Development of a novel stepping exercise program (StepIt) to improve fall risk factors in older adults

To maximize effectiveness, falls-prevention exercise programs need to implement research evidence into practice. The ability to execute steps that vary in amplitude, speed, accuracy in single and multi-task conditions is critical for preventing accidental falls. For that reason, stepping training has been found to be particularly effective in reducing falls. However, to achieve optimal effects, training plans need to be specific and well dosed. Based on an analysis of age-related changes in stepping patterns, relevant ingredients for step training as well as their gradual progression are defined and a structured approach to stepping training which allows systematic manipulation of spatiotemporal aspects (e.g. stepping speed, amplitude, direction), sensory aspects (e.g. stepping on wobbly surfaces) and task complexity (single-/, dual-tasking) is presented. The proposed framework can be used for the optimal design of dose-response based exercise programs in individual or group-based training of voluntary stepping, with or without assistive technology.