Effects of square‐stepping exercise on cognitive functions of older people

Abstract

Aim: Cognitive functions can decline with age, and interventions focusing on stimulating them may have positive results. Previous studies have shown that square-stepping exercise (SSE) has a good influence on balance, but this exercise also seems to promote cognitive stimulation. Therefore, the purpose of the present study was to analyse the effect of 16 weeks of SSE on cognitive functions in non-demented community-dwelling older people. Methods: This was a longitudinal, non-randomized study. Forty-one older adults (60 years and older) were recruited, and 21 participated in the SSE group (practised only SSE sequences) and 20 were in the control group (continued with their activities of daily living). Both groups were evaluated using the Mini-Mental State Examination, the Digit Span test, the ToulousePierón Attention Test and the Modified Card Sorting Test. Results:The SSE group showed a significant improvement in global cognitive status, concentrated attention and mental flexibility after 16 weeks of the SSE intervention. Conclusion: Evidence shows that SSE is a physical activity that positively influences cognitive functions in non-demented older people.

Step training improves reaction time, gait and balance and reduces falls in older people: a systematic review and meta-analysis

“…Findings from individual studies included in this review indicate that volitional step training improves global cognition,19 executive function,14 short-term memory19 and dual-task ability 13 14 19. Although these findings are not based on meta-analysis, improved gait under a cognitive load could be an important protective factor for falls when older people undertake activities requiring heightened attention and planning.…”

“…The effects of step training on cognitive measures are also inconsistent. Significant between-group differences in favour of stepping interventions have been reported for the Mini-Mental State Examination, Toulouse-Pierón speed and quality and the Modified Card Sorting Test,19 but non-significant between-group differences have been reported for δ Trail-making performance (B-A)14 and Digit Span (forward and backward) 19. Dual task gait performance improved postintervention in two studies in which participants counted backwards while walking13 or named animals (verbal fluency) during the TUG test 14…”

“…Seven studies did not fulfil criterion 1 (reporting source of participant recruitment and eligibility criteria) which relates to the external validity. Twelve studies were RCTs13 14 16 17 20–27 and four studies were CCTs 15 18 19 28. Outcome assessments were administered by blinded assessors in five studies,14 16 21 24 26 and no studies blinded therapists or participants to treatment allocation.…”

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

“…Many step patterns in multiple directions (forward, backward, lateral and oblique) lead to a narrow base of support while in a standing position or on an unstable surface and are, therefore, likely to provide a challenge to balance. Long-term practice of these exercises may promote improvements on motor and cortical centers, which affect vestibular ratio and directional control, improve information-processing speed and psychomotor processes to perform quick stepping in any direction when tripping or slipping to help balance and prevent falls 15) . However, no statistically significant differences were indicated between the SSE and control groups for the single leg balance with eyes closed and the TUG Test.…”

“…One study showed that the number of falls and the rate of falls per trip reported in SSE training were lower than in strength and balance training 14) . It not only has been shown to improve functional fitness, but also cognitive and depression symptoms 9,15) . Numerous intervention studies indicate that SSE improves balance and reduces the risk of falls among *Correspondence: poongkeeable@gmail.com older adults; however, no systematic review of the effect of SSE on balance in the elderly has been conducted as of date.…”