Placing Your Right Foot Forward: Demystifying Pedometers and Step Count

Written by: Jake Querciagrossa, DPT; Lone Peak Physical Therapy in Butte

As a health care provider, I am frequently asked by patients, “Is this a good form of exercise?” or “I’ve been walking a lot, but I can’t seem to lose weight.” Walking is something we do every day, but how much is enough? I find that people are unaware of how much they are moving throughout the day, even if time is set aside to exercise.  In 2019, most people are carrying a smart phone in their pocket for the majority of the day and the rest have watches that track steps. Phones today have pedometers, and some have accelerometers installed to their hardware. Pedometers are basic devices that track the number of steps someone takes while the device is on their person. Accelerometers are a little more involved and have the ability to track flights of stairs climbed or the intensity of a movement based on how fast the individual is moving. This data can be used by someone to track how active they are by simply opening an app on their phone. The catch is that you have to check it!

Most people have heard that 10,000 steps per day is a recommended daily value. This golden number has been shown to have effects on waist measurements, body mass index (BMI), and mood.1 To some, 10,000 steps may seem like an impossibility, especially when they become aware of how much they are actually moving. It has been found that 65% of people report they meet this recommended value, but when asked to carry an accelerometer, only 5% of those people actually met the mark.2 I have often asked patients to open their apps to see how many steps they take in a day and I have seen numbers varying from 1,200-4,200 steps, far from that 10K. So how can someone get to 10,000 steps? I suggest that becoming aware of your step count is a good place to start, then increase by 10% each week. A 10% increase is a safe progression for individuals to build up walking and running distance. Other predictors of weight loss include self-weighing and logging food intake at least 3x/week.3

What if weight loss is not your goal you ask? Increasing step count has been shown to improve cardiovascular function as well as decrease muscle/joint pain. Achieving 10,000 steps/day in bouts of >20 min of movement has been shown to improve blood vessel function in older adults.4 Muscle and joint pain are a hot topic in 2019, especially with the ramifications of the opioid crisis, patients being left out to dry in the process. Will walking completely eliminate a person’s pain? Probably not but increasing step count by an average of 1950 steps/day over a 12-week period (3 months) was shown to improve patient-reported pain scores and physical function.5,6

All in all, increasing a person’s step count is a great starting point when trying to take responsibility for one’s overall health. It may even have a trickle-down effect to their children; children who performed less than 5 min/day of vigorous physical activity are 4x more likely to be classified as overweight compared to their peers who performed 15 min/day.7 That 15 min/day is equivalent to 4,000-5,000 steps that children should acquire while at school!8 Influencing our children could have a resounding effect of the future health of our country and decrease burden on the health care system. If you are still not convinced or still don’t know where to start, ask your physical therapist for a more regimented program or how to access the pedometer on your phone. They can suggest a a way to move more appropriate for where you are today.

  1. Smith-McLallen A, Heller D, Vernisi K, Gulick D, Cruz S, Snyder RL. Comparative effectiveness of two walking interventions on participation, step counts, and health. Am J Health Promot. 2017; 31(2):119-127.
  2. Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008; 40(1):181-188.
  3. Painter SL, Ahmed R, Hill JO, Kushner RF, Lindquist R, Brunning S, Margulies A. What matters in weight loss? An in-depth analysis of self-monitoring. J Med Internet Res. 2017; 19(5):e160.
  4. Suboc TB, Strath SJ, Dharmashanker K, Coulliard A, Miller N, Wang J, Tanner MJ, Widlansky ME. Relative importance of step count, intensity, and duration on physical activity’s impact on vascular structure and function in previously sedentary older adults. J Am Heart Assoc. 2014;3:e000702.
  5. Krein SL, Bohnert A, Kim HM, Harris ME, Richardson CR. Opioid use and walking among patients with chronic low back pain. J Rehabil Res Dev. 2016; 53(1): 107-116.
  6. Mansi S, Milosavljevic S, Baxter GD, Turnity S, Hendrick P. A systematic review of studies using pedometers as an intervention for musculoskeletal diseases. BMC Musculoskelet Disord. 2014; 15:231-244. 
  7. Wittmeier KDM, Mollard RC, Kriellaars. Physical activity intensity and risk of overweight and adiposity in children. Obesity. 2008; 16(2):415-420.
  8. Burns RD, Brusseau TA, Fu Y, Zhang P. Development of step-count cut point for school-day vigorous physical activity. Biomed Res Int. 2018; 1-7.