How do muscle and bone strengthening and balance activities (MBSBA) vary across the life course, and are there particular ages where MBSBA are most important?

Abstract

This narrative review focuses on the role of strength and balance activities throughout the lifecycle to improve physical capacity and reduce all-cause mortality. The evidence suggests strong associations in middle and older age, with poor balance, poor strength or poor physical function having strong associations with mortality. Currently in the UK, the proportions of adults (69% of men and 76% of women) not meeting the strength and balance guidelines (of 2 or more sessions/week) is concerning. This report identifies specific time points in the lifecycle where specific promotion of and engagement with strength and balance activities would be most beneficial for health: 18-24y to maximize bone and muscle mass gains, 40-50y to maintain strength and reduce that downward cycle, and over 65s to preserve balance and strength and maintain independence). This review also suggests specific transition points/events in life where there may be an increase in sedentary behaviour or loss of muscle function (pregnancy, menopause, onset of on diagnosis of disease, retirement, on becoming a carer and following hospitalization), where it would be useful to initiate additional strength and balance exercises to improve future health outcomes.

Musculoskeletal pain intensity in different body regions and risk of disability pension among female eldercare workers: prospective cohort study with 11-year register follow-up

“…Thus, a higher physical capacity through physical exercise could potentially prolong the working life since workers with less physically demanding occupations retire later than workers with hard physical work [4]. Furthermore, an improved physical capacity will benefit the workers during the inherent age-related loss in muscle mass and strength with aging (sarcopenia) [49][50][51] and postpone the point when reaching the "disability threshold" where the workers are unable to meet their physical work demands [49,50]. Another initiative to reduce the pain intensity among eldercare workers, and thereby potentially prolong their working life, could be to adjust the work tasks to the worker's physical capacity.…”

Effects of a falls exercise intervention on strength, power, functional ability and bone in older frequent fallers: FaME (Falls Management Exercise) RCT secondary analysis

“…The frequently falling women undertaking this FaME intervention significantly improved their strength, power and functional ability, all known risk factors for falls. These positive changes in muscle and physical function, along with significant reduction in falls rate 10 , may have had an important role in the reduced likelihood of a change in residence, hospitalization or death on follow up at 3 years, in these frequently falling older women 6,10 .…”

“…For a holistic approach to falls prevention in frailer older people, an intervention should not only reduce falls, but also improve strength, power, balance and functional ability if that person is below functionally important thresholds, so that they can remain as active and independent as possible 6,7 . Indeed, frequent fallers have poor outcomes, 27% of people who fell three or more times in a year were admitted to hospital, transferred to nursing homes or died at one year follow-up 8 .…”

Characteristics of balance performance in the Chinese elderly by age and gender

“…With increased age, progressive dysfunctions on these systems would result in balance deficits. Where diversities in these functional disorders over age and cumulative impacts of these health inequities across life course would contribute to larger varieties in balance performance [ 23 , 24 ]. Previous study showed variability in gait velocity increased in older adults compared to young and middle-aged adults, which is in line with the present findings of increasing variations across ages [ 25 ].…”