This study investigates whether stepping training that uses an unpredictable, variable auditory cue - changing both the timing and the direction of each step - improves dynamic balance and stepping adaptability more than stepping training with a constant, predictable auditory cue. Sedentary young adults will be randomly assigned to one of two 4-week training programs and assessed before and after training.
Reduced physical activity is associated with diminished neuromuscular reactivity and postural control. While auditory-cued stepping/gait training has demonstrated benefits for balance and stepping performance in clinical populations (e.g., stroke, Parkinson's disease), evidence in healthy, sedentary young adults remains limited. Motor-learning theory suggests that greater practice variability - in both timing and spatial direction - promotes superior motor adaptation and retention compared with fixed, predictable practice conditions. This randomized controlled trial will compare a combined variable-timing and variable-direction auditory-cued stepping training protocol against a fixed-timing, fixed-direction protocol, in terms of their effects on dynamic balance (Y-Balance Test) and stepping adaptability (Choice Stepping Reaction Time), in sedentary young adults aged 18-35 years, over a 4-week supervised training period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
85
A supervised stepping-training program delivered 3 sessions/week for 4 weeks (12 sessions total). Each session includes a 5-minute warm-up, 20-25 minutes of auditory-cued stepping training, and a 5-minute cool-down. During the main training phase, participants respond to auditory cues with randomly varying inter-stimulus timing (1.5-3.5 seconds) and randomly varying step direction (anterior, posterior, lateral), stepping onto the cued target as quickly as possible before returning to a central start position.
A supervised stepping-training program delivered 3 sessions/week for 4 weeks (12 sessions total), identical in structure, duration, and total training volume to the Variable Cueing Group. During the main training phase, participants respond to auditory cues delivered at a constant, fixed inter-stimulus interval (every 2.5 seconds) and a single, fixed step direction (forward only), stepping onto the fixed target before returning to a central start position.
Change in Y-Balance Test Composite Reach Score
Dynamic balance assessed using the Y-Balance Test, with composite reach score (anterior, posteromedial, posterolateral directions) normalized to limb length and expressed as a percentage.
Time frame: Baseline and 4 weeks
Change in Choice Stepping Reaction Time
Stepping adaptability assessed using Choice Stepping Reaction Time, measured as mean reaction time in milliseconds in response to randomized directional auditory cues.
Time frame: Baseline and 4 weeks
Change in Choice Stepping Reaction Time
Stepping adaptability assessed using Choice Stepping Reaction Time, measured as accuracy (percentage of correct responses) in response to randomized directional auditory cues.
Time frame: Baseline and 4 weeks
Change in Four Square Step Test Time
Stepping agility and coordination assessed using the Four Square Step Test (FSST), recorded as the time (in seconds) taken to complete a standardized four-directional stepping sequence. Lower scores indicate better performance.
Time frame: Baseline and 4 weeks
Change in Timed Up and Go Test Time
Functional mobility assessed using the Timed Up and Go (TUG) test, recorded as the time (in seconds) taken to rise from a chair, walk 3 meters, turn, return, and sit back down. Lower scores indicate better functional mobility.
Time frame: Baseline and 4 weeks
Change in Berg Balance Scale Score
Overall functional balance assessed using the Berg Balance Scale (BBS), a 14-item performance-based scale with each item scored from 0 to 4, yielding a total score ranging from 0 to 56. Higher scores indicate better functional balance.
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Time frame: Baseline and 4 weeks