Background: It is well known that higher physical activity and physical fitness are associated with lower reduced risks for coronary heart disease or diabetes. Various types of exercise training programs have been developed for health promotion and disease prevention. We have developed a novel exercise "square-stepping exercise" (SSE) to prevent dementia and falls for older adults, and have reported that the regular SSE improved lower-extremity functional fitness, lack of which constitutes a risk factor for falls. However, little is known of the association between regular SSE and physical fitness in middle-aged or younger populations.
Objective: The objective of this study was to investigate whether regular SSE could affect health-related physical fitness in middle-aged Japanese women.
Methods: Subjects were 31 women, aged 55-64 yr (average, 59.6 ± 5.0 yr), who enrolled in a 60-min SSE class for health promotion once a week for 3 months (10 sessions in total). Each session consisted of 15-min warm-up, 30-min SSE, 15-min cool-down. The SSE was performed on a thin mat partitioned into 40 squares (25 cm each) arranged in 4 rows. We prepared over 100 stepping patterns in total, which were categorized by level of complexity. Subjects were required to memorize step patterns demonstrated by an instructor before each stepping and they enjoyed the challenge of more complicated patterns. Test items of health-related physical fitness and physical function consisted of grip strength, chair sit-to-stand, one-leg balance, simple and choice reaction times, functional reach, sit and reach, timed up-and-go, tandem walk, standing up from a lying position, and step test in 10 s. The items were measured before and after the intervention period.
Results: All items displayed significant improvements after the class with the exception of sit and reach. In addition, significant decreases were observed in waist circumference (pre 85.0 ± 9.6 cm, post 83.0 ± 10.0 cm, p < .001), systolic blood pressure (pre 129 ± 22 mmHg, post 122 ± 15 mmHg, p = .029), and diastolic blood pressure (pre 79 ± 11 mmHg, post 76 ± 9 mmHg, p = .036). The average of the number of steps, exercise-induced energy expenditure, heart rate (HR), and %HRreserve during the class were 2534 ± 635 step/session, 65.5 ± 15.4 kcal/session, 120.5 ± 15.4 bpm, and 51.3 ± 17.9%, respectively. Change in waist circumference was significantly correlated with the total of steps in 10 sessions (r = -.427, p = .018) and average number of steps per a class (r = -.548, p = .002). Change in weight was significantly correlated with the total of exercise-induced energy expenditure (r = -.378, p = .036).
Conclusions: Our data suggest that regular SSE could increase physical activity and improve health-related physical fitness of middle-aged Japanese women. However, further studies on the effects of frequency, duration, and training intensity of SSE on health-related physical fitness are needed.