# Effects of Square-Stepping Exercise on cognitive function in early geriatric rehabilitation: A randomized controlled explorative study

## TL;DR

This study compared a new exercise called Square-Stepping Exercise to regular physiotherapy in elderly patients and found similar improvements in attention and task switching, but no extra benefit for memory or executive function.

## Contribution

The study explores Square-Stepping Exercise as a potentially more engaging alternative to conventional physiotherapy in geriatric rehabilitation.

## Key findings

- Both groups improved in divided attention and task flexibility during rehabilitation.
- Square-Stepping Exercise did not show additional benefits for executive functions compared to conventional physiotherapy.
- No improvement in memory function was observed in either group.

## Abstract

The aim of the explorative study was to evaluate the effect of Square-Stepping Exercise (SSE) on cognitive function compared to conventional physiotherapy (cPT) in early geriatric rehabilitation. A training effect of SSE on cognitive function particularly on executive functions was expected.

This explorative study was conducted in the department of early geriatric rehabilitation in a general hospital. Fifty-eight inpatients (27 female), with a median age of 79.1 (range: 63–90) were randomized to the control group (CG, n = 29) or the intervention group (IG, n = 29). CG received cPT five days per week during their hospital stay. For the IG, SSE replaced cPT for at least six sessions throughout the hospital stay, alternating with cPT. Executive function was assessed via the test battery for attentional performance (TAP), memory function was evaluated using the digit span test.

Both groups improved in the divided attention task (total pre 9.9 missing items; total post 7.5 missing items, p = 0.011), and in the flexibility task (total pre 2034.49 ms; total post 1680.60 ms, p = 0.004). There was no specific training effect of SSE on executive functions measured with the TAP. No improvement in memory function was noted in either group.

Inpatients receiving SSE combined with cPT improved similarly in cognitive domains during early geriatric rehabilitation compared with inpatients offered cPT alone. SSE can be used as an additional component in early geriatric rehabilitation, which due to its playful characteristics might be more motivational or intriguing for some inpatients.

ClinicalTrials.gov DRKS00026191