Square-stepping Exercise for Older Adults Attending a Daycare Service Facility: A Feasibility Study

Square-stepping exercise (SSE) is a preventive program that reduces the risk of falls and improves physical function and agility in community-dwelling older adults. Although SSE has shown benefits in community-dwelling older adults, its feasibility in Japanese daycare service facilities, where physical and cognitive conditions may differ, remains unclear. This study aimed to assess its implementation and acceptability among older adults in daycare service facilities.

A single-arm, 4-week intervention was conducted at Daycare Service Facility A in Kagoshima, Japan. Participants performed SSE once weekly for 4 weeks, with each session lasting 60 min. Safety (absence of injuries or illnesses), program completion rates, and session attendance rates were monitored throughout the intervention, and one-on-one semi-structured interviews were conducted to assess acceptability.

The participants were 21 older adults (mean age 87.4 ± 4.6 years). Adherence was high, with a 95.2% completion rate and 100% attendance rate. No injuries were observed. All participants completed the exercises by following the step patterns, as instructed. Interviews revealed positive psychological changes, such as enjoyment and a sense of accomplishment, and physical improvements, including better lower-limb conditions and overall health.

The findings suggest that SSE may be safely implemented with high adherence in older females with care levels of 3 or below in daycare service facilities and may also promote positive psychological changes. It is necessary to conduct a more detailed evaluation of its effectiveness.