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Peer-reviewedCC BY 4.0Frontiers in Neurology

The application of square-stepping exercise in patients with stroke: a scoping review

  • Yali Yan1
  • Juan Xu1,2
  • Jiaxin Yao1
  • Yuanyuan Liu1
  • Mengdan Li1
  • Xinxin Geng3
  1. 1School of Nursing, Shanxi University of Chinese Medicine, Jinzhong, Shanxi, China
  2. 2Shanxi Provincial People’s Hospital, Taiyuan, Shanxi, China
  3. 3School of Nursing, Fujian University of Chinese Medicine, Fuzhou, Fujian, China
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Abstract

Background: Square-stepping exercise (SSE) is a form of dual-task training that has been used in studies involving patients with stroke. This scoping review provides an overview of the intervention protocols and outcomes reported in studies examining the use of SSE among patients with stroke.

Methods: PubMed, Embase, Web of Science, The Cochrane Library, CINAHL, CNKI, SinoMed, Wanfang Data, and the VIP Database were searched for studies published from 2006, when the first study on SSE was published, to April 30, 2026. A total of 459 records were identified, of which seven met the eligibility criteria and were included in the final analysis.

Results: A total of seven studies were included. The intervention types included face-to-face and hybrid interventions. The duration of a single session was generally 30 min, the frequency was mostly 3–5 times per week, and the intervention period ranged from 6 to 24 weeks. The outcome measures primarily covered two domains: motor function and cognitive function. The findings suggested that SSE may improve balance and gait function in patients with stroke and may reduce the risk of falls. In addition, SSE may improve global cognitive function, including executive function and attention.

Conclusion: SSE may help improve motor and cognitive function in patients with stroke, but related research remains at an exploratory stage. Future research should include large-scale, multicenter studies with long-term follow-up to further clarify its long-term effects and optimal intervention protocol, explore remotely delivered SSE interventions, and promote the standardized implementation and dissemination of SSE in stroke rehabilitation.

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Cite

BibTeXRIS
BibTeX
@article{yan2026application,
  title = {{The application of square-stepping exercise in patients with stroke: a scoping review}},
  author = {Yali Yan and Juan Xu and Jiaxin Yao and Yuanyuan Liu and Mengdan Li and Xinxin Geng},
  journal = {Frontiers in Neurology},
  year = {2026},
  month = oct,
  doi = {10.3389/fneur.2026.1952887},
  url = {https://doi.org/10.3389/fneur.2026.1952887},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - The application of square-stepping exercise in patients with stroke: a scoping review
AU  - Yali Yan
AU  - Juan Xu
AU  - Jiaxin Yao
AU  - Yuanyuan Liu
AU  - Mengdan Li
AU  - Xinxin Geng
PY  - 2026
DA  - 2026/10/12
JO  - Frontiers in Neurology
DO  - 10.3389/fneur.2026.1952887
UR  - https://doi.org/10.3389/fneur.2026.1952887
AB  - Background: Square-stepping exercise (SSE) is a form of dual-task training that has been used in studies involving patients with stroke. This scoping review provides an overview of the intervention protocols and outcomes reported in studies examining the use of SSE among patients with stroke.  Methods: PubMed, Embase, Web of Science, The Cochrane Library, CINAHL, CNKI, SinoMed, Wanfang Data, and the VIP Database were searched for studies published from 2006, when the first study on SSE was published, to April 30, 2026. A total of 459 records were identified, of which seven met the eligibility criteria and were included in the final analysis.  Results: A total of seven studies were included. The intervention types included face-to-face and hybrid interventions. The duration of a single session was generally 30 min, the frequency was mostly 3–5 times per week, and the intervention period ranged from 6 to 24 weeks. The outcome measures primarily covered two domains: motor function and cognitive function. The findings suggested that SSE may improve balance and gait function in patients with stroke and may reduce the risk of falls. In addition, SSE may improve global cognitive function, including executive function and attention.  Conclusion: SSE may help improve motor and cognitive function in patients with stroke, but related research remains at an exploratory stage. Future research should include large-scale, multicenter studies with long-term follow-up to further clarify its long-term effects and optimal intervention protocol, explore remotely delivered SSE interventions, and promote the standardized implementation and dissemination of SSE in stroke rehabilitation.
SN  - 1664-2295
ER  -