The Impact of a Pedometer Intervention on Physical Activity in Those With Serious Mental Illness

PURPOSE: Individuals with serious mental illness (SMI) are at increased risk for comorbidities, such as cardiovascular disease, diabetes, and other metabolic syndromes, ultimately leading to premature mortality of up to 25 years (Allison et al., 2009; Liu et al., 2017; National Association of State Mental Health Program Directors [NASMHPD], 2006). These individuals have decreased engagement in meaningful activities due to mental and physical symptoms (Gardner et al., 2017). This feasibility study investigated the impact of pedometer use on physical activity and engagement in daily activities, measured by the International Physical Activity Questionnaire Short Form (IPAQ-SF) and Difficulties in Occupational Engagement Questionnaire.

DESIGN: This pilot study used an exploratory cohort design. Eight participants who self-identified as having a mental illness were recruited from a community mental health setting and were provided with USB-enabled pedometers with preloaded recording software. These participants were also provided with weekly reminders to encourage pedometer use over the course of a 4-week intervention. The IPAQ-SF, Difficulties in Occupational Engagement Questionnaire, and a demographics survey were administered at pre-test. Weekly pedometer step counts were recorded using software installed on the pedometers. IPAQ-SF and Difficulties in Occupational Engagement Questionnaire were also administered at post-test, and participants were asked to respond to three informal questions regarding pedometer use.

RESULTS: Data showed increased step counts, decreased fatigue (p=0.043), and a positive relationship between change in pain and change in physical activity level (p=0.042). No relationship was found between pedometer use and engagement in daily activities.

CONCLUSION: Future studies should increase duration of intervention and sample size to further investigate these relationships. These findings can be used by occupational therapists and other health professionals to help guide treatment using physical activity to promote health and wellness in this population, thus preventing premature mortality among those with SMI.

References

Allison, D. B., Newcomer, J. W., Dunn, A. L., Blumenthal, J. A., Fabricatore, A. N., Daumit, G. L., ... & Alpert, J. E. (2009). Obesity among those with mental disorders: A National Institute of Mental Health meeting report. American Journal of Preventive Medicine, 36(4), 341-350. doi: 10.1016/j.amepre.2008.11.020.

Gardner, J., Swarbrick, M., Ackerman, A., Church, T., Rios, V., Valente, L., & Rutledge, J. (2017). Effects of physical limitations on daily activities among adults with mental health disorders. Journal of Psychosocial Nursing and Mental Health Services, 55(10), 45-51. doi: 10.3928/02793695-20170818-05.

Liu, N. H., Daumit, G. L., Dua, T., Aquila, R., Charlson, F., Cuijpers, P., … Saxena, S. (2017). Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 16(1), 30–40. doi:10.1002/wps.20384

National Association of State Mental Health Program Directors (NASMHPD). (2006). Morbidity and Mortality in People with Serious Mental Illness. Retrieved from National Association of State Mental Health Program Directors https://www.nasmhpd.org/sites/default/files/Mortality%20and%20Morbidity%20Final%2Report%208.18.08.pdf