Ambulation Orderlies and Recovery After Cardiac Surgery: A Pilot Randomized Controlled Trial

Background: One potential strategy to increasing physical activity after surgery is to use an ambulation orderly (AO), a dedicated employee who assures frequent patient walking. However, the impact of an AO on physical and functional recovery from surgery is unknown. Methods: We randomized postoperative cardiac surgical patients to receive either the AO or usual care. We measured average daily step count, changes in 6-min walk test (6MWT) distance, and changes in functional independence (Barthel Index). Our primary goal was to test protocols, measure variability in activity, and establish effect sizes. Results: Thirty-six patients were randomized (18 per group, 45% bypass surgery). Overall, patients exhibited significant recovery of physical function from baseline to discharge in the 6MWT (from 83 to 172 meters, p < 0.001) and showed improvement in independent function (Barthel Index, 67 to 87, p < 0.001). Moreover, each additional barrier to ambulation (supplemental oxygen, intravenous poles/fluid, walkers, urinary catheters, and chest tubes) reduced average daily step count by 330 steps/barrier, p = 0.04. However, the AO intervention resulted in only a small difference in average daily step counts (2718 versus 2541 steps/d, Cohen's d = 0.16, 608 patients needed for larger trial), which we attributed to several trial factors that likely weakened the AO intervention. Conclusion: In this pilot study, we observed significant in-hospital physical and functional recovery from surgery, but the addition of an AO made only marginal differences in daily step counts. Future studies should consider stepped-wedge or cluster trial designs to increase intervention effectiveness. Clinical Trials Registration: Clinicaltrials.gov unique identifier: NCT02375282.

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Feedback From Activity Trackers Improves Daily Step Count After Knee and Hip Arthroplasty: A Randomized Controlled Trial

The Journal of Arthroplasty ◽

10.1016/j.arth.2018.06.024 ◽

2018 ◽

Vol 33 (11) ◽

pp. 3422-3428 ◽

Cited By ~ 13

Author(s):

Neill Van der Walt ◽

Lucy J. Salmon ◽

Benjamin Gooden ◽

Matthew C. Lyons ◽

Michael O'Sullivan ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Hip Arthroplasty ◽

Controlled Trial ◽

Step Count ◽

Daily Step ◽

Randomized Controlled ◽

Activity Trackers ◽

Daily Step Count ◽

Knee And Hip Arthroplasty

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Adding team-based financial incentives to the Carrot Rewards physical activity app increases daily step count on a population scale: a 24-week matched case control study

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-020-01043-1 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Emma Pearson ◽

Harry Prapavessis ◽

Christopher Higgins ◽

Robert Petrella ◽

Lauren White ◽

...

Keyword(s):

Physical Activity ◽

Financial Incentives ◽

Step Count ◽

Daily Step ◽

Individual Level ◽

Significant Difference ◽

Daily Step Count ◽

Steps Per Day ◽

The Impact ◽

Experimental Group

Abstract Background Mobile health applications (mHealth apps) targeting physical inactivity have increased in popularity yet are usually limited by low engagement. This study examined the impact of adding team-based incentives (Step Together Challenges, STCs) to an existing mHealth app (Carrot Rewards) that rewarded individual physical activity achievements. Methods A 24-week quasi-experimental study (retrospective matched pairs design) was conducted in three Canadian provinces (pre-intervention: weeks 1–12; intervention: weeks 13–24). Participants who used Carrot Rewards and STCs (experimental group) were matched with those who used Carrot Rewards only (controls) on age, gender, province and baseline mean daily step count (±500 steps/d). Carrot Rewards users earned individual-level incentives (worth $0.04 CAD) each day they reached a personalized daily step goal. With a single partner, STC users could earn team incentives ($0.40 CAD) for collaboratively reaching individual daily step goals 10 times in seven days (e.g., Partner A completes four goals and Partner B completes six goals in a week). Results The main analysis included 61,170 users (mean age = 32 yrs.; % female = 64). Controlling for pre-intervention mean daily step count, a significant difference in intervention mean daily step count favoured the experimental group (p < 0.0001; ηp2 = 0.024). The estimated marginal mean group difference was 537 steps per day, or 3759 steps per week (about 40 walking min/wk). Linear regression suggested a dose-response relationship between the number of STCs completed (app engagement) and intervention mean daily step count (adjusted R2 = 0.699) with each new STC corresponding to approximately 200 more steps per day. Conclusion Despite an explosion of physical activity app interest, low engagement leading to small or no effects remains an industry hallmark. In this paper, we found that adding modest team-based incentives to the Carrot Rewards app increased mean daily step count, and importantly, app engagement moderated this effect. Others should consider novel small-teams based approaches to boost engagement and effects.

