Strength and Balance Important for Older Adults: Top Doctors

Peter Russell

September 09, 2019

New guidance from the UK's most senior doctors on staying fit and healthy emphasised the importance of improving strength and balance as well as maintaining cardiovascular health in older people.

The update to the 2011 guidelines from all four chief medical officers (CMOs) also offered specific advice for the first time to pregnant women, new mothers, and disabled adults.

The general advice on exercise levels to the population as a whole remained that "some is good, more is better".

'If Physical Activity Were a Drug, We Would Refer to It as a Miracle Cure'

The CMOs said there was evidence that physical activity protected against a range of chronic conditions, and that meeting guidelines could reduce the risk of:

The guidelines recommended that over-65s should take up activities such as dancing, bowls, or tai chi to improve balance.

This should be combined with exercises to build muscle and improve cardiovascular health, such as brisk walking, climbing stairs, or swimming.

An important aim was to reduce the number of falls in older people, a principle reason why people in this age group were taken to accident and emergency

Prof Dame Sally Davies, England's CMO, said in a news release: "Physical activity is an under-appreciated asset in our clinical arsenal. It is cheap and brings a long list of health benefits.

"As we age, our muscles weaken and we can become stiff, leading to falls and difficulty preforming everyday activities. Physical activity can prevent fragility and support mobility in old age. By keeping active, both throughout the day and also through hobbies, we can slow muscle and bone decline, ultimately keeping us independent for longer."

The guidelines also included t recommendations for new mothers. They advised that a moderate amount of exercise was proven to help them regain strength, ease back pain, and reduce the risk of gestational diabetes.

The new guidelines included chapters covering specific age groups: under-5s, children and young people (5-18 years), adults (19-64 years) and older Adults (65+).

Under 5s

Infants should be physically active several times every day in a variety of ways, including crawling.

Toddlers should spend at least 180 minutes per day in a variety of physical activities at any intensity, including active and outdoor play.

Pre-school children should spend at least 180 minutes per day in a variety of physical activities spread throughout the day, including active and outdoor play.

Children and Young People Aged 5 to 18

  • Should engage in moderate-to-vigorous intensity physical activity for an average of at least 60 minutes per day across the week.

  • Engage in activities to develop movement skills, muscular fitness, and bone strength.

  • Minimise the amount of time spent being sedentary.

Adults Aged 19 to 64 Years

  • Should aim to be physically active every day.

  • Engage in activities to develop or maintain strength in the major muscle groups.

  • Accumulate at least 150 minutes per week of moderate intensity activity, or 75 minutes of vigorous intensity activity, or a combination of activity.

  • Minimise the amount of time spent being sedentary.

Adults Aged 65 Years and Over

  • Participate in daily physical activity to maintain good physical and mental health, and promote wellbeing and social functioning.

  • Maintain or improve physical function by undertaking activities aimed at improving or maintaining muscle strength, balance, and flexibility on at least 2 days a week.

  • Accumulate 150 minutes of moderate intensity aerobic activity, building up gradually from current levels, and include weight-bearing activities to help maintain bone health.

  • Break up prolonged periods of being sedentary with light activity.

Advice for Pregnant Women and New Mothers

The guidelines also recommended that physical activity during pregnancy and during postpartum could be safely recommended, reflecting pre-pregnancy activity levels, and including strength training.

More intense activities could be resumed following the 6 to 8 week postnatal check.


Tim Hollingsworth, CEO of Sport England, said: "It’s great to see the new CMO guidelines putting the building of strength and balance on a similar footing to cardiovascular exercise as important for our health and wellbeing."

Dr Max Davie, officer for health improvement for the Royal College of Paediatrics and Child Health, commented: "We know that healthy children are much more likely to grow into healthy adults. But key to longevity and success, is embedding healthy habits into life early and making them part of a routine."

Disability Exercise

The Activity Alliance welcomed activity advice for disabled people and those with long-term conditions. These recommended specific targets below recommended levels, such as 10 minute bouts of exercise, as a step on the journey to extended physical activity.

Chief Executive Barry Horne said: "The stark reality is that disabled people are twice as likely to be inactive as non-disabled people. Our insight shows that expecting every adult to do the same allotted amount of time or intensity is unrealistic.

"Disabled people and people with long-term health conditions often tell us about the mix of ways they can get active. This includes small bouts of exercise, where people can have fun together."


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