Square-stepping exercise versus strength and balance training for fall risk factors

Background and aims: Feasible and low-cost exercise programmes targeting fall risk factors may decrease the risk of falling in older adults. The purpose of this study was to compare the effects of square-stepping exercise (SSE) training, which is a new and low-cost method designed to improve lower-extremity functional fitness, with strength and balance (SB) training. Methods: The study included 39 community-dwelling adults aged 65 to 74 years. The participants were randomized to either group SSE (n=20) or SB (n=19). They engaged in 70-min group exercise sessions twice a week for 12 weeks. The efficacy of the program was measured with both a 9-item test battery for assessment of physical performance and self-reported scales (fear of falling, pleasure in exercise, perceived health status). Fall incidence was followed up for 14 months. Results: The results of a 2-way ANOVA revealed that the time effect in 7 of the 9 performance tests was significant, although group-by-time interactions were not. No significant changes were observed in the self-reported scales. During the 14-month follow-up period, 7 falls in 6 participants in the SSE group and 12 falls in 11 participants in the SB group were reported. The incidence rate per person in the SSE group (30.0%) was not significantly different from that in the SB group (57.9%). The rate of falls per trip [falls/(falls + trips)] in the SSE group (17.1 %) was significantly lower than in the SB group (50.0%). Conclusions: SSE is as equally effective as SB training in improving lower-extremity functional fitness. SSE may also be recommended for older adults, due to its low cost and effectiveness.

[1]  A. Mallinson,et al.  Results of a 10 week community based strength and balance training programme to reduce fall risk factors: a randomised controlled trial in 65–75 year old women with osteoporosis , 2001, British journal of sports medicine.

[2]  R. Shigematsu,et al.  Age scale for assessing functional fitness in older Japanese ambulatory women , 2000, Aging.

[3]  C. Jessie Jones,et al.  Development and Validation of a Functional Fitness Test for Community-Residing Older Adults , 1999 .

[4]  S. Wolf,et al.  The influence of intense Tai Chi training on physical performance and hemodynamic outcomes in transitionally frail, older adults. , 2006, The journals of gerontology. Series A, Biological sciences and medical sciences.

[5]  E. Bassey,et al.  A new method for measuring power output in a single leg extension: feasibility, reliability and validity , 2004, European Journal of Applied Physiology and Occupational Physiology.

[6]  S. Kawai,et al.  Nationwide survey of hip fractures in Japan , 2004, Journal of Orthopaedic Science.

[7]  A B Schultz,et al.  Muscle activities used by young and old adults when stepping to regain balance during a forward fall. , 2000, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[8]  Michael L Madigan,et al.  Age and stepping limb performance differences during a single-step recovery from a forward fall. , 2005, The journals of gerontology. Series A, Biological sciences and medical sciences.

[9]  Orthopaedic Surgeons Panel On Falls Prevention Guideline for the Prevention of Falls in Older Persons , 2001 .

[10]  T. Okura,et al.  A novel exercise for improving lower-extremity functional fitness in the elderly , 2006, Aging clinical and experimental research.

[11]  B. E. Maki,et al.  Control of rapid limb movements for balance recovery: age-related changes and implications for fall prevention. , 2006, Age and ageing.

[12]  Elizabeth Eckstrom,et al.  Tai Chi and fall reductions in older adults: a randomized controlled trial. , 2005, The journals of gerontology. Series A, Biological sciences and medical sciences.

[13]  K. Hauer,et al.  Exercise Training for Rehabilitation and Secondary Prevention of Falls in Geriatric Patients with a History of Injurious Falls , 2001, Journal of the American Geriatrics Society.

[14]  T. M. Owings,et al.  Mechanisms leading to a fall from an induced trip in healthy older adults. , 2001, The journals of gerontology. Series A, Biological sciences and medical sciences.

[15]  Y. Carter,et al.  Education and debate , 2022 .

[16]  C. Becker,et al.  Development of a Common Outcome Data Set for Fall Injury Prevention Trials: The Prevention of Falls Network Europe Consensus , 2005, Journal of the American Geriatrics Society.

[17]  S. Ebrahim,et al.  Falls by elderly people at home: prevalence and associated factors. , 1988, Age and ageing.