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A Pilot Study Comparing Pedometer Counts with Reported Physical Activity in Elementary Schoolchildren

Pediatric Exercise Science ◽

10.1123/pes.16.4.355 ◽

2004 ◽

Vol 16 (4) ◽

pp. 355-367 ◽

Cited By ~ 18

Author(s):

Greet Cardon ◽

Ilse De Bourdeaudhuij

Keyword(s):

Physical Activity ◽

Pilot Study ◽

Vigorous Physical Activity ◽

Step Count ◽

Regression Equations ◽

Moderate Correlation ◽

Daily Step ◽

Step Counts ◽

Daily Step Count

In this study pedometer counts were recorded for 6 consecutive days for 92 children (mean age = 9.6 years; range 6.5–12.7) and were compared with the number of minutes per day in which the participants engaged in moderate-to-vigorous physical activity (MVPA). Diaries filled out with the assistance of one of the children’s parents were used to determine minutes of MVPA. The average daily step count was significantly higher in boys than in girls, although the average daily MVPA engagement in minutes did not vary significantly between genders. Based on the regression equations, 60 min of MVPA was equivalent to 15,340 step counts in boys, 11,317 step counts in girls, and 13,130 step counts when results for both genders were combined. A moderate correlation (r = .39, p < .001) was found between pedometer step counts and reported minutes of MVPA. According to the present study findings, however, predictions and promotion of daily MVPA engagement in children based on pedometer counts per day should be made with caution.

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Daily step counts to predict hospitalizations during chemoradiotherapy for head and neck cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.1571 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 1571-1571

Author(s):

Elena S. Izmailova ◽

Andrew Cohen ◽

Rafi Kabarriti ◽

Jeremy Eichler ◽

Chengrui Huang ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Cox Regression ◽

Step Count ◽

Daily Step ◽

Step Counts ◽

The Past ◽

Daily Step Count ◽

Ecog Ps

1571 Background: Wearable activity trackers could provide useful data for managing cancer patients with respect to treatment selection, toxicity monitoring, and implementation of supportive care measures. Here, we seek to evaluate the association between daily step counts and hospitalizations in a cohort of patients with head and neck cancer (HNC). Methods: This analysis consists of patients enrolled in one of three prospective trials involving activity monitoring (NCT02649569, NCT03115398, NCT03102229) during chemoradiation. Study subjects were asked to wear a commercial fitness tracker continuously during the therapy. ECOG performance status (PS) was assessed at baseline, and quality of life (QoL) EORTC QLQ-C30 questionnaires were completed weekly. Multivariable Cox regression models with time-dependent covariates (average step count over the past 3 days, most recent QoL score) and time-fixed covariates (age, sex, baseline PS, study number, baseline tumor volume, and treatment setting [definitive versus postoperative]) were used to identify predictors of first hospital admission during the chemoradiotherapy course. In addition to the Cox regression models, linear mixed models were fitted with daily step count as the dependent variable to examine its relationship with certain independent variables including age, sex, weekend status, days after treatment initiation, and study number. Results: Sixty-six HNC patients who received chemoradiotherapy between 2015 and 2019 were included in the analysis. Median age was 60 (range: 27-88). 47% of patients had ECOG PS score 0, 47% ECOG score 1, and 6% ECOG score 2. 29% of patients had HPV-positive oropharyngeal tumors, and the most common other tumor subsites were larynx (27%), and nasopharynx (12%). The Cox regression survival model demonstrated a 26% reduction in the short-term hospitalization risk for every 1000 daily steps (averaged over the past 3 days, hazard ratio 0.74; 95% confidence interval (CI) 0.55-0.98, p = 0.0367). Hospitalizations were not significantly associated with most recent QoL or baseline ECOG PS. Additionally, according to the linear mixed model results, daily step count was not associated with age (p = 0.8048). Study subjects moved less on weekends (on average 245 fewer steps on weekends than weekdays, 95% CI 134-357, p < 0.0001). Also, an increase in most recently measured ECOG PS was associated with a decrease in daily step count (167 fewer steps for every increase in ECOG PS, 95% CI -289 to -45, p < 0.0072). Conclusions: Daily step counts are a dynamic predictor of hospitalizations in patients undergoing chemoradiotherapy for head and neck cancer. Interventional studies are needed to demonstrate feasibility of leveraging physical activity data to optimize supportive care during cancer therapy and enhance cancer care quality. Clinical trial information: NCT02649569, NCT03115398, NCT03102229.

