Division of Experimental Medicine, Department of Medicine, McGill University Health Centre, McGill University, Canada.
Division of Clinical Epidemiology, Department of Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
J Sci Med Sport. 2020 Oct;23(10):962-967. doi: 10.1016/j.jsams.2020.04.010. Epub 2020 Apr 18.
Higher steps are associated with lower mortality and cardiovascular event rates. We previously demonstrated that tailored physician-delivered step count prescriptions successfully increased steps/day in adults with type 2 diabetes mellitus (T2DM) and/or hypertension. In the present analysis, we examined patterns of step count change and the factors that influence different responses.
Longitudinal observational study METHODS: Active arm participants (n=118) recorded steps/day. They received a step count prescription from their physician every 3-4 months. We computed mean steps/day and changes from baseline for sequential 30-day periods. Group-based trajectory modeling was applied.
Four distinct trajectories of mean steps/day emerged, distinguishable by differences in baseline steps/day: sedentary (19%), low active (40%), somewhat active (30%) and active (11%). All four demonstrated similar upward slopes. Three patterns emerged for the change in steps from baseline: gradual decrease (30%), gradual increase with late decline (56%), and rapid increase with midpoint decline (14%); thus 70% had an increase from baseline. T2DM (odd ratios [OR]: 3.7, 95% CI 1.7, 7.7) and age (OR per 10-year increment: 2, 95% CI 1.3, 2.8) were both associated with starting at a lower baseline but participants from these groups were no less likely than others to increase steps/day.
T2DM and older age were associated with lower baseline values but were not indicators of likelihood of step count increases. A physician-delivered step count prescription and monitoring strategy has strong potential to be effective in increasing steps irrespective of baseline counts and other clinical and demographic characteristics.
较高的步数与较低的死亡率和心血管事件发生率相关。我们之前的研究表明，量身定制的医生提供的步数处方成功地增加了 2 型糖尿病（T2DM）和/或高血压成人的每日步数。在本分析中，我们检查了步数变化的模式以及影响不同反应的因素。
纵向观察性研究
积极组参与者（n=118）记录每日步数。他们每 3-4 个月从医生那里收到一份步数处方。我们计算了连续 30 天的每日平均步数和基线变化。应用基于群组的轨迹建模。
出现了四种不同的平均步数轨迹，区别在于基线步数/天的差异：久坐（19%）、低活跃（40%）、有点活跃（30%）和活跃（11%）。所有四个轨迹都显示出相似的上升趋势。从基线变化的步数出现了三种模式：逐渐减少（30%）、逐渐增加后下降（56%）和中间点下降后快速增加（14%）；因此，70%的人从基线增加。T2DM（比值比 [OR]：3.7，95%CI 1.7，7.7）和年龄（每增加 10 岁的 OR：2，95%CI 1.3，2.8）都与较低的基线值相关，但这些组的参与者增加步数/天的可能性并不低于其他参与者。
T2DM 和年龄较大与较低的基线值相关，但不是增加步数的可能性的指标。医生提供的步数处方和监测策略具有很强的潜力，可以增加步数，无论基线计数和其他临床和人口统计学特征如何。
