title: Physical activity improves strength, balance and endurance in adults aged 40-65 years: a systematic review.
abstract: OBJECTIVE
  Can physical activity in adults aged 40-65 years enhance strength and balance and prevent falls?
  
  
  METHODS
  Systematic review with meta-analysis of randomised clinical trials.
  
  
  METHODS
  Healthy adults aged 40-65 years.
  
  
  METHODS
  Programs that involved the performance of any physical activity in community settings and workplaces.
  
  
  METHODS
  Strength, balance, endurance, and falls rate.
  
  
  RESULTS
  Twenty-three eligible trials were identified and 17 of these were pooled in the meta-analyses. The meta-analysis of strength outcomes found a moderate effect of physical activity on strength (SMD=0.54, 95% CI 0.38 to 0.70). Larger effects were observed from programs that specifically targeted strength (SMD=0.68, 95% CI 0.49 to 0.87), when compared to those that did not (SMD=0.32, 95% CI 0.09 to 0.55). This difference was statistically significant (effect of strength in meta-regression p=0.045). Physical activity also had a moderate effect on both balance (SMD=0.52, 95% CI 0.24 to 0.79) and endurance (SMD=0.73, 95% CI 0.50 to 0.96). No trials reported effects of physical activity on falls soon after receiving the intervention. A statistically non-significant effect on falls 15 years after receiving a physical activity intervention was found in one trial (RR=0.82, 95% CI 0.53 to 1.26).
  
  
  CONCLUSIONS
  This review found that muscle strength, balance, and endurance can be improved by physical activity in people aged 40-65 years. There were bigger effects on muscle strength from programs that used resistance exercises, indicating the need to include a resistance training component if strength enhancement is the goal.
authors.affiliation: The University of Sydney, Australia. mferreira@georgeinstitute.org.au
authors.forename: Manuela L
authors.initials: ML
authors.lastname: Ferreira
authors.forename: Catherine
authors.initials: C
authors.lastname: Sherrington
authors.forename: Kate
authors.initials: K
authors.lastname: Smith
authors.forename: Phil
authors.initials: P
authors.lastname: Carswell
authors.forename: Rebecca
authors.initials: R
authors.lastname: Bell
authors.forename: Morton
authors.initials: M
authors.lastname: Bell
authors.forename: Dafne P
authors.initials: DP
authors.lastname: Nascimento
authors.forename: Leani Souza
authors.initials: LS
authors.lastname: Máximo Pereira
authors.forename: Paul
authors.initials: P
authors.lastname: Vardon
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D053580:Muscle Strength / Q000502:physiology*; D010807:Physical Endurance / Q000502:physiology*; D004856:Postural Balance / Q000502:physiology*