Balance Training

What It Is

Balance- and stability-focused exercises, like single-leg stances and reactive balance drills.

Why It Matters

Balance and functional exercise reduces the rate of falls in older adults, and for that finding, from one Cochrane review, the certainty is high.¹ Isolating balance training from the programs it usually comes bundled in is less settled, though one network analysis ranks it first for reducing falls; the bundled programs rest on more trials and show a smaller but steadier effect.² Whether the same training extends life is a separate, far less settled question: the evidence is very uncertain about whether it changes the risk of death at all, and it comes from a population too far from Boddy's readers to back a behavior.³

The gap is about who was studied and what was measured, not a contradiction in the results. The falls evidence comes from adults in their seventies,^1,2 and no trial has tested balance training against mortality directly; where the broader exercise programs it belongs to have been tested against mortality, the interval around the result is wide enough to hold both no effect and a worthwhile reduction.^3,4 Below 60, where most of Boddy's readers are, a review of trials in adults aged 40 to 60 found none that measured falls at all.⁵

None of that makes balance training a bad idea. If falls, stability, or long-term mobility already concern you, working single-leg stances, reactive balance drills, or a dedicated balance program into your week is a reasonable, well-supported thing to do. It just isn't, on the evidence so far, a lever we can put a number on and ask every reader to track.

• 1 Sherrington, C. et al. (2019). Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews. doi.org/10.1002/14651858.CD012424.pub2
• 2 Wiedenmann, T. et al. (2023). Exercise based reduction of falls in communitydwelling older adults: a network meta-analysis. European Review of Aging and Physical Activity. doi.org/10.1186/s11556-023-00311-w
• 3 García-Hermoso, A. et al. (2020). Safety and Effectiveness of Long-Term Exercise Interventions in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Sports Medicine. doi.org/10.1007/s40279-020-01259-y
• 4 Pahor, M. et al. (2014). Effect of Structured Physical Activity on Prevention of Major Mobility Disability in Older Adults: The LIFE Study Randomized Clinical Trial. JAMA. doi.org/10.1001/jama.2014.5616
• 5 Adams, M. et al. (2023). Effects of Physical Activity Interventions on Strength, Balance and Falls in Middle-Aged Adults: A Systematic Review and Meta-Analysis. Sports Medicine - Open. doi.org/10.1186/s40798-023-00606-3