Effects of Square Stepping Exercise on Physical, Cognitive and Psychosocial Fitness in People with Parkinson's Disease

Abstract

Parkinson's disease (PD) is a progressive disease characterised by motor and non-motor symptoms that affect patients' daily activities. Square Stepping Exercise (SSE) is a training programme that requires physical and cognitive effort. The aim was to investigate whether the application of SSE is safe, applicable, can improve balance and is effective in preventing falls, improving cognitive and psychological aspects in people with PD. The randomised controlled study involved 22 people with PD, divided into 2 groups, SSE (n = 11) and control (n = 11). The results show that in the experimental group there were significant improvements in the variables related to physical condition: Balance: L-Test (p = 0.034), Time Up and Go 3 m test (p = 0.026), Time Up and Go 7 m test (p = 0.016). Speed: 6 mi walking test (p < 0.001). Strength: 30 s Sit to Stand test (p = 0.005) and 5 rep sit to stand (p = 0.003); except for the 30 m walking test (p = 0.947) and the functional reach test (p = 0.448). Similarly, the following cognitive tests showed post-intervention improvements: (SDMT) Symbol Digit Modalities Test (21 vs. 29, p = 0.003), (CVLT) The California Verbal Learning Test (55 vs. 69, p = 0.009), (BVMT) Brief Visuospatial Memory Test (5 vs. 8, p = 0.005) and the total score of the (Bicams) Brief International Cognitive Assessment (88 vs. 112, p < 0.001) and on psychosocial factors related to Perceived Social Support (p = 0.014). There was no significant effect on the frequency of falls, depression, anticipatory cognition and health-related quality of life. The SSE programme had a positive effect on physical condition, cognitive condition and psychosocial factors related to perceived social support.

Keywords: Anticipatory cognition; Balance; Cognitive aspects; Depression; Perceived social support.