The impact of digitalized community-based squarestepping exercise program on cognitive and balance functions among older adults living in senior facilities: A pilot study




Lee, Kyoung Eun
Boham, Mikaela
Zhang, Meng
Ro, YoungHee
Cong, Xiaomei
Huang, Yuxia


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Objectives: Older adults exhibit a high desire for active and healthy aging without physical or mental dysfunction, particularly those living independently in senior facilities. Preserving or improving cognitive function and minimizing fall risks are essential for older adults to live a happy and active lifestyle. The purpose of this pilot study was to examine the feasibility, safety, and preliminary effectiveness of the innovative digitalized community-based square-stepping exercise program (DC-SSEP) in improving cognitive and physical function among older adults residing in senior facilities. Methods: Guided by the Health Promotion Model and Social Cognitive Theory, this pilot study used a quasi-experiment design with one intervention group. A total of 17 older adults recruited from a senior facility in Southern Texas participated in 40 sessions of DC-SSEP over 20 weeks. Cognitive function was measured using the latest version (8.1) of Montreal Cognitive Assessment and the balance function focusing on balance and functional mobility was measured using Berg Balance Scale and Time to Up and Go. Results: Most participants were non-Hispanic white women. The DC-SSEP was a feasible and safe exercise program for older adults living in senior facilities; and the results showed the preliminary effectiveness of the DC-SSEP in improving cognitive and balance function (P < 0.01) among older adults. Conclusion: This pilot study is distinctive as it is among the first to evaluate the multi-layered impacts of DC-SSEP using Internet of Things (IoT) technology and integrated operating software in the United States. Despite the small sample size and homogeneity of participants, this pilot study suggests multiple valuable directions for future research using DC-SSEP.



active and healthy aging, exercise, older adults, cognitive function, balance


This study was supported by the Texas Comprehensive Research Fund from Texas A&M University, Corpus Christi (TCRF-09/2022; grant number # 143403-00140).


CC BY-NC-ND 4.0 DEED Attribution-NonCommercial-NoDerivs 4.0 International


Lee, Kyoung Eun PhD, RN, WHCNPa; Boham, Mikaela PhDb; Zhao, Meng PhD, RNc; Ro, YoungHee PhDd; Cong, Xiaomei PhD, RNe; Huang, Yuxia PhDf. The impact of digitalized community-based square-stepping exercise program on cognitive and balance functions among older adults living in senior facilities: a pilot study. Interdisciplinary Nursing Research 3(1):p 9-16, March 2024.