Effects of Square-Stepping Exercise on Agility in Older Adults

Abstract

The square-stepping exercise (SSE) was developed as a novel fall-prevention program for older adults. The participants have to simply walk along a thin mat partitioned into 40 squares (25 cm each) arranged in 4 rows; they are also required to memorize the step patterns demonstrated by an instructor prior to stepping and step as quickly as possible. The exercise improves fall risk factors such as leg power, balance, and reaction time because the participants are required to raise their heels during stepping and immediately take a step backward if they misstep. PURPOSE: We have reported the effects of SSE on fitness elsewhere; however, its effect on stepping ability, namely, agility, has not been evaluated yet. We conducted this study based on the fact that deterioration in agility increases the risk of falling. METHODS: The study participants included 65 older adults aged 65-74 years who were randomly allocated into 2 groups, namely, an SSE group (n = 32) and a control group (n = 33). The SSE group participated in a 40-min SSE intervention twice a week for 3 months. The control group participated in an outdoor-walking session instead of performing the SSE and was required to increase the number of daily walking steps. We measured the stepping time and number of missteps at pre- and postintervention in 2 step patterns_A and B (pattern B was more complicated than pattern A). The 2 step patterns were not demonstrated during intervention. RESULTS: A significant time-by-group interaction (F = 5.64, P = 0.02) was observed for pattern A; the effect was larger in the SSE group than in the control group (average, −3.6 s). A significant time-by-group interaction was also observed for pattern B (F = 4.12, P = 0.048); the stepping time was considerably shortened in the SSE group (average, −7.3 s). There were no significant differences in the number of missteps between the 2 groups. CONCLUSIONS: Based on the results, we concluded that the SSE could improve lower extremity agility in older adults with other ameliorated fall risk factors. This study was supported by a grant from the Ministry of Education, Culture, Sports, Science and Technology.