Comparison of Square Stepping Exercise and Wobble Board Exercise in Elderly Population

NCT07150364 | Recruiting

• 1 other identifier: REC/RCR&AHS/24/02101
• Study Type: interventional
• Target: 38
• Locations: 1 country
• Sites: 1

Brief Summary

Cognitive decline and balance issues are key contributors to falls. Square Stepping Exercise (SSE) and Wobble Board Exercise (WBE) both are the promising forms of balance training. Therefore, the aim of this study is to compare these two exercises to determine their effects on cognition, balance, and fall risk in elderly population.

Conditions

Elderly Population

Keywords

Balance; Cognition; Fall risk; Square-stepping exercise; Wobble board

Outcome Measures

Primary Outcomes (3)

• Fall Efficacy Scale- international (FES- I)

  The FES-I is designed to assess concern about falling while performing basic and instrumental indoor and outdoor activities. This scale consists of 16 items (10 items from the original FES and six additional social activities items). Each item is scored with a four- point scale (1 = not concerned at all, 4 = very concerned). The summation of scores gives a total score from 16 (absence of FOF) to 64 (extreme concern of falling). This scale was used as a criterion scale in the present study with a cutoff point of 23.

  6th week

• Mini Mental State Examination (MMSE)

  The Mini-Mental State Examination (MMSE) is a widely used tool for screening cognitive function and assessing the severity of cognitive impairment. It assesses areas such as orientation, registration, attention and calculation, recall, language, and visual construction. The MMSE consists of 30 questions with a maximum score of 30 points in which score between 24-30 is consider normal, score 18-23 is consider mild cognitive impairment and score between 0-17 is consider severe cognitive impairment.

  6th week

• Berg Balance Scale (BBS)

  The BBS evaluates a participant's balance based on 14 items scored and takes 15-20 min to complete. The score for each item ranges from 0 to 4 points, with an overall maximum score of 56 points. Balance is evaluated by asking participants to perform a variety of sitting, transferring and standing positions. In an assessment of which cut- off scores on the BBS best predict the risk of falling. The score of 41-56 indicates low risk of fall, 21-40 indicates medium risk of fall, and 0-20 indicates the high risk of fall.

  6th week

Secondary Outcomes (1)

• Time up and Go test (TUG)

  6th week

Study Arms (2)

Square Stepping Exercise

EXPERIMENTAL

In SSE, step patterns are performed on a mat

Other: Square Stepping Exercise

Wobble Board Exercise

EXPERIMENTAL

Person is standing on a wobble board, that unexpectedly translates or tilts

Other: Wobble Board Exercise

Interventions

Square Stepping Exercise OTHER

5 days per week for 6 weeks. 30 minutes per session with appropriate rest interval in between.

Square Stepping Exercise

Wobble Board Exercise OTHER

5 days per week for 6 weeks. 30 minutes per session with appropriate rest interval in between.

Wobble Board Exercise

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Elderly individuals age 60 years and above of both genders according to the guidelines of World Health Organization (WHO).
• Participants whose Mini Mental State Examination (MMSE) score will be \>24/30 ensuring sufficient cognitive ability to follow instructions and participate in exercise.
• Participants whose Berg Balance Scale scores of more than 41/56 ensuring that the participants have moderate level of balance ability.
• Vital signs within normal range for elderly population.
• Ability to walk independently with or without an assistive device (e.g., canes).

You may not qualify if:

• Participants who have severe musculoskeletal or neurological disorders affecting gait or balance (e.g., Parkinson's disease, and stroke) because of the complex impacts of these conditions on general cognitive and physical functions.
• Participants who undergoes recent fractures or injuries affecting participation in physical activity.
• Participants who have uncontrolled cardiovascular or metabolic conditions (e.g., uncontrolled hypertension, and diabetes mellitus) that could significantly interfere with exercise.

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Khursheed Old Home

Lahore, Punjab Province, 54800, Pakistan

RECRUITING

Related Publications (14)

• Delbaere K, Valenzuela T, Lord SR, Clemson L, Zijlstra GAR, Close JCT, Lung T, Woodbury A, Chow J, McInerney G, Miles L, Toson B, Briggs N, van Schooten KS. E-health StandingTall balance exercise for fall prevention in older people: results of a two year randomised controlled trial. BMJ. 2021 Apr 6;373:n740. doi: 10.1136/bmj.n740.

  PMID: 33824131 BACKGROUND

• Forbes PA, Chen A, Blouin JS. Sensorimotor control of standing balance. Handb Clin Neurol. 2018;159:61-83. doi: 10.1016/B978-0-444-63916-5.00004-5.

