Balance and stability: Evidence-Based Supplement Guide

Balance is trainable. A Cochrane review of 108 randomised trials with 23,407 people aged 60 and over found that exercise reduced the rate of falls by 23 percent (PMID 30703272). The type of exercise mattered. Balance and functional exercises reduced the rate of falls, and programmes combining several types, usually balance and functional exercises plus resistance exercise, probably reduced it by about a third (PMID 30703272). Tai chi may also reduce falls, while the effect of resistance training alone, dance or walking was uncertain (PMID 30703272). Guidelines build balance into everyday activity. The WHO 2020 guidelines advise older adults to do varied activity that combines aerobic, muscle-strengthening and balance training on three or more days a week (PMID 33239350).

1. **Add balance and functional exercises to your week**, the type that reduced falls most clearly (PMID 30703272). 2. **Combine balance work with strength exercises**, as the multi-type programmes did (PMID 30703272). 3. **Consider tai chi** if you prefer a class format (PMID 30703272). 4. **Fold balance into other exercise.** WHO examples include walking backwards or sideways, or standing on one foot during an upper body exercise (PMID 33239350). 5. **Progress in small steps and stay near something stable to hold**, for example by narrowing your stance before trying harder positions.

The review expressed its results over a year of follow-up in older people living in the community (PMID 30703272). The guideline activity is weekly and ongoing, on three or more days a week for older adults (PMID 33239350).

- **Most trials had unclear or high risk of bias in at least one area** (PMID 30703272). - **Effects on outcomes other than falls were less certain** (PMID 30703272). - **The review excluded trials focused on particular medical conditions** (PMID 30703272). - **This guide has not been reviewed by a clinician.** `reviewStatus` above says so.

- **Side effects were mostly minor and musculoskeletal**, but they were closely monitored in only one trial (PMID 30703272). - **If you have fallen recently or feel unsteady, start balance training with a clinician or physiotherapist.**

No ingredient is linked from this guide. It covers balance training, and it does not point to a product.

| PMID | Title | | --- | --- | | 30703272 | "Exercise for preventing falls in older people living in the community" | | 33239350 | "World Health Organization 2020 guidelines on physical activity and sedentary behaviour" |