title: Square-stepping exercise and fall risk factors in older adults: a single-blind, randomized controlled trial.
abstract: BACKGROUND
  Decreased fitness of the lower extremities is a potentially modifiable fall risk factor. This study aimed to compare two exercise programs--square-stepping exercise (SSE), which is a low-cost indoor program, and walking--for improving the fitness of the lower extremities.
  
  
  METHODS
  We randomly allocated 68 community-dwelling older adults (age 65-74 years) to either the SSE or walking group (W group). During the 12-week regimen, the SSE group participated in 70-minute exercise sessions conducted twice a week at a local health center, and the W group participated in outdoor supervised walking sessions conducted weekly. The W group was instructed to increase the number of daily steps. Prior to and after the program, we obtained information on 11 physical performance tests for known fall risk factors and 3 self-reported scales. The fall incidence was followed-up for 8 months.
  
  
  RESULTS
  At 12 weeks postregimen, significant differences were observed between the two exercise groups with respect to leg power (1 item), balance (2 items), agility (2 items), reaction time (2 items), and a self-reported scale (1 item); the SSE group demonstrated a marked improvement in the above-mentioned items with Group x Time interactions. Significant time effects were observed in the tests involving chair stands, functional reach, and standing up from a lying-down position without Group x Time interactions. During the follow-up period, the fall rates per person-year in the SSE and W groups were 23.4% and 33.3%, respectively (p =.31).
  
  
  CONCLUSIONS
  Although further studies are required, SSE is apparently more effective than walking in reducing fall risk factors, and it appears that it may be recommended as a health promotion exercise in older adults.
authors.affiliation: Faculty of Education, Mie University, Japan. rshige@edu.mie-u.ac.jp
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Shigematsu
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Okura
authors.forename: Masaki
authors.initials: M
authors.lastname: Nakagaichi
authors.forename: Kiyoji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Sakai
authors.forename: Suguru
authors.initials: S
authors.lastname: Kitazumi
authors.forename: Taina
authors.initials: T
authors.lastname: Rantanen
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D035002:Lower Extremity; D008297:Male; D012307:Risk Factors; D016037:Single-Blind Method; D016138:Walking