1. Walking in rhythm: Using the power of music to promote health-enhancing walking

2. Setting the scenery Introduction
Walking intensity and cadence – the scientific evidence (David Rowe)
Listen while you walk – music and walking (Allan Hewitt)
Using technology and music in an intervention (Maria Faulkner)
Discussion

3. Walking intensity and cadence: The evidence for regulating walking pace
David Rowe
Reader in Exercise Science
Physical Activity for Health Research Group
University of Strathclyde

4. Who described walking as ...
“… the closest thing to perfect exercise”?

5. Rationale
Usefulness of cadence as a “metric” for monitoring and promoting ambulatory PA
Focus on walking (high participation levels, inexpensive, convenient, easy skill level)
Definitions:
Walking cadence - stepping rate (steps/min)
Walking speed – velocity (mph, km/h, m/min)
Walking intensity – rate of energy expenditure (VO2 in L/min, METs, kcal/min, “moderate/vigorous”)
Music tempo – pulse rate (beats/min)

7. Walking intervention goals
“Steps-only pedometers were tested, and progressive step goals were provided”
“The overall goal of the walking program was for participants to increase their mean daily step-count by 3,000 accumulated steps”
“The goal was to increase walking activity to a minimum of 90 min per week”
“Participants were instructed to set weekly personal walking goals”
“[participants] walked around the gym perimeter at 2.5 mph for 60 minutes”

8. Should we be asking: How many steps? (total physical activity volume)*
or ...
How many steps per minute? (intensity, variability patterns)
* See:
Tudor-Locke, C., et al. (2011). How many steps/day are enough? For children and adolescents. International Journal of Behavioral Nutrition and Physical Activity, 8, 78.
Tudor-Locke, C., et al. (2011). How many steps/day are enough? For adults. International Journal of Behavioral Nutrition and Physical Activity, 8, 79.
Tudor-Locke, C., et al. (2011). How many steps/day are enough? For older adults and special populations. International Journal of Behavioral Nutrition and Physical Activity, 8, 80.

9. Dose-response – step “volume”
B1127 Physiology and Biomechanics
Exercise testing lecture
Dose-response – step “volume”
Source: Ewald et al. (in press), Journal of Physical Activity for Health

10. Three questions
Can we predict energy expenditure (METs) from walking cadence?
In different populations
Factors affecting – leg length, mode (treadmill/ground)
What are people’s interpretations of certain walking instructions, or intensity labels?
“Normal”, “slow”, “moderate”, and (most importantly), “brisk”
Can people match a prescribed cadence?
Sound prompts (metronome or music)
Macro-cadence* vs. micro-cadence

11. The “Healthy Steps” studies
Study
Pop. N
Sex
Age
Ht Cm
WtKg
HS I
General 75
M/F
18-64
172
±8.6 76
±15.5
HS II
Inactive 25
20-59
165
±9.7 78
±21.5
HS III
Amputees 17
31-65
±10.0 85
±22.2
HS IV
Older 29 F
60-87
158
±7.6 64
±11.7

12. Question 1
Can we predict energy expenditure (METs) from walking cadence?
In different populations
Factors affecting – leg length, age, walking context (treadmill/overground)

13. Energy expenditure (METs)
Why is it important?
“Intensity”
Public health recommendations:
5 days x 30 mins “moderate”, or ...
Accumulate 150 mins “moderate”, or ...
3 days x 20 mins “vigorous”, or ...
Combination of “moderate” and “vigorous”
Moderate = METs
Vigorous  6.0 METs

14. Predicting METs from cadence
Study
Sample
Mode
3 METs
RSq
SEE
Tudor-Locke et al. (2005)
N = 50 (25 M, 25 F) yr
TM, walk, run
102 steps/min
80(M)
.83 (F)
1.27 MET
1.14 MET
Marshall et al. (2009)
N = 97 (39 M, 58 F) yr
TM walk
106 steps/min
35(M)
.23 (F)
1.30 MET
1.52 MET
Abel et al. (2010)
N = 19 (9 M, 10 F) 28.8 ± 6.8 yr
TM walk, run
101 steps/min
.71 (M)
.85 (F)
Not reported
Beets et al. (2010)
N = 20 (9 M, 11 F) 26.4 ± 4.6 yr
OG walk
100 steps/min
.61 (?)
0.49 MET (?)
Rowe et al. (2011)
N = 75 (37 M, 38 F) yr
TM & OG walk
103 steps/min
.38
0.69 MET

15. Source: Tudor-Locke & Rowe (2012), Sports Medicine
Predicting METs from cadence
Walking data
Running data
r = .93
Source: Tudor-Locke & Rowe (2012), Sports Medicine

16. Predicting METs from cadence
Source: Rowe & Tudor-Locke (2012), AAHPERD Measurement Symposium
- presentation available on request

17. HS I study (general population)
3 x 4+ min OG trials, metronome-paced
Measured VO2 (Cosmed K4b2)
Stride-length related measures:
Height
“Iliac leg length”
Standing minus sitting height
10-m stride test (# steps)
10-step test (distance)

18. Healthy Steps I (Rowe et al., 2011)
Range = 23 steps/min, or 690 steps in a 30-min walk target
From: Rowe, et al. (2011). Stride rate guidelines for moderate intensity walking. Med Sci Sports Exerc, 43,

19. HS IV (Older women)
3 x 4-min TM trials, self-selected “slow”, “moderate”, and “fast” walking speeds
VO2 measured in final minute
Douglas bag + Oxycon analyzer

20. Comparison of cadence cutpoints
Height (cm)
3 METs
5 METs
Rowe et al.
Peacock et al.
150 cm
114
104
152
142
160 cm
109 98
147
136
170 cm 92
130
180 cm 99 86
137
125
≈ steps/min difference – at a similar height, older women have higher METs for a given cadence

21. Question 2
What are people’s interpretations of certain walking instructions, or intensity “labels”?
“Normal”, “slow”, “moderate”, and (most importantly), “brisk”
“Brisk” – common instruction in walking programs
Also, what is typical walking pace during free-living walking?

