Potential value of home square-stepping exercises for inactive older adults: an exploratory case study

Background Most older adults do not engage in regular physical activity. However, more research on options to partake in regular exercise in this population by reducing barriers and enhancing enablers while still reaching benefits is needed. Methods Using embedded mixed methods, 10 inactive older adults over the age of 65 completed a 3-week square-stepping exercise intervention to help overcome the initial barriers and activate initial enablers to perform regular exercise. Physical activity level was tracked at home with a pedometer using median steps/day over seven days for pre-post measure. Aerobic intensity while doing square-stepping exercises was quantified via a heart rate monitor in a supervised session. Each participant had an interview asking about barriers and enablers to regular exercise and if the intervention could modify any. Based on initial physical activity a framework matrix was used to pull potential barriers to compare, contrast, and search for patterns between participants with lower and higher initial physical activity levels. Results The 3-week square-stepping exercise intervention helped participants overcome barriers such as being uncomfortable in a fitness facility and body image and activate enablers such as the use of home equipment and convenience. The median total steps/day increased by 12% (p = 0.02), and a moderate-intensity level was reached by 80% of the sample participants when performing the square stepping exercise during a supervised session. Common barriers such as having a suitable program, hard to keep the intensity were reported by participants regardless of the initial physical activity level. Conclusion Regardless of initial physical activity level, inactive older adults can increase physical activity level at the recommended intensity and overcome common barriers to exercise when performing square-stepping exercises, especially for those intimidated by a fitness facility setting and those concerned with their body image. A longer intervention including more participants using the square-stepping exercises is required to understand if square-stepping exercises can increase the proportion of older adults exercising regularly.

Pedagogical Proposal of Tele-Exercise Based on “Square Stepping Exercise” in Preschoolers: Study Protocol

Early childhood education aims to achieve the motor, cognitive, emotional, and social development of preschoolers by providing them with a variety of learning opportunities. The square-stepping exercise (SSE) is a balance and lower limb strength training programme used to prevent falls and stimulate cognitive function in older adults. This project aims to propose an SSE tele-exercise (Tele-SSE) protocol to evaluate its effects on the motor and cognitive development of children aged between 3 and 6 years. A randomized controlled trial with experimental (Tele-SSE) and control (general education) groups will be carried out. The application of Tele-SSE will be performed for 9 months (three times per week) and one additional follow-up after the intervention at the beginning of the next academic year. One-hundred and two preschoolers will be recruited and randomly distributed into the two groups: experimental (n = 51) and control (n = 51). Although the main outcome will be balance due to the nature of the SSE, outcomes will include physical and motor (body mass index, waist circumference, handgrip and lower-limb strength, speed-agility, and cardiorespiratory fitness) and cognitive (executive functions and attention, episodic memory, and language assessment, using the Fitness Assessment in the Preschool Battery (PREFIT) and The National Institutes of Health Toolbox—Early Childhood Cognition Battery. This project aims to improve cognitive and motor skills in preschoolers aged between 3 and 6 years old, based on a 9-month Tele-SSE intervention. If this intervention proves to be effective, it could be implemented in those centres, entities and associations specializing in early childhood education.

Acute effects of Square Stepping Exercise on cognitive and social functions in sedentary young adults: a home-based online trial

Background The Square Stepping Exercise (SSE) is an exercise training program incorporating cognitive and physical exercise components, which was originally developed for older adults to reduce falling risks. SSE’s potential in delaying cognitive decline in older adults seems to be promising. However, there is scarce research on the SSE program with young adults. Furthermore, the outbreak of coronavirus disease has imposed people to change their lifestyle and behaviors, including exercise behaviors. Hence, the purpose of this study was to examine the acute effects of a home-based online SSE trial on cognitive and social functions in sedentary young adults. Methods A total of 18 young adults (6 males, 12 females) participated in the present study. They completed two exercise conditions (SSE and active control exercise), consisting of 3 sessions per week, over 2 weeks. A 2 times (pre vs. post) × 2 conditions (SSE vs. active control) repeated-measures ANCOVA was conducted on the score of the Modified Card Sorting Task with age and education year as covariates. A one-way repeated-measures MANOVA was performed on the subscale scores of the Physical Activity Group Environment Questionnaire to examine the effects of the exercise conditions (SSE vs. active control) on group cohesion. Results SSE was found effective to improve executive function such as abstract reasoning, mental flexibility, and problem-solving skills. Furthermore, participants’ perceptions of social interaction with their group, and closeness and bonding existing in their group were significantly higher in the SSE condition than the active control condition. Conclusions In the present study, SSE was conducted online and found to be effective to enhance executive function and group cohesion in sedentary young adults. These novel approach and findings are the strengths of the present study. People aged 60 years and over are more vulnerable to the coronavirus and at higher risk of developing serious illness. Given the coronavirus pandemic circumstances, it is worthwhile to explore the possibility of the online SSE approach to older adults in future research.

