The purpose of this study was to evaluate the association between subjective usefulness of pedometer and step count, exercise adherence, and the possibility of a pedometer helping exercise adherence.
The subjects were 106 community-dwelling citizens (mean age±SD, 66±5) who were put on an individual exercise program in addition to walking. The targeted step count was 8000 steps/day. Every subject wore a pedometer that registers 7 days of physical activity.
The rate of adherence was 98.1%, and about 73% of subjects answered that using a pedometer is useful for physical activity. There was no difference in exercise habit at baseline between subjects answering useful or not useful.
Only in the case of females, was step count and prevalence of targeted 8000 steps significantly higher in the group who felt a pedometer was useful than in the group who didn't feel it useful. However, in the group of males who felt the usefulness of a pedometer, step count significantly increased during the 3 months. In addition, the females who reached their targeted step count performed better in the 10 m hurdle walk and 6 min walk than those who could not reach the targeted step count.
The awareness of self-health wellness, without the anxiety of physical fitness and adherence to exercise was higher in the subjects who felt a pedometer was useful than in the subjects who didn't.
The subjects who felt a pedometer was useful achieved their targeted number of steps and increased walking ability and tended to adhere better to physical activity.
It is suggested that a pedometer motivates adherence to physical activity and is useful for helping exercise adherence in the future. However, we need a randomized control trial for determining the relationship between exercise adherence and using a pedometer.

A 79-year-old woman, who had undergone mitral valve replacement with a Björk-Shiley valve 16 years previously, was transferred to our institute due to active prosthetic valve infection associated with severe heart failure on respirator. On admission, her white blood cells and c-reactive protein (CRP) were elevated to 15,700/µl and 7.29 mg/dl, respectively, and she had anemia (hemoglobine 8.1 g/dl), thrombocytopenia (platelets 75,000/µl), and renal dysfunction (blood urea nitrogen 57 mg/dl, creatinine 1.8 mg/dl, estimated glomerular filtration rate 21.5 ml/min/1.73 m²). Her brain natriuretic peptide was elevated to 456.7 pg/dl. Blood culture revealed bacteremia with Streptococcus agalactiae. Though CT scan revealed cerebellum infarction, we decided to perform emergency surgery because of uncontrollable infection and heart failure, even with massive infusion of catecholamine and respiratory support. At surgery, huge vegetation proliferated over the prosthetic valve. The prosthetic valve was detached from approximately two-thirds of the annulus due to an annular abscess. The infected annulus was resected aggressively. Mitral annulus was reconstructed and reinforced with a bovine pericardial patch, and the bioprosthetic valve of 23 mm in size was implanted in an intra-annular position. In the postoperative phase, antibiotics (ampicillin, gentamicin) was given, and CRP became negative 47 days postoperatively, and the patient discharged from the hospital 56 days after the operation.