International Journal of Health Sciences and Research Vol.12; Issue: 2; February 2022 Website: www.ijhsr.org Original Research Article ISSN: 2249-9571 International Journal of Health Sciences and Research (www.ijhsr.org) 287 Vol.12; Issue: 2; February 2022 Effect of Square-Stepping Exercise in Improving Lower Extremity Strength, Cadence and Confidence among Female Geriatric Population Arun Thachil 1 , Leya Thomas 2 1 Professor, College of Physiotherapy, Medical Trust Institute of Medical Sciences, Kochi- 682309. 2 P.G. Student, (Musculoskeletal), College of Physiotherapy, Medical Trust Institute of Medical Sciences, Kochi- 682309. Corresponding Author: Arun Thachil DOI: https://doi.org/10.52403/ijhsr.20220240 ABSTRACT Background and Objectives: Falls are frequent among elderly people. Fear of falling can become incapacitating and predisposes people who perceive themselves at risk of falling to inactivity, which itself can lead to problems of debilitation, increased handicap, and disability. Due to fear of fall, the elderly develops social isolation, a reduction in their confidence to accomplish normal activities of daily living, and mobility problems, and adopt an inactive life style, functional decline, resulting in institutionalization. Parameters like lower extremity strength, cadence and confidence are important for fall prevention. This study was designed to investigate effect of Square- Stepping Exercise (SSE) in improving lower extremity strength, cadence and confidence among female geriatric population. Methodology: 30 subjects from 1) FCC Convent & Assissi old age home, and 2) Mundakapadam Agathimandiram, were recruited for the study through convenient sampling. Activities- specific Balance Confidence (ABC) scale questionnaire was taken as an inclusion criteria and those who score below 80% was considered to be included in the study. After baseline measurement, 30 subjects satisfying the inclusion criteria were assigned into either a control group (Group A, n=15) and experimental group (Group B, n=15). Pre-test analysis was performed for both groups for lower extremity strength using hand-held dynamometer, cadence using 10 M walk test and confidence using ABC Scale questionnaire sheets. Experimental group received SSE in addition to conventional exercise whereas; control group received conventional exercise for 4 weeks. Post-test analysis was conducted. Statistical analysis was performed. Paired t test analysed the within group changes, independent t test was used to compare the changes between the group. Level of significance was kept at p≤0.05. Results: There was a significant improvement in lower extremity strength, cadence and confidence within group analysis. While comparing the control and experimental group, the experimental group showed a high significant difference (p<0.05) in lower extremity strength and confidence. Cadence shown no significant difference (p>0.05) between the group analysis. Conclusion: This study revealed that Square-stepping exercise provided a significant improvement in lower extremity strength and confidence with p≤0.05. Improvement in these physical parameters will reduce the risk of fall in young-old female geriatric population. SSE is safe to administer and advantageous to prevent falls. Keywords: Square stepping exercise; Older adults; Fall; Fear of fall; Balance confidence; Strength; Cadence INTRODUCTION Falls are frequent among elderly people. 1 According to Lamb et.al, 2005, a fall is defined as ‘An unexpected event in which the participant comes to rest on the ground, floor or lower level’. 2 Falls are