Table 4

Cadence-related intervention studies

ReferenceParticipantsStudy design and durationIntervention group/protocolInstrumentsFindings
Intervention studies that prescribed cadence in physical activity programme
Johnson5820068 type 2 diabetes patients; 40–70 years (54.4±7.5 years)Single group pre-post; 12 weeks
  • 30 min/day, 3 days/wk of cadence-based ‘pick up the pace’ (PUP) walking to increase speed/intensity

  • Participants first determined normal cadence during a 10 min walk (accumulated steps/10 min); normal cadence then multiplied by 1.1 (ie, 10% increase) to provide PUP training cadence

Intervention: Pedometer—device make and model NR
Assessment: Accelerometer —AMP 331 (Dynastream,
Calgary, AB, Canada
  • Average walking speed (km/hour) for PUP walking, non-PUP walking on PUP days and non-PUP days:

    • Week 1—5.2±0.7, 3.2±0.5, and 3.1±0.4

    • Week 4—5.4±0.7, 3.2±0.5, and 3.1±0.3

    • Week 12—5.7±0.8, 3.0±0.5, and 3.3±0.4

  • Heart rate response to modified Bruce protocol significantly lower (data presented only in figure)

  • Haemoglobin A1c decreased (−0.35±0.55%), but was not statistically different

Richardson59200730 sedentary adults with type 2 diabetes; >18 years (52±12 and 53±9 years for groups, respectively)Randomised trial; 6 weeks
  • Lifestyle goals (LG; n=17) targeting individualised daily total step count;

  • Structured goals (SG; n=13) targeting bout steps, defined as walking for ≥10 min at ≥60 steps/min

Omron HJ-720IT (Omron Healthcare, Lake Forest, Illinois)
  • LG group significantly increased total steps (2122±3179, P=0.01), whereas SG group failed to reach statistical significance (1697±3564, P=0.11). No between-group difference (P=0.73)

  • Both groups significantly (P<0.05) increased bout steps (1783±2741 vs 2101±2815 for LG and SG, respectively). No between-group difference (P=0.76)

Marshall60 2013180 Latina women;
18–65 years (36.94±8.86, 35.27±8.76 and 35.42±8.41 years for groups, respectively)
Randomised trial; 12 weeksTheory-based PA intervention+one of the following:
  • Self-selected goal (SELF, n=60)

  • A goal of 10 000 steps per day (FREQUENCY, n=60)

  • A goal of 3000 steps in 30 min (CADENCE, n=60)

Yamax Digi-Walker
SW-200 (New Lifestyles, Lees Summit, Missouri),
Assessment: Accelerometer ActiGraph 7164 (ActiGraph, Pensacola, Florida)
  • CADENCE group engaged in similar levels of MVPA compared with SELF and FREQUENCY groups

  • CADENCE group more likely to engage in bouts of MVPA>10 min compared with SELF (P=0.01) and FREQUENCY (P=0.001) groups

25 inactive older adults; aged >65 years (71.9±4.5)Randomised trial; 8 weeks
  • Manual pulse (n=8)

  • HR monitor (n=9)—using heart rate reserve (HRR) (≥40% of HRR) to achieve moderate intensity

  • Pedometer (n=8)—targeting 100 steps/min to achieve moderate intensity

Intervention: HR monitor—Polar Accurex Plus (Polar Electro, Woodbury, New York, USA) and Pedometer (Yamax Health Sports, San Antonio, Texas, USA)
Assessment: the long version of the International Physical Activity Questionnaire; CR-10—perception of aerobic exercise intensity on the Borg scale
  • Only HR monitor and pedometer groups increased total aerobic exercise time as measured by HR monitor (both P<0.01)

  • No group improved the time spent at MVPA (≥40% of HRR)

  • No group improved the ability to correctly identify moderate intensity, but an observed tendency in pedometer group (P=0.07)

2017 *
42 inactive older adults; aged >65 years (66–77)Randomised trial; 12 weeks
  • Individualised walking cadence prescription using pedometer (n=20)—achieving moderate-to-vigorous intensity physical activity in 10 min bouts

  • Control group (n=22)— walking at a moderate-to-vigorous intensity in 10 min bouts at least 150 min/wk without any additional information

Intervention: Pedometer (StepRx, Ontario, Canada)
Assessment: Pedometer (StepRx, Ontario, Canada) and accelerometer (Phillips, Respironics, Oregon, USA)
  • Increased time at moderate intensity and 10 min bout moderate intensity were found only in the intervention group compared with baseline (P≤0.01)

