Square Step Exercises in Healthy Young Adults

Comparison of the Effects of Square Step Exercises and Aerobic Exercise on Cognitive Functions and Physical Fitness in Healthy Young Adults

This study aims to compare the effectiveness of Square Stepping Exercise and aerobic exercise on cognitive function and physical fitness in young adults. Participants aged 18-30 with low physical activity levels will be randomly assigned to either the Square Stepping Exercise Group or Aerobic Exercise Group. Both interventions will be supervised by a physiotherapist, performed twice a week for 40 minutes over 4 weeks. Cognitive function will be assessed using various tests, including attention, short-term memory, and executive function evaluations. Physical fitness will be evaluated through jump tests and balance assessments. Blinded assessors will conduct evaluations at baseline and post-intervention in both groups to determine the impact of square stepping exercise and aerobic exercise on cognitive and physical health in young adults.

Study Overview

• Status: Not yet recruiting
• Conditions: Exercise; Cognitive Function; Aerobic Exercise; Physical Fitness; Square Step Exercises
• Intervention / Treatment: Other: Aerobic Exercise Training; Other: Square Stepping Exercise training

• Study Type: Interventional
• Enrollment (Estimated): 50
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Maltepe, Turkey
    • Marmara University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• International Physical Activity Questionnaire score <600 Metabolic Equivalents (METs),
• No neurological or orthopedic problems affecting gait, balance and lower extremities
• No vision or hearing problems, and no history of musculoskeletal surgery.

Exclusion Criteria:

• Participants who have pain due to a musculoskeletal problem
• Participants who are continuing another routine exercise program

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Square Stepping Exercise Group; The experimental group will have Square Stepping Exercise training twice a week for 4 weeks. Each session will start with a 15-minute warm-up, followed by a 40-minute Square Stepping Exercise workout and ending with a 15-minute cool-down. The Square Stepping Exercise part will start with the Elementary 2 level, which has 30 different patterns. Participants will start with the first pattern at this level. If they can complete it without mistakes within 15 seconds, they'll move on to the next pattern. If not, they'll repeat the pattern until they get it right within the time limit. Each session will have four participants, with two participants working on each of the two mats, which are divided into 40 squares and measure 100cm by 250 cm.	Other: Square Stepping Exercise training; The experimental group will have Square Stepping Exercise training.
Active Comparator: Aerobic Exercise Group; Individuals in the aerobic control cohort will partake in a 40-minute treadmill walking session, maintaining their heart rate at 60% of their individual heart rate reserve as calculated using the Karvonen formula. Before and after the aerobic exercise, a 5-minute warm-up session incorporating stretching and calisthenics, as well as a 5-minute cool-down session, will be conducted.	Other: Aerobic Exercise Training; Individuals in the aerobic control cohort will partake in a treadmill walking session.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Schulte Grid Test	Schulte Grid Test will be used to evaluate the attention level of the participants. The task involves participants locating and selecting numbers in sequential order within a table filled with random numbers ranging from 1 to 64. Participants are required to find and click the correct numbers in ascending order, with completion time serving as the primary metric for assessment. Once a participant selects the correct number "1," the corresponding box will illuminate in green, prompting the participant to locate and select "2," and so forth until reaching "64." The test concludes upon successfully clicking the last number in the sequence. Schulte grid test will be conducted on a 15.6-inch laptop screen. A shorter reaction and completion time for the test will show good attention.	Baseline and after the interventions (4th week)
Stroop Test	This test will be used to evaluate executive functions, particularly selective attention and cognitive flexibility. In this assessment, participants are tasked with identifying the colors of rectangles, reading color names, and stating the color of color names printed in differing hues. Subsequently, error rates and spontaneous corrections are meticulously recorded and assessed. A shorter completion time and fewer number of errors for the test will show good executive functions.	Baseline and after the interventions (4th week)
Verbal Fluency Test	Letter Fluency Test: Participants are instructed to count words beginning with the letters K, A, S, and non-numerical characters within one minute, while a voice recording is made. Words not starting with the specified letters and repeated words are tallied as errors/points. It is scored on the number of words derived. Repetition of the same word is considered as perseveration; Category Fluency Test: Participants are prompted to enumerate names of animals, fruits, and objects purchasable from the market within one minute, with a voice recording taken. Words falling outside the designated categories and repetitions are logged as error count/score. Total score based on the number of groups formed by the individual in one minute points are awarded. The more groups the individual has made, the more points individual gets. In this study, these tests will be utilized to assess information processing speed and attention as part of executive functions.	Baseline and after the interventions (4th week)
Digit Span Test	The test consists of two parts. Part One is Digits Forward and Part Two is Digits Backward. In both tests administered separately, random numbers are read to the participants at one-second intervals. The norm value of the Digits Forward is 7, while the norm value of the Digits Backward is 5; results below these values indicate impaired attention.	Baseline and after the interventions (4th week)
Vertical jump test	This test will be used for physical fitness assessment. During the assessment, the participant positions themselves adjacent to a wall. Using one arm, they extend upwards without bending, making contact with a wall marked in centimeters (cm). This measurement is then recorded. Following this, the participant is directed to perform a maximal force jump, aiming to touch the highest point achievable. This process is repeated thrice, with a 60-second rest interval between each jump. The highest value attained among the three jumps is documented in centimeters.	Baseline and after the interventions (4th week)
Horizontal jump test	In the assessment of horizontal jump, a key component of physical fitness, the standing long jump technique will be utilized. A designated starting line will be marked, with a ruler spanning 3 meters in length fixed at 1-centimeter intervals from the starting point. Participants will assume the starting position, ensuring their feet are not touching the line and are fully grounded, then execute a forward jump using both legs. The distance from the starting line to the point where the participant's feet last touch the ground will be measured. Each participant will perform three jumps, and the best distance achieved will be recorded as the final measurement.	Baseline and after the interventions (4th week)
Y Balance Test	Dynamic balance, an essential component of physical fitness crucial for executing functional tasks and occupational activities, will be evaluated using the Y balance test. This test involves reaching as far forward as possible along anterior, posterolateral, and posteromedial directional lines placed on the ground while maintaining balance on one foot. Participants will be instructed to reach as far as they can in each direction with their raised foot while keeping their hands on their hips. The maximum reach distances achieved in the anterior, posteromedial, and posterolateral directions will be marked and recorded as three valid measurements for each direction. The key outcome measures of interest will include the reach distances in the three directions as well as the composite score derived from the test.	Baseline and after the interventions (4th week)

Collaborators and Investigators

• Sponsor: Fenerbahce University

Study record dates

Study Major Dates

• Study Start (Estimated): December 1, 2025
• Primary Completion (Estimated): December 1, 2027
• Study Completion (Estimated): December 1, 2027

Study Registration Dates

• First Submitted: March 19, 2024
• First Submitted That Met QC Criteria: March 19, 2024
• First Posted (Actual): March 26, 2024

Study Record Updates

• Last Update Posted (Actual): August 19, 2025
• Last Update Submitted That Met QC Criteria: August 14, 2025
• Last Verified: March 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: 29.02.2024/45

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
• product manufactured in and exported from the U.S.: No