Almost always, Anna. I have major knee issues, and if I cut out the step to once per week, it seems to help immensely. I struggle with this, because it is not quite as intense, but by making arm movements much bigger, and by using about 3X the floor space, I think I get a nearly comparable workout. I really make my movements pretty darn huge! When I switch back to using the step once or twice a week, I feel like I'm hardly using any space! (and I'm able to do the workout on the step feeling pretty much the same as I do when I'm on the floor--not overly out of breath or anything.)
Wendy