Pedometer-measured physical activity patterns of youth: a 13-country review

Context: Insufficient physical activity among young people aged 5-18 years is a global public health issue, with considerable disparities among countries. A systematic review was conducted to identify studies reporting pedometer daily steps (steps x day(-1)) in order to compile comparative, global cross-sectional data on youth physical activity patterns.

Evidence acquisition: Articles were included if they were in English, published by April 2009, and reported steps x day(-1) for boys and girls, separately, and reported steps x day(-1) for age groupings of no more than 4 years (e.g., 5-8 years) or combined no more than three grade levels (e.g., third- to fifth-graders). Studies could have been intervention-based but had to have reported baseline steps x day(-1), which would reflect unadulterated physical activity steps x day(-1) estimates. Inverse variance weighted estimates (steps x day(-1w)) were calculated for each country, and random effects models were estimated. Analyses were conducted in May and June 2009.

Evidence synthesis: Forty-three studies, representing young people in 13 countries (N=14,200), were included. The majority of studies were from the U.S. (17/43). Overall, there was considerable variation within and among countries in steps x day(-1w). Boys and girls from European and Western Pacific regions had significantly more steps x day(-1w) than young people from the U.S. and Canada. Significantly lower steps x day(-1w) estimates for girls were observed for studies that combined measured steps x day(-1) for weekdays and weekend days, in comparison to weekdays only.

Conclusions: Limited sample sizes and non-population-based data preclude definitive statements regarding projected steps x day(-1) within countries. Nevertheless, these findings provide preliminary information for policymakers and researchers on the extent of the disparities among countries in the physical activity patterns of young people.