Author(s): UCHIDA, R., SHIGEMATSU, R., SASAI H., KUROSAKI, T., HIKIJI, Y., NAKAGAICHI, M., Institution: NATIONAL INSTITUTE OF FITNESS AND SPORTS IN KANOYA, Country: JAPAN, Abstract-ID: 1963

INTRODUCTION:
Daycare service facilities in Japan provide recreational and functional training to those requiring nursing care. More effective functional training programs are required to maintain patients’ physical function and reduce the burden on staff at daycare service facilities. The Square-Stepping Exercise (SSE), an exercise regime in which participants step continuously on a felt mat with 4 x 10 squares (25 cm each) based on their memory of the step pattern demonstrated by the instructor, has been confirmed as an effective recreational program for healthy older adults [1][2]. The SSE program has thus been considered a potential exercise program for older adults with long-term care needs. This study investigated the changes in physical function and subjective feelings after engagement with the SSE program in older women with long-term care needs.
METHODS:
The participants were 15 older women with long-term care needs (mean age: 87.7 ± 2.9 years) who attended a daycare service facility in a local city in Japan. The SSE was conducted once a week for 30 minutes over four weeks. The five elementary step patterns of SSE were implemented step by step across the four sessions. Physical function (Short Physical Performance Battery: SPPB, Timed Up & Go Test) and fear of falling (assessed using Japanese version of the Falls Efficacy Scale) were assessed before and after the SSE program. The participants were also interviewed regarding their feelings on the SSE after the last session.
RESULTS:
The total SPPB score decreased significantly from 7.5 to 6.7 points. The balance score of the SPPB decreased significantly from 3.1 to 2.1 points. For the nine participants who completed the five-time sit/stand measurement, the time required was significantly reduced from 14.6 seconds to 11.2 seconds. Additionally, the results of interviews indicated positive feelings related to the physical and psychological aspects of the SSE, with participant stating, "It makes me feel physically better" and "I became calmer now."
CONCLUSION:
Although there was a substantial decline in lower limb function, particularly balance, positive changes in physical function and well-being were observed following application of the SSE in older women using daycare service facilities. The structure of the SSE program (step pattern, frequency) could be modified to facilitate its application in other daycare service facilities.
References:
1. Shigematsu, R. and Okura, T. A novel exercise for improving lower-extremity functional fitness in the elderly. Aging Clin Exp Res, 2006. 18 (3): p.242-248.
2. Wang, YH. et al., Effects of square-stepping exercise on motor and cognitive function in older adults - A systematic review and meta-analysis. Geriatr Nurs, 2021. 42 (6): p.1583-1593.