22. Brisk walking speed Study Design Pop’n Speed Murtagh et al. (2002)
Outdoor park, 18.6 metre section of path
82 recreational walkers
3.5 mph (95% CI = mph).
Parise et al. (2002)
1 km “there and back” path
212 older adults who reported regularly walking briskly for exercise
3.0 mph (range = 2.2 mph to 4.3 mph).
Taylor et al. (2010)
1 km level path (mix of concrete and grass)
10 participants in a long-term walking intervention
7 of 10 participants walked faster than 3.0 mph
(Note: Moderate intensity speed [3 METs] ≈ 2.7 mph)

23. Pedestrian walking cadence
8 covert observation studies of pedestrian walking
Generally > moderate cadence (means ranged from 104 steps/min to 125 steps/min)
Some methodologically good
Short distances
Habitual walkers …?
“Purposive” walking (walking “to get somewhere” – work, college, etc.)
Source: Tudor-Locke & Rowe (2012), Sports Medicine

24. Healthy Steps II (inactive)
Two overground trials (“brisk”, and “prescribed moderate”)
“prescribed moderate” was guided by metronome with tempo set from treadmill trial at 2.7 mph
Indoor circular track
10+ mins

25. Healthy Steps II (“brisk”)
ALL > 100 steps/min

26. Healthy Steps II (prescribed “moderate”)
91% > 100 steps/min

27. Healthy Steps II (inactive)

28. Self-selected “brisk” cadence: NS effect for time F(1,9) = 1. 10, p =
Self-selected “brisk” cadence: NS effect for time F(1,9) = 1.10, p = .35 Mean speed = 3.62 mph
Metronome-guided “moderate” cadence:
NS effect for time
F(1,9) = 1.19, p = .31
Mean speed = 3.14 mph

29. Healthy Steps III (trans-tibial amputees)
Two overground trials (“brisk”, and “prescribed moderate”)
“prescribed moderate” was guided by digital music with tempo set from treadmill trial at  3 METs)
Indoor circular track
5+ mins

30. Healthy Steps III (trans-tibial amputees)
92% > 100 steps/min

31. Healthy Steps III (trans-tibial amputees)

32. Healthy Steps III (trans-tibial amputees)

33. Question 3 Can people match a prescribed cadence?
Sound prompts (metronome or music)?
Macro-cadence* vs. micro-cadence (gait symmetry, synchronicity, etc.)

35. Healthy Steps II (sedentary)
Source: Rowe et al. (2013), Journal of Science and Medicine in Sports

36. Healthy Steps III (trans-tibial amputees)
Source: Rowe et al. (2013), Journal of Physical Activity for Health

37. Healthy Steps IV (older women)
Source: Peacock et al. (in revision), Journal of Aging and Physical Activity

38. “Healthy Steps” summary
Energy expenditure (METs) can be estimated relatively accurately from cadence
Variables to consider: Height/leg length; age; treadmill vs. overground
Various populations (inactive, old, adults with TTA) voluntarily walk above 3 METs when asked to walk briskly
And can maintain for reasonable bouts of time
[in quasi-lab conditions]
Most people can match the tempo of an auditory signal
If the tempo of the signal is “reasonable”

39. Where to next?

40. Evolution of the mobile phone
B1127 Physiology and Biomechanics
Exercise testing lecture
Evolution of the mobile phone

41. Where to now (and next)?
Use of music to monitor and promote “healthy” walking behaviors
General population
Clinical/gait training (stroke, Parkinsons, CP)
Ubiquitous mobile technology
Prompts
Feedback
Ergogenic effects of music
User studies
Cognitive and affective tolerance for tempo manipulation

42. (time for one question or comment during changeover) …
Thank you!
(time for one question or comment during changeover) …

43. “The 5 Apps” “Accelerometer capture” “Stepper”
Time-stamped recording of triaxial accelerometer output
“Stepper”
Activity points feedback
“Preloaded” (“Playlist commander”)
Collects accelerometer data synchronously with a preloaded music (or other) soundtrack
“Playlist logger”
Logs music choices
“Tapper”
For recording events (and timing of events)

44. Conclusions – food for thought
Advantages of cadence over accelerometer counts:
Much more agreement between studies as to a reasonable cadence cut point versus the accelerometer threshold “battleground”
Even considering inter-instrument (dis)agreement at low/high ends, within healthy cadence range ( steps/min; 2.7+ mph), instruments seem to measure relatively consistently and accurately
Cadence metric can be compared across instruments (activity counts cannot)
Cadence is much more user-friendly
Cadence is grounded in free-living behaviour

45. Looking even further ahead
Application of cadence in the real world:
Investigation of cadence parameters and health outcomes
“Acceptability” of music-guided walking
Medium- and long-term adherence to music-guided walking programs (vs. self-paced)