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Adding Team-Based Financial Incentives to the Carrot Rewards App Increases Daily Step Count on a Population Scale: A 24-Week Matched Pairs Study

10.21203/rs.3.rs-54028/v1 ◽

2020 ◽

Author(s):

Emma Pearson ◽

Harry Prapavessis ◽

Christopher Higgins ◽

Robert Petrella ◽

Lauren White ◽

...

Keyword(s):

Physical Activity ◽

Financial Incentives ◽

Step Count ◽

Matched Pairs ◽

Daily Step ◽

Significant Difference ◽

Daily Step Count ◽

Steps Per Day ◽

The Impact ◽

Experimental Group

Abstract Background Mobile health applications (mHealth apps) targeting physical inactivity have increased in popularity yet are usually limited by low engagement. This study examined the impact of adding team-based incentives (Step Together Challenges, STCs) to an existing mHealth app (Carrot Rewards) that rewarded individual physical activity achievements. Methods A 24-week quasi-experimental study (retrospective matched pairs design) was conducted in three Canadian provinces (pre-intervention: weeks 1–12; intervention: weeks 13–24). Participants who used Carrot Rewards and STCs (experimental group) were matched with those who used Carrot Rewards only (controls) on age, gender, province and baseline mean daily step count (± 500 steps/d). Carrot Rewards users earned individual-level incentives (worth $0.04 CAD) each day they reached a personalized daily step goal. With a single partner, STC users could earn team incentives ($0.40 CAD) for collaboratively reaching individual daily step goals 10 times in seven days (e.g., Partner A completes four goals and Partner B completes six goals in a week). Results The main analysis included 61,170 users (mean age = 32yrs; % female = 64). Controlling for pre-intervention mean daily step count, a significant difference in intervention mean daily step count favoured the experimental group (p < 0.0001; ηp2 = 0.024). The estimated marginal mean group difference was 537 steps per day, or 3759 steps per week (about 40 walking min/wk). Linear regression suggested a dose-response relationship between the number of STCs completed (app engagement) and intervention mean daily step count (adjusted R2 = 0.699) with each new STC corresponding to approximately 200 more steps per day. Conclusion Despite an explosion of physical activity app interest (100,000 + published apps), low engagement leading to small or no effects remains an industry hallmark. In this paper, we found that adding modest team-based incentives to the Carrot Rewards app increased mean daily step count, and importantly, app engagement moderated this effect. Others should consider novel small-teams based approaches to boost engagement and effects.

