Brief Report
Effects of Pedometer Use in Veterans With Chronic Heart Failure

https://doi.org/10.1016/j.nurpra.2015.04.027Get rights and content

Highlights

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    We examined the effects of pedometer use in veterans with chronic heart failure.

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    Both exercise with or without a pedometer increased exercise tolerance.

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    The use of a pedometer was not better than routine walking exercise.

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    Pedometer malfunction was a major cause for noncompliance.

Abstract

Routine physical activity can improve exercise tolerance in individuals with chronic heart failure (HF). Lack of exercise can lead to worsening of HF. This study examined the effect of a pedometer on exercise tolerance in veterans with chronic HF. Although both pedometer and routine exercise groups improved 6-minute walk test distance, the use of a pedometer was not better than routine exercise in improvement in exercise tolerance after 6 weeks. Factors that may have impacted the effectiveness of pedometer use include pedometer malfunction, low pedometer compliance, and severe wintery weather.

Section snippets

Theoretical Framework

The Health Promotion Model is a middle-range nursing theory that was used to guide this study. The foundation of Health Promotion Model focuses on factors that influence an individual’s ability to achieve health-promoting behaviors.6

Design

A prospective randomized controlled design was used in this study. Using permuted block randomization, veterans were assigned to either the control (routine exercise) group or the pedometer (exercise with a pedometer) group.

Setting and Sample

Veterans were recruited from the Veterans Administration Connecticut Healthcare System. Veterans with NYHA class II-III HF symptoms and confirmed ejection fraction ≤ 45% were eligible to participate. Exclusion criteria included unstable angina, untreated cardiac

Results

A total of 102 veterans meeting the criteria were identified. Seventy-four veterans declined to participate in the study. Twenty-eight veterans were recruited, but 2 veterans dropped out, making the final sample size 26. Twelve veterans (46.2%) were randomized into the pedometer group and 14 (53.8%) into the control group (Figure 1).

Demographic characteristics of both groups are displayed in Table 1. The only significant difference between the 2 groups was that veterans in the control group

Discussion

Among the veterans who completed the pre- and post-6MWT in the experimental group, pedometer use significantly improved their exercise tolerance after 6 weeks of exercise (P = .005). This finding is consistent with previous studies reporting that pedometer use was associated with increased exercise tolerance.2, 3, 4, 5

Veterans in the control group also experienced statistically significant improvement in their exercise tolerance (P = .01). However, there was no significant difference in the

Conclusion

Routine mild to moderate exercise motivated by either pedometer use or verbal instruction improved exercise tolerance in veterans with HF. Although the improvement may not have reached MCID (Figure 2), this positive trend is encouraging. Pedometers provide specific numbers of steps walked daily and can be easily tracked by telehealth nursing services. A select group of veterans with HF may experience increased health benefits by tracking their daily or weekly steps via a pedometer and reporting

Vicky M. Chang, DNP, APRN, is a cardiology nurse practitioner at the VA Connecticut Healthcare System in West Haven, CT, and can be reached at [email protected].

References (10)

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Vicky M. Chang, DNP, APRN, is a cardiology nurse practitioner at the VA Connecticut Healthcare System in West Haven, CT, and can be reached at [email protected].

Mary I. Dallas, PhD, PT, is a physical therapy specialist at the VA Connecticut Healthcare System.

Tammy M. Lampley PhD, RN, CNE, and Kerry A. Milner, DNSc, RN, are assistant professors of nursing at the School of Nursing at Sacred Heart University in Fairfield, CT.

In compliance with national ethical guidelines, the authors report no relationships with business or industry that would pose a conflict of interest.

Vicky M. Chang is a recipient of the National Nursing Education Initiative scholarship by the Department of Veterans Affairs.

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