Abstract
<title>Abstract</title> <p>Background “SI Kumbang” is a newly developed, moderate-intensity, low-impact aerobic exercise program based on rhythmic, multidirectional stepping. This trial compared the effects of SI Kumbang with those of a standard aerobic exercise program for older adults in Indonesia on physical performance and inflammasome-related biomarkers. Methods A single-blind randomized controlled trial was conducted among prefrail female older adults aged 60–70 years. Participants were randomly assigned to either the SI Kumbang group or the control group. Both groups completed supervised exercise sessions three times weekly. Physical performance outcomes over 12 weeks were compared between groups, including 6-min walk distance (6MWD), handgrip strength, Short Physical Performance Battery (SPPB) score, and Physical Activity Scale for the Elderly (PASE) score. Blood samples were analyzed to assess inflammasome-related biomarkers (caspase-1 and interleukin-18 [IL-18]). Results A total of 72 participants were randomized (36 per group), of whom six withdrew. Both programs were safe and well tolerated. After 12 weeks, the SI Kumbang group demonstrated greater improvements in 6MWD and PASE scores than those by the control group (p = 0.005 and p = 0.001, respectively). No significant between-group differences were observed in handgrip strength, SPPB score, caspase-1, or IL-18 levels. Conclusion The SI Kumbang program yielded greater improvements in cardiorespiratory endurance, and physical activity than those of the standard program. SI Kumbang appears to be a practical low-impact exercise option to enhance cardiorespiratory fitness and physical activity and may confer anti-inflammatory benefits in prefrail older adults; further studies with longer follow-up and expanded inflammatory profiling are warranted. Clinical Trial Registration This clinical trial was registered at ClinicalTrials.gov with the registration number NCT07300722. The Unique Protocol ID was 24-10-1593. The trial was released on December 17, 2025, under the title “Impact of ‘SI Kumbang’ Gymnastic Exercise on Physical Performance and Immunity in the Elderly.”</p>