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IMPACT OF PHYSICIAN LED LIFE STYLE MODIFICATIONS (DIET AND DAILY STEP COUNT BY USING PEDOMETER) ON GLYCEMIC CONTROL OF PATIENTS WITH TYPE II DIABETIC

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i2.2788 ◽

2021 ◽

Vol 71 (2) ◽

pp. 478-81

Author(s):

Rimsha Azhar ◽

Khurshid Uttra ◽

Andaleeb Khan ◽

Marriam Hussain Awan ◽

Ayesha Anwer ◽

...

Keyword(s):

Glycemic Control ◽

Life Style ◽

Step Count ◽

Diabetic Patients ◽

Care Hospital ◽

Type Ii ◽

Daily Step ◽

Significant Difference ◽

Daily Step Count ◽

The Impact

Objective: To determine the impact of physician led life style modifications (diet and daily step count by using pedometer) on glycemic control of type II diabetic patients Study Design: Quasi experimental study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi, Aug 2018 to Feb 2019. Methodology: The sample population comprised of 200 diabetic patients reporting for the routine follow-up at a tertiary care hospital in Rawalpindi. Patients were divided into two groups by random method. Group A had the patients with continuation of the routine anti-diabetic medication while group received the physician led life style modifications in addition to the routine anti diabetic medication. Values of HBA1c among the groups were compared three months after the start of study. Results: Mean age of the patients was 42.19 ± 6.175 years. Mean duration of DM in the study participants was 4.52 ± 4.166 years. Out of 115 patients were male while 85 were female. HBA1c in the intervention group was 7.96% ± 0.39 while in the control group was 7.04% ± 0.81. Difference between the two groups was statistically significant (p-value<0.01). Conclusion: This study showed a significant difference in glycemic control of patients who received physician led life style modification in addition to conventional biological treatment than those who only received the routine anti-diabetic medication. Physicians should be trained to impart this sort of education to the diabetic patients in routine diabetic clinics.

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Adding team-based financial incentives to the Carrot Rewards physical activity app increases daily step count on a population scale: A 24-week matched case control study

10.21203/rs.3.rs-54028/v3 ◽

2020 ◽

Author(s):

Emma Pearson ◽

Harry Prapavessis ◽

Christopher Higgins ◽

Robert Petrella ◽

Lauren White ◽

...

Keyword(s):

Physical Activity ◽

Financial Incentives ◽

Step Count ◽

Daily Step ◽

Individual Level ◽

Significant Difference ◽

Daily Step Count ◽

Steps Per Day ◽

The Impact ◽

Experimental Group

Abstract Background: Mobile health applications (mHealth apps) targeting physical inactivity have increased in popularity yet are usually limited by low engagement. This study examined the impact of adding team-based incentives (Step Together Challenges, STCs) to an existing mHealth app (Carrot Rewards) that rewarded individual physical activity achievements.Methods: A 24-week quasi-experimental study (retrospective matched pairs design) was conducted in three Canadian provinces (pre-intervention: weeks 1-12; intervention: weeks 13-24). Participants who used Carrot Rewards and STCs (experimental group) were matched with those who used Carrot Rewards only (controls) on age, gender, province and baseline mean daily step count (±500 steps/d). Carrot Rewards users earned individual-level incentives (worth $0.04 CAD) each day they reached a personalized daily step goal. With a single partner, STC users could earn team incentives ($0.40 CAD) for collaboratively reaching individual daily step goals 10 times in seven days (e.g., Partner A completes four goals and Partner B completes six goals in a week).Results: The main analysis included 61,170 users (mean age=32yrs; % female=64). Controlling for pre-intervention mean daily step count, a significant difference in intervention mean daily step count favoured the experimental group (p<0.0001; ηp2=0.024). The estimated marginal mean group difference was 537 steps per day, or 3759 steps per week (about 40 walking min/wk). Linear regression suggested a dose-response relationship between the number of STCs completed (app engagement) and intervention mean daily step count (adjusted R2=0.699) with each new STC corresponding to approximately 200 more steps per day.Conclusion: Despite an explosion of physical activity app interest, low engagement leading to small or no effects remains an industry hallmark. In this paper, we found that adding modest team-based incentives to the Carrot Rewards app increased mean daily step count, and importantly, app engagement moderated this effect. Others should consider novel small-teams based approaches to boost engagement and effects.

