Step-Count Guidelines for Children and Adolescents: A Systematic Review

Background: The aim of this systematic review was to identify the most optimal step-count cutoff for children and adolescents (5-19 years old) among guidelines currently available in the literature. Methods: The databases searched were PubMed, SportDiscus, Science Direct, Web of Science and LILACS. Studies were categorized into Health Cohort studies or Physical Activity (PA) Cohort studies according to the reference standard used. The quality of the studies was assessed using the QUADAS-2 instrument. Results: Six Health and 3 PA Cohort studies were included in the final pool of papers after Full Text reading. With the exception of a single study, studies demonstrated a high risk of methodological bias in at least 1 of the QUADAS-2 domains. Guidelines ranged from 10,000 to 16,000 steps/day for the Health studies (5-16 years old), and from 9,000 to 14,000 steps/day for PA studies (6-19 years old). Due to the high risk of methodological bias, none of the Health Cohort guidelines were endorsed. The PA Cohort study with the lowest risk of methodological bias suggested 12,000 steps/day for children and adolescents irrespective of gender. Conclusion: PA Cohort studies demonstrated lower risk of methodological bias than Health Cohort studies. The optimal youth step-count guideline of 12,000 steps/day was endorsed.