Effect of square-stepping exercise on balance in older adults: A systematic review and meta-analysis

Abstract

The physiological changes of normal ageing result in diminished input from visual, proprioceptive and vestibular systems, with reduction in the strength of the lower extremities and balance control among the elderly. This systematic review determined the effect of square-stepping exercise (SSE) on balance in older adults. PubMed, CINAHL (EBSCO), Embase, Scopus, the Cochrane Library and the Web of Science database were searched using specific keywords for randomized controlled trials and pseudo-randomized controlled trials published 2006-2016. Two reviewers independently extracted data, which included specific details about study methods, populations, interventions, outcome measures and results. Eight studies were assessed. The meta-analysis of this study indicates that there was a large significant effect on balance [ES 0.94; confidence interval (CI), 0.36 to 1.52]. The strongest effect was found on the BBS [ES 1.83; confidence interval (CI), 0.52 to 3.15]. However, no statistically significant differences were observed between SSE and control groups regarding single leg balance with eyes closed and the Timed Up and Go (TUG) Test. Conclusions, SSE was effective for improving short-term balance in older adults and reduced their risk of falling. High-quality studies with large sample size, including more balance related fall and adherence outcomes measured over a longer period are necessary for further study.