Background: Systematic review evidence has shown that step training reduces the number of falls in older people by half. This study investigated the feasibility and effectiveness of a bespoke Kinect stepping exergame in an unsupervised home-based setting.

Materials and Methods: An uncontrolled pilot trial was conducted in 12 community-dwelling older adults (mean age 79.3 ± 8.7 years, 10 females). The stepping game comprised rapid stepping, attention, and response inhibition. Participants were recommended to exercise unsupervised at home for a minimum of three 20-minute sessions per week over the 12-week study period. The outcome measures were choice stepping reaction time (CSRT) (main outcome measure), standing balance, gait speed, five-time sit-to-stand (STS), timed up and go (TUG) performance, and neuropsychological function (attention: letter–digit and executive function:Stroop tests) assessed at baseline, 4 weeks, 8 weeks, and trial end (12 weeks).

Results: Ten participants (83%) completed the trial and reassessments. A median 8.2 20-minute sessions were completed and no adverse events were reported. Across the trial period, participants showed significant improvements in CSRT (11%), TUG (13%), gait speed (29%), standing balance (7%), and STS (24%) performance (all P < 0.05). There were also nonsignificant, but meaningful, improvements for the letter–digit (13%) and Stroop tests (15%).

Conclusions: This study found that a bespoke Kinect step training program was safe and feasible for older people to undertake unsupervised at home and led to improvements in stepping, standing balance, gait speed, and mobility. The home-based step training program could therefore be included in exercise programs designed to prevent falls.