title: Square-stepping exercise versus strength and balance training for fall risk factors.
abstract: OBJECTIVE
  Feasible and lowcost 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.
authors.affiliation: Faculty of Education, Mie University, Mie, Japan 514-8507. 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: Tomoaki
authors.initials: T
authors.lastname: Sakai
authors.forename: Taina
authors.initials: T
authors.lastname: Rantanen
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D003362:Cost-Benefit Analysis; D015444:Exercise / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000191:economics / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D004856:Postural Balance / Q000502:physiology*; D012307:Risk Factors