Intervention studies that analysed accelerometer data using cadence-based metrics
Gardner632011119 peripheral artery disease patients with intermittent claudication; 66±12, 65±11 and 65±10 years for groups, respectivelyRCT; 12 weeks
  • Supervised treadmill-walking programme (n=33)–3 days/week, intermittent walking at ~2 mph for 15 min/session (first 2 weeks) progressing to 40 min (final 2 weeks)

  • Home-based walking programme (n=29)—3 days/week, intermittent walking at self-selected speed for 20 min/session (first 2 weeks) progressing to 45 min (final 2 weeks)

  • ) Control group—usual care (n=30)

Accelerometer - StepWatch3 (Cyma, Mountlake Terrace, Washington)
  • Home-based walking programme resulted in significant differences both within (P<0.01) and between groups (P<0.01) (ie, control group)

    • Daily average (2.2±4.0 vs −0.6±3.6 steps/min)

    • Maximum 20 min (6.6±12.2 vs −3.8±13.8)

    • Maximum 30 min (6.8±11.4 vs −3.6±10.6)

    • Maximum 60 min (5.0±9.4 vs −2.6±8.4)

  • Cadence indicators (change-scores) home-based vs control group (all P<0.01)

  • No significant within-group or between-group changes in cadence indicators for supervised treadmill-walking and control groups

28 adults; 21–65 years (54.7±7.9 years)Randomised trial; 8 weeks
  • Diet and PA intervention targeting MVPA time ≥40 min/day, 5 days/wk

  • Diet and PA intervention targeting MVPA time ≥40 min/day, 5 days/wk+reducing TV time ≤10 hours/week

NB: no between-group differences at 8 weeks for PA outcomes; group data collapsed for this analysis
Omron HJ-720ITC (Omron Healthcare, Lake Forest, Illinois)
  • Aerobic steps/day (ie, cadence >60 steps/min in ≥10 min bouts) Increased (baseline: 662±1008 steps/day; 8 weeks: 2514±2105 steps/day; P=0.001)

  • Aerobic min/day increased (baseline: 6.0±14.9 min; 4 weeks: 25.7±27.0 min, P<0.05; and 8 weeks: 22.5±28.3; P>0.05)

  • Aerobic steps/min (cadence) increased (baseline: 60±53.8 steps/min; 4 weeks: 109±23.0 steps/min, P<0.05; and 8 weeks: 100±36.0 steps/min, P>0.05)

  • Participants exceeded 100 steps/min for 89% of their aerobic minutes

57 subacute patients with stroke; 64 (range 22–92) and 61.5 (24–81) years for groups, respectivelyRandomised controlled trial; median duration of intervention 14 (range 4–91) and 14 (3–36) days for groups, respectively
  • Intervention (n=29) - daily feedback about walking activity, including: walking time, steps/day, average cadence, longest bout duration, number of ‘long’ walking bouts

  • Control (n=28)—no feedback

Two tri-axial accelerometers – Model X6-2mini (Gulf Data Concepts, Waveland, Mississippi), worn on each limb
  • No significant between-group differences in change in walking time, number of steps, longest bout duration or number of long walking bouts for the feedback group compared with the control group (P>0.20).

  • Intervention group significantly increased average cadence (76.3 (95% CI 72.9 to 79.8) to 81.1 (77.9 to 84.4) steps/min) compared with control group (76.0 (72.3 to 79.6) to 77.0 (73.7 to 80.3) steps/min; P=0.013, for between-group comparison)

Barreira66201690 overweight and obese white and African-American adults;
35–64 years
Randomised trial; 12 weeks
  • Diet education and behaviour change (DE)

  • Diet education plus a pedometer-based PA intervention (DE+PA); step goal of 8300–9100 steps/day (including 30 min/day MVPA)

Accelerometer— ActiGraph GT3X+ (ActiGraph, Pensacola, Florida)
  • No significant difference for changes in steps/day between groups

  • DE+PA group accumulated significantly more steps in the 80–99, 100–119 and 120+ cadence bands at postintervention (all P<0.02)

  • DE+PA group increased peak 30 and 60 min cadences and steps accumulated within the 100–119 (463±1092 vs56±546 steps; P=0.01) and 120+ (390±999 vs 34±321 steps; P=0.03) cadence bands compared with DE group

  • *An additional article, McLellan 2017,67 arising from the same trial was omitted to avoid duplication of information.

  • Min/wk, minutes per week; MVPA, moderate-to-vigorous intensity physical activity; NR, not reported; PA, physical activity; RCT, randomised controlled trial.