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

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 life style, typically by increasing ambulatory activity. Step counting devices (accelerometers and pedometers) offer an oppurtunity to monitor daily ambulatory activity; however, an appropiate translation of public health guidelines in terms of steps/day. Normative data indicates that 1) healthy older adults average 2000-9000 steps/day, and 2) special populations average 1200-8800 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 2215 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 3000 steps. However, this cadence may be unattainable in some frail/diseased populations. Regardless, to truly translate public heath 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 5000 steps/day (which may actually be too high for some older adults and/or special populations), a computed translation approximates 8000 steps on days that include a target of achieving 30 minutes of moderate-to-vigorous physical activity (MVPA), and approximately 7100 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 acitivities in healthy older adults os equivalent to taking approximately 7000-10,000 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.

This article is obtained from the International Journal of Behavioral Nutrition and Physical Activity.