  PMID: 30482333 BACKGROUND

• Guirguis-Blake JM, Michael YL, Perdue LA, Coppola EL, Beil TL. Interventions to Prevent Falls in Older Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2018 Apr 24;319(16):1705-1716. doi: 10.1001/jama.2017.21962.

  PMID: 29710140 BACKGROUND

• Henry M, Baudry S. Age-related changes in leg proprioception: implications for postural control. J Neurophysiol. 2019 Aug 1;122(2):525-538. doi: 10.1152/jn.00067.2019. Epub 2019 Jun 5.

  PMID: 31166819 BACKGROUND

• Franzel K, Koschate J, Freiberger E, Shigematsu R, Zieschang T, Tietgen S. Square-stepping exercise in older inpatients in early geriatric rehabilitation. A randomized controlled pilot study. BMC Geriatr. 2024 Apr 10;24(1):326. doi: 10.1186/s12877-024-04932-3.

  PMID: 38600478 BACKGROUND

• Thomas E, Battaglia G, Patti A, Brusa J, Leonardi V, Palma A, Bellafiore M. Physical activity programs for balance and fall prevention in elderly: A systematic review. Medicine (Baltimore). 2019 Jul;98(27):e16218. doi: 10.1097/MD.0000000000016218.

  PMID: 31277132 BACKGROUND

• Kawabata M, Gan SR, Shen-Hsing AC. Effects of Square Stepping Exercise on cognitive, physical, psychological, and group functioning in sedentary older adults: A center-based hybrid trial. BMC Geriatr. 2024 Apr 25;24(1):374. doi: 10.1186/s12877-024-04904-7.

  PMID: 38664613 BACKGROUND

• Taghavi Asl A, Shojaedin SS, Hadadnezhad M. Comparison of effect of wobble board training with and without cognitive intervention on balance, ankle proprioception and jump landing kinetic parameters of men with chronic ankle instability: a randomized control trial. BMC Musculoskelet Disord. 2022 Sep 30;23(1):888. doi: 10.1186/s12891-022-05706-x.

  PMID: 36180870 BACKGROUND

• Rudnicka E, Napierala P, Podfigurna A, Meczekalski B, Smolarczyk R, Grymowicz M. The World Health Organization (WHO) approach to healthy ageing. Maturitas. 2020 Sep;139:6-11. doi: 10.1016/j.maturitas.2020.05.018. Epub 2020 May 26.

  PMID: 32747042 BACKGROUND

• Meimandi M, Fadavi-Ghaffari M, Taghizadeh G, Azad A, Lajevardi L. Falls Efficacy Scale and Single Item Question: Screening Accuracy for Older Adults Residing in Nursing Homes. Clin Gerontol. 2021 Oct-Dec;44(5):544-551. doi: 10.1080/07317115.2020.1858467. Epub 2020 Dec 15.

  PMID: 33320074 BACKGROUND

• Dewan N, MacDermid JC. Fall Efficacy Scale-International (FES-I). J Physiother. 2014 Mar;60(1):60. doi: 10.1016/j.jphys.2013.12.014. Epub 2014 May 3. No abstract available.

  PMID: 24856947 BACKGROUND

• Patnode CD, Perdue LA, Rossom RC, Rushkin MC, Redmond N, Thomas RG, Lin JS. Screening for Cognitive Impairment in Older Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2020 Feb 25;323(8):764-785. doi: 10.1001/jama.2019.22258.

  PMID: 32096857 BACKGROUND

• Meekes WM, Korevaar JC, Leemrijse CJ, van de Goor IA. Practical and validated tool to assess falls risk in the primary care setting: a systematic review. BMJ Open. 2021 Sep 29;11(9):e045431. doi: 10.1136/bmjopen-2020-045431.

  PMID: 34588228 BACKGROUND

• Zahedian-Nasab N, Jaberi A, Shirazi F, Kavousipor S. Effect of virtual reality exercises on balance and fall in elderly people with fall risk: a randomized controlled trial. BMC Geriatr. 2021 Sep 25;21(1):509. doi: 10.1186/s12877-021-02462-w.

  PMID: 34563120 BACKGROUND

Study Officials

• Fatima Tariq

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Imran Amjad, Phd

CONTACT

03324390125; imran.amjad@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 24, 2025
• First Posted: September 2, 2025
• Study Start: November 17, 2024
• Primary Completion: November 30, 2025
• Study Completion: January 30, 2026
• Last Updated: September 2, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)