A Novel Square-Stepping Exercise Program for Older Adults (StepIt): Rationale and Implications for Falls Prevention

Abstract

The ability to effectively execute compensatory steps is critical for preventing accidental falls, and consequently stepping training is an essential ingredient of fall prevention programs. In this paper, we propose a concept for stepping training that aims to maximize training effects by taking into account recent research evidence and a precise dosing of training ingredients. The concept addresses motor as well as cognitive falls-related aspects, it is suitable for individual as well as group based training, and it does not require costly equipment. Theory and evidence behind all of the training principles is reviewed, and an example of an exercise protocol is described in detail. Participants are presented with stepping patterns which they have to memorize and implement on a mat. In order to enable investigation of dose-response effects, the difficulty level systematically and gradually increases session by session based on four principles: execution speed, pattern complexity, pattern length and execution in dual-/multi-tasking conditions. The presented concept can be used as a framework for the development of further prevention and/or rehabilitation stepping exercise programs. Further studies using this exercise regimen or modified versions of it are encouraged.

Acceptance of a Virtual Reality Headset Designed for Fall Prevention in Older Adults: Questionnaire Study

“…Recent studies also demonstrated the effectiveness of training programs implemented via new technologies for improving the control mechanisms involved in balance [ 9 , 10 ] and goal-directed locomotion [ 11 , 12 ] in older adults. For instance, specific exergames have been designed to train balance control, focusing on either the static control of the center of mass or its control while performing precise, rapid, and well-directed steps in balance-threatening situations [ 13 , 14 ]. They allow the cognitive and motor demands of the training conditions to be finely controlled during balance control tasks.…”

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

“…The execution will be performed at the rhythm given by a metronome. Rhythmic auditory stimulation is a neurological technique that uses the physiological effects of auditory rhythm on the motor system to improve rhythmic movements such as walking [ 47 ]. A pedometer will also be used to verify the volume of physical activity performed [ 38 ].…”

Potential Benefits of a Novel Home-Based Exercise Program for Inactive Older Adults: An Exploratory Case Study

“…In general, taking multidirectional steps in a pattern was shown to enhance motor learning, balance, and memory that could potentially prevent falls (19). It was suggested that SSE is safe and acceptable especially for lower-body functional tness and it may be recommended to older adults due to its low cost and effectiveness (20).…”

“…When considering the impacts of health and physical activity in tandem with the needs of the aging population, suitable options for moderate-intensity exercise were needed. A stepping program like the SSE could be modi ed to t different purposes, settings, and populations (19). This study aimed to employ a single case study design to determine if a home-based exercise program for inactive older adults would help overcome barriers and stimulate enablers for regular physical activity following the World Health Organization (WHO) recommendations at the recommended intensity.…”