Author(s): SEBASTIAO, E., YE, M., GÓMEZ, V., Institution: UNIVERSITY OF ILLINOIS URBANA-CHAMPAIGN, Country: UNITED STATES, Abstract-ID: 786

INTRODUCTION:
The aging process is associated with declines in both cognitive and physical function, which can compromise independence and quality of life in older adults. Interventions that simultaneously target cognitive and physical abilities are particularly valuable. Square-Stepping Exercise (SSE) is a cognitive-motor training designed to improve cognitive and physical function in older adults [1]. However, the intensity demands of this type of exercise remains unclear. This study examined the intensity and volume of an acute session of SSE in older adults under two different conditions.
METHODS:
This repeated-measures study included 24 older adults (Age: 75.4±6.8 yrs, BMI 27.3±4.8 kg·m2; 67% females). Participants completed a single session of SSE under normal pace (Normal) and externally paced by a metronome at 150% their normal walking speed (Paced) conditions. For each condition, participants performed 3 different step patterns for 7 minutes each: Step 1 (S1, beginner), Step 2 (S2, intermediate), and Step 3 (S3, advanced). Conditions and steps were randomized prior to session start. Intensity was assessed via heart rate (HR) monitor and Rating of Perceived Exertion (RPE). Volume was assessed using tri-axial accelerometer and expressed as step count (SC) and percentage of time in moderate-to-vigorous physical activity (%MVPA). Data were analyzed using descriptive and inferential statistics and significance set at P<0.05.
RESULTS:
HR significantly increased under the Paced condition across all steps: S1 (Normal: 98.0±12.1 b·min-1 vs. Paced: 114.1±14.6 b·min-1; P=.001), S2 (Normal: 96.2±12.4 b·min-1vs. Paced: 112.1±15.9 b·min-1; P=0.001), and S3 (Normal: 95.5±11.2 b·min-1vs. Paced: 111.9±15.8 b·min-1; P=0.001). Similarly, for RPE: S1 (Normal: 11.5±1.8 vs. Paced: 13.2±1.9; P=0.045), S2 (Normal: 10.6±1.9 vs. Paced: 12.7±2.0; P=0.002), and S3 (Normal: 10.3±1.7 vs. Paced: 12.7±1.9; P<0.001). SC was significantly higher in the Paced condition across all steps: S1 (Normal: 345.6±100.4 vs. Paced: 462±146.7; P=0.028), S2 (Normal: 308.2±111.1 vs. Paced: 454.3±156.8; P=0.002), and S3 (Normal: 334±76.4 vs. Paced: 471.8±149.5; P=0.004). There was a significant main effect for step pattern for %MVPA (P<0.001), with S1 showing the highest values. A main effect for condition (Normal x Paced) was observed (P<.001), though not between steps (S1 x S2 x S3). No significant interactions were observed (P>0.05).
CONCLUSION:
SSE is a low-cost, scalable cognitive–motor training approach that can be implemented across a variety of settings and formats (e.g., virtual, in-person). Our findings suggested that both intensity and volume increased under Paced compared to Normal acute SSE. We further observed that step complexity influenced %MVPA. These results suggest that adjusting pace and complexity may help tailor SSE intensity for older adults.

References
1. Shigematsu R, Okura T. A novel exercise for improving lower-extremity functional fitness in the elderly. Aging Clin Exp Res. 2006;18(3):242-248.