Short-Term Effects of Square Stepping Exercise on Cognitive and Social Functions in Sedentary Older Adults: A Home-Based Online Trial

Su Ren Gan; Kimmy Low; Tomohiro Okura; Masato Kawabata

doi:10.15294/ajpesh.v2i2.62184

Su Ren Gan
Kimmy Low Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singaporee
Tomohiro Okura Faculty of Health and Sport Sciences, University of Tsukuba
Masato Kawabata Nanyang Technological University https://orcid.org/0000-0002-1927-1359

DOI: https://doi.org/10.15294/ajpesh.v2i2.62184

Keywords: COVID-19, Executive control function, Group cohesion, Integrated exercise, Online intervention

Abstract

Background: The Square Stepping Exercise (SSE) is an exercise training program integrating physical exercise and cognitive components. The potential of SSE in deferring cognitive decline in older adults is encouraging. However, the coronavirus pandemic has made it harder for older adults worldwide to exercise together in person. Therefore, the present study aimed to investigate the short-term effects of a home-based online SSE trial on cognitive and social functions in sedentary older adults. Methods: A sample of 24 older adults (2 men, 22 women) took part in the current study. Seven participants (2 men, 5 women) completed home-based online SSE sessions under tighter safety regulations, whereas other 17 women attended SSE sessions in person when group exercise with more than 5 people were permitted. To investigate the effects of the online SSE on cognitive and social functions compared to the in-person SSE, 2 times (pre vs. post) × 2 groups (online vs. in-person) mixed ANOVAs were conducted with classic and robust statistical methods on the scores of the Trail Making Test (TMT), the subscale scores of the Physical Activity Group Environment Questionnaire, and the score of the Subjective Vitality Scale. Results: The interaction between time and groups was significant on the TMT-B to TMT-A (B/A) ratio score (p = .049) and the subscale scores of Individuals Attractions to the Group‒Task (p = .034) and ‒Social (p = .037). The B/A ratio score is an indicator of executive control function. The online SSE group’s ratio score slightly decreased over the sessions, whereas the ratio score significantly increased in the in-person group. As for group cohesion, participants’ involvements with the group task and social interaction with their group were enhanced in the online SSE group over the sessions, compared to the in-person SSE group. Conclusions: In this study, SSE was carried out online for a short-term and found to be successful to enhance executive function and group cohesion in sedentary older adults. Considering the coronavirus pandemic circumstances, it is valuable to examine the long-term effects of the online SSE in older adults in future research.