Effect of Tai Chi and Stepping Exercise for Balance Training in Geriatrics: Randomized Control Trial

Introduction: Approximately 40% of geriatric population in India experience some form of balance difficulty. It may be due to decreased muscular strength, flexibility, impaired vision and hearing problem. There are many approaches for improving balance such as Tai Chi exercise, stepping exercise, wobble board exercises, strengthening exercises. Tai Chi is a series of slow, smooth and graceful movements for improving neuromuscular function, endurance, joint sense and cognitive function. Stepping exercise is exercise performed using stepper. It improves balance by strengthening muscles, flexibility and range of motion. Objective: To compare the effect of Tai Chi and stepping exercise for improving balance in geriatric population. Method: In the present study, 40 participants of age group 60-80 years with balance problem were taken. Random sampling was done in two group, group A (n=20) and group B (n=20) giving Tai Chi and Stepping exercise respectively. Outcome measured used were BBS, TUG, FES and POMA. Results: In present study, Tai Chi exercise was more effective than Stepping exercise statistically proved with unpaired t test BBS (p=0.0001), TUG(p=0.0001), FES (p=0.0679) and POMA (p=0.0039). When comparison was done within the groups, all outcome measures showed significant values at pre and post intervention, BBS (p=<0.0001 in group A and B), TUG (p=<0.0001 in group A and B), FES (p=<0.0001 in group A and B) and POMA (p=<0.0001 in group A and B), Conclusion: Tai Chi exercise showed more effect than Stepping exercise in geriatric population with balance impairments. Key words: Tai Chi exercise, stepping exercise, geriatric population, Balance Training in Geriatrics, balance impairments.

Falls Prevention and Quality of Life Improvement by Square Stepping Exercise in People with Parkinson’s Disease: Project Report

Parkinson’s disease (PD) is a chronic neurodegenerative disorder that affects physical, psychological, and social quality of life. Square Stepping Exercise (SSE) is an effective balance training program to prevent falls and to stimulate cognitive function in the elderly; however, no study has analyzed the effect of SSE in people with PD. The main objective is to investigate whether the application of SSE is safe, applicable, and can improve balance, and is effective in preventing falls, improving cognitive and psychological aspects and thus maximize quality of life in people with PD. Methods/Design: SSE will be performed three times per week for 8 weeks with an additional month follow-up after the intervention. Sixty people with PD will participate, randomly distributed into two groups: experimental group (SSE: n = 30) and control group (Usual care: n = 30). The primary measurements will be: (1) Applicability, (2) Safety, (3) Balance, and (4) Annual number of falls. Secondary measurements will be: (1) Sociodemographic information, (2) Physical condition, (3) Health-related quality of life, (4) Depressive symptoms, (5) Cognitive aspects, (6) Perceived functional social support, and (7) Anticipatory cognition.

Effects of Cognitive Versus Mind-Motor Training on Cognition and Functional Skills in the Community-Dwelling Older Adults

Background: There is a decline in cognitive and functional skills in older adults. The objective of this study was to compare the effects of cognitive and mind-motor training (MMT) on cognition and functional skills in a community-dwelling sample of older adults. Methods: In this observer-blinded randomized clinical trial, 40 older adults with medical stability, ability to comprehend and respond to simple verbal instructions, no diagnosed psychological disorders, absence of severe visual and hearing problems, the capacity to walk independently, and a score of more than 46 in Berg Balance Scale were included. They were randomly allocated into cognitive or MMT groups. Cognitive training (CT) was practiced with activities for memory and attention, using paper–pencil tasks. MMT was practiced using a simple, indoor based square-stepping exercise. They practiced one-hour of training per day, three days a week, for eight weeks. Results: General linear model analysis showed that the time by groups was not statistically significant. The mean (standard deviation) scores in General Practitioner Assessment of Cognition Scale and Hindi Mental State Examination improved significantly (P < 0.001) following MMT [1.75 (1.29); 2.4 (1.34)] and CT [1.5 (1.36); 2.7 (0.99)]. The functional skills measured using Lawton Instrumental Activities of Daily Living Scale revealed beneficial changes for both the groups. None of the outcomes were statistically significant between the groups (P > 0.05). Conclusion: Both cognitive and MMTs showed similar practice effects on cognition and functional skills in community-dwelling older adults.