Tess Harris and colleagues from the St George's University of London, UK and other institutions, conducted two trials of walking interventions which aimed to increase step count and physical activity. Not only did the investigators see sustained increases in physical activity at 3-4 years in the intervention group participants, but they also noted fewer cardiovascular events and fractures.
Physical activity has been shown to be protective for many health conditions, and inactivity is a key risk factor contributing to the global burden of disease.
However, long-term follow-up of physical activity trials is lacking. Here, two randomized controlled trials of 12-week pedometer-based walking interventions in primary care were followed up with long-term data from primary health records at four years.
The team studied data from 1297 participants of the PACE-UP and PACE-Lift trials. People in the intervention arms were less likely to have a cardiovascular event (Hazard Ratio 0.34, 95% CI 0.12-0.91, p = 0.03) or a fracture (HR 0.56, 95% CI 0.35-0.90, p = 0.02) than those in the control arms. No differences were seen in the incidence of diabetes or depression in people in the intervention as compared with those in the control arms.
Based on these observations, about 61 people would need to receive the walking intervention to prevent one cardiovascular event and 28 people to prevent one fracture. Although the rates of adverse health events were low in this study and were restricted to only those recorded in primary care records, under-recording would not have differed by intervention status, so should not have led to bias.
The authors note that "short-term walking interventions can produce long-term health benefits and should be more widely used to help address the public health inactivity challenge."