Feasibility study design and methods for a home-based, square-stepping exercise program among older adults with multiple sclerosis: The SSE-MS project

Sebastião, Émerson; McAuley, Edward; Shigematsu, Ryosuke; Motl, Robert W.

doi:10.1016/j.conctc.2017.07.012

Cited by 8 publications

(8 citation statements)

References 48 publications

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“…Participants then practiced the sequence of step patterns designated for the two-week period at home until the next meeting. For additional details in the intervention please see reference elsewhere [17].…”

Section: Participant Recruitment and Eligibilitymentioning

confidence: 99%

“…We recently described and proposed a methodological protocol paper involving a feasibility study of the squarestepping exercise (SSE) in older adults with MS [17]. The SSE program was originally developed by Japanese researchers and focused on improving functional fitness (e.g., lower limb muscle strength, walking ability, balance, reduce the risk of falls) and enhancing cognition in older adults of the general population [18].…”

Section: Introductionmentioning

confidence: 99%

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Home-based, square-stepping exercise program among older adults with multiple sclerosis: results of a feasibility randomized controlled study

Sebastião

McAuley

Shigematsu

et al. 2018

Contemporary Clinical Trials

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There is very little known about exercise rehabilitation approaches for older adults with multiple sclerosis (MS), yet this growing segment of the MS population experiences declines in cognition and mobility associated with disease progression and aging. We conducted a RCT examining the feasibility of a 12-week, home-based Square-Stepping Exercise (SSE) program in older adults with MS. Older adults with MS (N = 26) with mild-to-moderate levels of disability were recruited and randomized into the intervention (i.e., SSE) or a minimal activity, attention-control conditions. Participants in the SSE condition received a mat for home-based practice of the step patterns, an instruction manual, and a logbook along with a pedometer for monitoring compliance. Both conditions received weekly Skype™ calls and had biweekly meetings with an exercise trainer. Feasibility was assessed based on process, resource, management and scientific outcomes. Regarding scientific outcomes, participants in both conditions completed in-lab assessments before and after the 12-week period. Twenty-five participants completed the study (96%) and the total cost of the study was $13,387.00 USD. Pedometer data demonstrated good compliance with the SSE intervention condition. Effect sizes calculated for all treatment outcomes ranged from small-to-moderate for both mobility and cognitive variables between the intervention and attention-control conditions, thereby providing preliminary evidence that participation in the SSE program may improve cognition and mobility function. The results support the feasibility, acceptability, and possible efficacy of a home-based SSE intervention for older adults with MS.

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Section: Participant Recruitment and Eligibilitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Home-based, square-stepping exercise program among older adults with multiple sclerosis: results of a feasibility randomized controlled study

Sebastião

McAuley

Shigematsu

et al. 2018

Contemporary Clinical Trials

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“…The implementation of SSE interventions has been shown to be effective in the older-adult population [28][29][30], as well as in specific populations, such as those with type 2 diabetes mellitus [33], multiple sclerosis [32], Parkinson's disease [48] or fibromyalgia [39], among others. Thus, we hypothesise that a 9-month intervention based on Tele-SSE will improve motor and cognitive skills in preschoolers.…”

Section: Discussionmentioning

confidence: 99%

“…SSE has shown benefits in functionality, balance, lower limb strength, flexibility and agility, concentration, memory, mental acuity and visual memory in older adults [28][29][30]; as well as in preventing and reducing the number of falls, improving cognitive abilities [31]. Additionally, it has been shown to be effective in pathologies such as multiple sclerosis [32] or type 2 diabetes mellitus [33]. However, there is only one study that has analyzed the effects of SSE in preschoolers, showing cognitive and motor benefits in a small sample [34].…”

Section: Introductionmentioning

confidence: 99%

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

Domínguez-Muñoz

Carlos‐Vivas

Barrios-Fernández

et al. 2021

IJERPH

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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.

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“…Home-based exercise offers the opportunity to complete exercise every day using a flexible schedule at a low cost [ 15 ]. Square-Stepping Exercise is an example of a home-based aerobic exercise [ 16 ]. Shigematsu and Okura [ 17 ] developed this exercise in Japan and it was deemed suitable for home settings [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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

Lees

Edwards²,

McCain³

et al. 2022

BMC Geriatr

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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.

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Feasibility study design and methods for a home-based, square-stepping exercise program among older adults with multiple sclerosis: The SSE-MS project

Cited by 8 publications

References 48 publications

Home-based, square-stepping exercise program among older adults with multiple sclerosis: results of a feasibility randomized controlled study

Home-based, square-stepping exercise program among older adults with multiple sclerosis: results of a feasibility randomized controlled study

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

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

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