Effects of Twelve Weeks of Square Stepping Exercises on Physical and Cognitive Function and Plasma Content of SMP30: A Randomised Control Trial

Background: Ageing and sedentary lifestyles affect physical and cognitive function and markers of frailty, increasing the risk of falls in older adults and affecting their quality of life. The aim of this study was to evaluate the effects of a Square Step Exercise programme on physical and cognitive function and plasma SMP30 levels for the prevention of falls in older adults. Methods: A randomised controlled trial was designed with 44 participants assigned to an experimental group (SSE group) and a control group. The SSE group performed SSE sessions twice a week for three months, with a follow-up in the fourth month. The assessments of physical function included tests such as the Four-Square Step Test, Brisk Walking and its dual-task variant, Time Up and Go and its imagined and dual-task variants, 30 s Sit-to-Stand and its dual-task and imagined variants and a 6 min walking test. Questionnaires were also used to assess the risk and fear of falling. Resting EEG activity was also recorded to assess electrocortical brain activity. SMP30 levels were measured by Western blotting. Results: The SSE group showed significant improvements compared to the control group in the Four-Square Step Test (p < 0.001), Brisk Walking (p < 0.05) and reduction in the fear of falling (p < 0.001) after the training programme, but these adaptations were not maintained one month after the programme ended (p < 0.05). No significant changes were observed in the remaining variables of physical function, cognitive function, fall risk questionnaire, EEG activity or plasma levels of SMP30 compared to the control group (p > 0.05). Conclusions: The SSE programme showed efficacy in improving balance, gait speed and reducing fear of falling in older adults but did not show improvement over the control group in other areas of physical or cognitive function or plasma SMP30 levels for fall prevention.