maine, 37 College Ave, Gorham, USA

7 Department of Movement and Sport Sciences, Sint-Pietersnieuwstraat 25, Ghent University, B - 9000 Ghent, Belgium

8 Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Callaghan, NSW 2308, Australia

9 CMRI Diabetes and Metabolic Research Program, Harold Hamm Oklahoma Diabetes Center, University of Oklahoma Health Sciences Center, 1000 N. Lincoln Boulevard, Oklahoma City, OK, USA

10 Tokyo Gakugei University, 4-1-1 Nukuikitamachi, Koganeisi, Tokyo 184-8501, Japan

11 Department of Psychology, East Carolina University, Greenville, NC 27858, USA

12 Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul (CELAFISCS) & Agita São Paulo, São Caetano do Sul, Brazil

13 Southern Illinois University School of Medicine, Department of Medicine, Springfield IL

14 Department of Physical Education and Recreation, Rio Piedras Campus, University of Puerto Rico, San Juan, Puerto Rico

15 Department of Medicine, Southern Illinois University School of Medicine, Springfield, IL, USA

16 School of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland, UK

17 Department of Kinesiology, 115 Ramsey, University of Georgia, Athens GA 30602, USA

18 Menzies Research Institute, Medical Science 1, 17 Liverpool Street, University of Tasmania, Hobart TAS 7000, Australia

19 UKCRC Centre for Public Health (NI), Royal Victoria Hospital, Grosvenor Road, Queen's University, Belfast, Ireland

20 Departments of Exercise Science and Epidemiology/Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, USA

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International Journal of Behavioral Nutrition and Physical Activity 2011, 8:80  doi:10.1186/1479-5868-8-80

Published: 28 July 2011

Abstract

Older adults and special populations (living with disability and/or chronic illness that may limit mobility and/or physical endurance) can benefit from practicing a more physically active lifestyle, typically by increasing ambulatory activity. Step counting devices (accelerometers and pedometers) offer an opportunity to monitor daily ambulatory activity; however, an appropriate translation of public health guidelines in terms of steps/day is unknown. Therefore this review was conducted to translate public health recommendations in terms of steps/day. Normative data indicates that 1) healthy older adults average 2,000-9,000 steps/day, and 2) special populations average 1,200-8,800 steps/day. Pedometer-based interventions in older adults and special populations elicit a weighted increase of approximately 775 steps/day (or an effect size of 0.26) and 2,215 steps/day (or an effect size of 0.67), respectively. There is no evidence to inform a moderate intensity cadence (i.e., steps/minute) in older adults at this time. However, using the adult cadence of 100 steps/minute to demark the lower end of an absolutely-defined moderate intensity (i.e., 3 METs), and multiplying this by 30 minutes produces a reasonable heuristic (i.e., guiding) value of 3,000 steps. However, this cadence may be unattainable in some frail/diseased populations. Regardless, to truly translate public health guidelines, these steps should be taken over and above activities performed in the course of daily living, be of at least moderate intensity accumulated in minimally 10 minute bouts, and add up to at least 150 minutes over the week. Considering a daily background of 5,000 steps/day (which may actually be too high for some older adults and/or special populations), a computed translation approximates 8,000 steps on days that include a target of achieving 30 minutes of moderate-to-vigorous physical activity (MVPA), and approximately 7,100 steps/day if averaged over a week. Measured directly and including these background activities, the evidence suggests that 30 minutes of daily MVPA accumulated in addition to habitual daily activities in healthy older adults is equivalent to taking approximately 7,000-10,000 steps/day. Those living with disability and/or chronic illness (that limits mobility and or/physical endurance) display lower levels of background daily activity, and this will affect whole-day estimates of recommended physical activity.