References

Arbuthnott, K., & Frank, J. (2000). Trail making test, part B as a measure of executive control: validation using a set-switching paradigm. Journal of Clinical and Experimental Neuropsychology, 22, 518–528.
Audiffren, M. (2009). Acute exercise and psychological functions: A cognitive-energetic approach. In T. McMorris, P. Tomporowski, & M. Audiffren (Eds.), Exercise and cognitive function (pp. 3–39): Wiley-Blackwell.
Caffarra, P., Vezzadini, G., Dieci, F., Zonato, F., & Venneri, A. (2004). Modified Card Sorting Test: Normative data. Journal of Clinical and Experimental Neuropsychology, 26, 246–250.
Estabrooks, P. & Carron, A., (2000). The physical activity group environment questionnaire: an instrument for the assessment of cohesion in exercise classes. Group Dynamics Theory Research and Practice, 4, 230-243.
Field, A. P., & Wilcox, R. R. (2017). Robust statistical methods: A primer for clinical psychology and experimental psychopathology researchers. Behaviour Research and Therapy, 98, 19-38.
Fisseha, B., Janakiraman, B., Yitayeh, A., & Ravichandran, H. (2017). Effect of square stepping exercise for older adults to prevent fall and injury related to fall: systematic review and meta-analysis of current evidences. Journal of Exercise Rehabilitation, 13, 23.
Karr, J. E., Areshenkoff, C. N., Rast, P., & Garcia-Barrera, M. A. (2014). An empirical comparison of the therapeutic benefits of physical exercise and cognitive training on the executive functions of older adults: A meta-analysis of controlled trials. Neuropsychology, 28, 829.
Kawabata, M., Gan, S. R., Goh, G., Omar, S. A. B., Oh, I. T. F., Wee, W. Q., & Okura, T. (2021). Acute effects of Square Stepping Exercise on cognitive and social functions in sedentary young adults: A home-based online trial. BMC Sports Science, Medicine and Rehabilitation, 13, 82.
Kawabata, M., Yamazaki, F., Guo, D. W., & Chatzisarantis, N. L. D. (2017). Advancement of the subjective vitality scale: examining alternative measurement models for Japanese and Singaporeans. Scandinavian Journal of Medicine & Science in Sports 27, 1793–1800.
Nokham, R., & Kitisri, C. (2017). Effect of square-stepping exercise on balance in older adults: A systematic review and meta-analysis. Journal of Physical Fitness and Sports Medicine, 6, 183-190.
Noma, A., Uchida, R., Kurosaki, T., Numao, S., & Nakagaichi, M. (2020). Effects of the Square-Stepping Exercise program on physical fitness and cognitive function in elderly Japanese Journal of Physical Fitness and Sports Medicine, 69, 393-400.
Pereira, J.R., Gobbi, S., Teixeira, C.V, Nascimento, C.M., Corazza, D.I., Vital, T.M., … & Shigematsu, R. (2014). Effects of square-stepping exercise on balance and depressive symptoms in older adults. Motriz: Revista de Educacao Fisica, 20, 454-460.
Ravichandran, H., Janakiraman, B., Yitayeh, A., Sundaram, S., & Fisseha, B., (2017). Effectiveness of square stepping exercise among subjects with Parkinson’s disease: A pilot randomized controlled trial. Journal of Geriatric Mental Health, 4, 54057.
Ryan, R. M., & Frederick, C. M. (1997). On energy, personality and health: subjective vitality as a dynamic reflection of well-being. Journal of Personality, 65, 529–565.
Sánchez-Cubillo, I., Periáñez, J. A., Adrover-Roig, D., Rodríguez-Sánchez, J. M., Ríos-Lago, M., Tirapu, J., & Barceló, F. (2009). Construct validity of the Trail Making Test: role of task-switching, working memory, inhibition/interference control, and visuomotor abilities. Journal of the International Neuropsychological Society, 15, 438–450.
Savonix.com (2021). Savonix [Computer software]. Retrieved from https://savonix.com/
Shigematsu, R., & Okura, T. (2006). A novel exercise for improving lower-extremity functional fitness in the elderly. Aging Clinical and Experimental Research, 18, 242-248.
Shigematsu, R., Okura, T., Nakagaichi, M., & Nakata, Y. (2014). Effects of exercise program requiring attention, memory and imitation on cognitive function in elderly persons: a non-randomized pilot study. Journal of Gerontology and Geriatric Research, 3, 147.
Shigematsu, R., Okura, T., Nakagaichi, M., Tanaka, K., Sakai, T., Kitazumi, S., & Rantanen, T. (2008a). Square-stepping exercise and fall risk factors in older adults: a single-blind, randomized controlled trial. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 63, 76-82.
Shigematsu, R., Okura, T., Sakai, T., & Rantanen, T. (2008b). Square-stepping exercise versus strength and balance training for fall risk factors. Aging Clinical and Experimental Research, 20, 19-24
Springer, B. A., Marin, R., Cyhan, T., Roberts, H., & Gill, N. W. (2007). Normative values for the unipedal stance test with eyes open and closed. Journal of Geriatric Physical Therapy, 30, 8-15.
Taniguchi, Y., Kitamura, A., Seino, S., Murayama, H., Amano, H., Nofuji, Y., ... & Shinkai, S. (2017). Gait performance trajectories and incident disabling dementia among community-dwelling older Japanese. Journal of the American Medical Directors Association, 18, e13-e20.
Teixeira, C. V., Gobbi, S., Pereira, J. R., Vital, T. M., Hernandéz, S. S., Shigematsu, R., & Gobbi, L. T. (2013). Effects of square-stepping exercise on cognitive functions of older people. Psychogeriatrics, 13, 148–156.
World Health Organization. (2020, October 12). Coronavirus disease (COVID-19). https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/coronavirus-disease-covid-19