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Stay Home and Stay Active? The impact of stay-at-home restrictions on physical activity routines in the UK during the COVID-19 pandemic

10.1101/2021.01.31.21250863 ◽

2021 ◽

Cited By ~ 1

Author(s):

Victoria Eshelby ◽

Muhammed Sogut ◽

Kate Jolly ◽

Ivo Vlaev ◽

Mark T. Elliott

Keyword(s):

Physical Activity ◽

Urban Areas ◽

Step Count ◽

Daily Step ◽

Physical And Mental Health ◽

Targeted Interventions ◽

Factors Associated ◽

Daily Step Count ◽

The Uk ◽

The Impact

ABSTRACTGovernment restrictions applied during the COVID-19 pandemic in the UK led to the disruption of many people’s physical activity routines, with sports and leisure facilities closed and outdoor exercise only permitted once per day. In this study we investigated which population groups were impacted most in terms of reduced physical activity levels during these periods, and which groups benefitted in terms of increasing their usual level of physical activity. We surveyed UK residents, sampled through users of a rewards-for-exercise app (Sweatcoin; n=749) and an online panel (Prolific; n=907). Of the app users, n=487 further provided daily step-count data collected by the app, prior to, and during the periods of restrictions between March and June 2020. Regression models were applied to investigate factors associated with subjective change (perceived change in physical activity) and objective change (log-percentage change in daily step-count) in physical activity during the periods of restrictions. ANOVAs were used to further investigate the significant factors identified. Key factors associated with a substantial subjective reduction in physical activity included those classed as obese, gym users and people living in urban areas. All participants had a reduced step count during restrictions, with Black, Asian and minority ethnic (BAME) groups, students and urban dwellers showing the largest reductions. Therefore, targeted interventions are required to ensure that the physical and mental health impacts of sedentary behaviour are not exacerbated over the long-term by significant reductions in physical activity identified in these groups, particularly those who are also more vulnerable to the COVID-19 virus.

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The Impact of a Structured, Supervised Exercise Program on Daily Step Count in Sedentary Older Adults With and Without HIV

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0000000000002326 ◽

2020 ◽

Vol 84 (2) ◽

pp. 228-233

Author(s):

Alex C. Stabell ◽

Melissa Wilson ◽

Catherine M. Jankowski ◽

Samantha MaWhinney ◽

Kristine M. Erlandson

Keyword(s):

Older Adults ◽

Exercise Program ◽

Step Count ◽

Daily Step ◽

Supervised Exercise ◽

Daily Step Count ◽

Supervised Exercise Program ◽

The Impact

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Comparison of Pedometer and Accelerometer Measures of Physical Activity in Preschool Children

Pediatric Exercise Science ◽

10.1123/pes.19.2.205 ◽

2007 ◽

Vol 19 (2) ◽

pp. 205-214 ◽

Cited By ~ 53

Author(s):

Greet Cardon ◽

Ilse De Bourdeaudhuij

Keyword(s):

Physical Activity ◽

Preschool Children ◽

Vigorous Physical Activity ◽

Step Count ◽

Activity Levels ◽

Accelerometer Data ◽

Strongly Correlated ◽

Daily Step ◽

Step Counts ◽

Daily Step Count

In this study, daily step counts were recorded for 4 consecutive days in 129 four- and five-year-old children. To compare daily Yamax Digiwalker step counts with minutes of engagement in moderate to vigorous physical activity (MVPA), concurrent accelerometer data were collected in a random subsample (n = 76). The average daily step count was 9,980 (± 2,605). Step counts and MVPA minutes were strongly correlated (r = .73, p < .001). The daily step count of 13,874, equating to 1-hr MVPA engagement, was reached by 8% of the children. Daily step counts in preschool children give valid information on physical activity levels—daily step counts in preschoolers are low.

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