Predictors of Walking Activity in Patients With Systolic Heart Failure Equipped With a Step Counter: Randomized Controlled Trial

Josefine Dam Gade*, Helle Spindler, Malene Hollingdal, Jens Refsgaard, Lars Dittmann, Lars Frost, Kiomars Mahboubi, Birthe Dinesen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Physical activity has shown to decrease cardiovascular mortality and morbidity. Walking, a simple physical activity which is an integral part of daily life, is a feasible and safe activity for heart failure (HF) patients. A step counter, measuring daily walking activity, might be a motivational factor for increased activity.


The aim of this study was to examine the association between HF patients’ walking activity and demographical and clinical data, and whether these associations could be used as predictors of walking activity.


65 HF patients from the Future Patient Telerehabilitation program (FPT) were included in this study. The patients monitored their daily activity using a Fitbit step counter during one year. This monitoring allowed for continuous and safe data transmission of self-monitored activity data.


A higher walking activity was associated with younger age, lower New York Heart Association (NYHA) classification, and higher EF. There was a statistically significant correlation between the number of daily steps and NYHA classification at baseline, between the increase in daily steps and EF at baseline, and between the increase in daily steps and improvement in EF. The patients’ demographic, clinical, and activity data could predict 81% of the variation in daily steps.


The patients in FPT walked more than patients in comparable studies. This study demonstrated an association between demographic, clinical, and activity data for HF patients that could predict daily steps. A step counter can thus be a useful tool to help patients monitor their own physical activity. Clinical Trial: Clinical Trial: NCT03388918 Danish Ethical Committee: N-20160055
Original languageEnglish
Article numbere20776
JournalJMIR Biomedical Engineering
Issue number1
Number of pages14
Publication statusPublished - 2020


  • heart failure
  • cardiovascular rehabilitation
  • step counters
  • physical activity
  • telerehabilitation


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