Effects of Square-stepping Exercise Training on the Attention, Dynamic Balance and Lower Extremity Motor Coordination

Physical activity plays an indispensable role to lead a healthy life. Square-stepping exercises (SSE) are aerobic exercises. Our study was designed to investigate the effects of square-stepping exercise training on the attention, dynamic balance and lower extremity motor coordination of sedentary healthy young individuals.

A total of 112 volunteers within the age range of 20-25 participated in the research. Participants were randomly divided into two groups, as 56 participants were study group (28 females, 28 males) and 56 participants were control group (28 females, 28 males). Demographic data and exercise habit of the individuals were documented. Stroop Test was used to assess Attention, Four-step Square Test was used to assess Dynamic Balance and Lower-extremity Motor Coordination Test was used to assess Motor Coordination. Throughout 3 weeks SSE training was administered 4 days a week for a length of 45 minutes in each session. All the analyses were conducted at the start and at the end of 3-week long training.

Study Overview

• Status: Completed
• Conditions: Sedentary Healthy Young Individuals
• Intervention / Treatment: Other: Exercise Trainig

Detailed Description

Demographic data and exercise habit of the individuals were documented. Stroop Test: The Stroop test measures cognitive functions such as cognitive flexibility, attention, inhibition, and reaction time. The test is administered by asking participants to name the colors of words written in different colors; they must focus on the colors of the words, not their meanings. Research has shown that age significantly affects processing speed and reaction time, especially in children aged 5-15 and adults aged 20-82.

Four-step Square Test: The subject is required to sequentially step over four canes set-up in a cross configuration on the ground. At the start of the test, the subject stands in Square 1 facing Square 2. The aim is to step as fast as possible into each square with both feet in the following sequence: Square 2, 3, 4, 1, 4, 3, 2, 1 (clockwise to counterclockwise).

Lower-extremity Motor Coordination Test was developed as an easy, yet effective tool to clinically assess, measure, and evaluate the deficits in Lower Limb Motor Coordination

• Study Type: Interventional
• Enrollment (Actual): 112
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Denizli, Turkey, 20100
    • Pamukkale University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 25 years (Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Being within the age range of 20-25,
• Not continuing any exercise program for the last 1 year,
• Not having any disease impacting neurological, orthopedic or lower extremity system,
• Not having surgery history on lower extremity,
• Not having visual and hearing problem.

Exclusion Criteria:

• Having visual and hearing problem,
• Neurological problem debilitating one's walking,
• Having psychiatric or orthopedic problem
• Having surgery history on lower extremity.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Training Group; Throughout 3 weeks SSE training was administered 4 days a week for a length of 45 minutes in each session. All the analyses were conducted at the start and at the end of 3-week long training.	Other: Exercise Trainig; SSE is performed on a thin exercise mat divided into 40 small squares in 250 cm x 100 cm of size (25 cm each part). Participants are given patterns of a few steps and asked to take steps that match them. Participants must, in principal, move ahead in line with the length forward with no contact on the lines forming the squares. Forward, backward, lateral and oblique stepping patterns are required. Stepping patterns get increasingly difficult. Each pattern consists of 2 to 16 steps; participants are asked to repeat step pattern till the end of exercise mat. Upon completing a pattern, another pattern in the same mirror-image is repeated. In essence each pattern is reiterated for 3-5 times and next its mirror-image pattern is repeated but if participants face challenge in performing the pattern it is repeated till the pattern is learnt; Other Names: Square-steeping exercise
No Intervention: Control Group; This group has no intervention. Evaluations were only made at the start and at the end of 3-week long.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Attention Assessment (Stroop test)	The Stroop test measures cognitive functions such as cognitive flexibility, attention, inhibition, and reaction time. The test is administered by asking participants to name the colors of words written in different colors; they must focus on the colors of the words, not their meanings.	3 weeks
Dynamic Balance Assessment (Four-step Square Test)	The subject is required to sequentially step over four canes set-up in a cross configuration on the ground. At the start of the test, the subject stands in Square 1 facing Square 2. The aim is to step as fast as possible into each square with both feet in the following sequence: Square 2, 3, 4, 1, 4, 3, 2, 1 (clockwise to counterclockwise)	3 weeks
Motor Coordination Assessment (Lower extremity Motor Coordination Test)	This test is completed with the patient sitting.There are two red targets on a sheet, 6 cm in diameter each, which are placed 30 apart in a vertical direction. The patient, sitting in a comfortable position with their knees flexed at 90 degrees and their heels on the proximal target, is asked to alternately move their leg back and forth to accurately touch the red target with their big toe. They must do this as quick as they can, and as many times as they can, in 20 seconds.	3 weeks

Collaborators and Investigators

• Sponsor: Pamukkale University
• Investigators: Principal Investigator: Gulsum Tikac, Pamukkale University; Study Director: Ayse Unal, Pamukkale University; Study Chair: Filiz Altug, Pamukkale University

Study record dates

Study Major Dates

• Study Start (Actual): September 10, 2019
• Primary Completion (Actual): September 10, 2020
• Study Completion (Actual): September 10, 2020

Study Registration Dates

• First Submitted: March 16, 2021
• First Submitted That Met QC Criteria: March 16, 2021
• First Posted (Actual): March 18, 2021

Study Record Updates

• Last Update Posted (Actual): June 3, 2025
• Last Update Submitted That Met QC Criteria: June 2, 2025
• Last Verified: March 1, 2021

More Information

Terms related to this study

• Keywords: dynamic balance; attention; motor coordination; Square-stepping exercise training
• Other Study ID Numbers: Effect of SSE Training

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No