Henri Dibra1, Robert Citozi1, Vlad Adrian Geantă2
1Sports University of Tirana, Faculty of Physical Activity and Recreation, Tirana, Albania
2Aurel Vlaicu University of Arad, Faculty of Physical Education and Sport, Arad, Romania
Recreational Exercise as a Preventive Strategy for Balance Decline in Late Middle Age Adults
Sport Mont 2026, 24(3), Ahead of Print | DOI: 10.26773/smj.261006
Abstract
Age-related decline in balance may begin during late middle adulthood (55–65 years), increasing the risk of future falls and functional limitations. Evidence regarding recreational exercise as a preventive strategy in this population remains limited. This study aimed to evaluate the effects of a 12-week recreational exercise program on balance in adults aged 55–65 years. A quasi-experimental controlled pre–post design included 60 participants (experimental group: n=30; con- trol group: n=30). The experimental group completed a supervised recreational exercise program four times per week for 12 weeks, while the control group maintained usual activities. Balance was assessed using Leonardo Mechanog- raphy during tandem and single-leg stance under eyes open and eyes closed conditions. Center of pressure variables included standard ellipse area, path length, and equilibrium index. Non-parametric statistical tests were applied. The ex- perimental group demonstrated significantly greater improvements in all center of pressure parameters compared with the control group (p<0.05), particularly under eyes-closed and single-leg stance conditions. Large effect sizes indicated enhanced postural control, reduced sway magnitude, and improved sensory integration. The control group showed min- imal changes or slight deterioration in several variables. A 12-week recreational exercise program significantly improved static and dynamic balance in adults aged 55–65 years, supporting its role as a preventive strategy for early postural decline.
Keywords
balance, recreational exercise, postural control, center of pressure, middle-aged adults, fall prevention

View full article
(PDF – 228KB)
References
Adams, M., Gordt-Oesterwind, K., Bongartz, M., Zimmermann, S., Seide, S., Braun, V., & Schwenk, M. (2023). Effects of physical activity interventions on strength, balance and falls in middle-aged adults: A systematic review and meta-analysis. Sports Medicine - Open, 9(1), 61. https://doi.org/10.1186/s40798-023-00606-3
Alizadehsaravi, L., Bruijn, S. M., Muijres, W., Koster, R. A. J., & van Dieën, J. H. (2022). Improvement in gait stability in older adults after ten sessions of standing balance training. PLOS ONE, 17(7), e0242115. https://doi.org/10.1371/journal.pone.0242115
Álvarez-Bustos, A., da Silva Aguiar, S., Gonçalves, I. d. O., Rodríguez-Sánchez, I., Marzetti, E., & Coelho-Junior, H. J. (2025). Effects of a one-year multicomponent exercise program on community-dwelling older adults at risk of sarcopenic obesity. Journal of Clinical Medicine, 14(21), 7839. https://doi.org/10.3390/jcm14217839
Bauman, A. E., Reis, R. S., Sallis, J. F., Wells, J. C., Loos, R. J., Martin, B. W., & Lancet Physical Activity Series Working Group. (2012). Correlates of physical activity: Why are some people physically active and others not? The Lancet, 380(9838), 258-271. https://doi.org/10.1016/S0140-6736(12)60735-1
Cabo, C. A., Tomas-Carus, P., Fernandes, O., Parraca, J. A., & Espada, M. C. (2025). The role of physical exercise in enhancing health, quality of life and joy among older adults. Scientific Reports, 15(1), 42495. https://doi.org/10.1038/s41598-025-26683-w
Caña-Pino, A., & Marín-Rubio, A. (2025). Efficacy of a multicomponent occupational therapy intervention on balance, functional mobility, and proprioception in institutionalized older adults: A randomized controlled pilot trial. Healthcare, 13(18), 2287. https://doi.org/10.3390/healthcare13182287
Chase, J. D., Phillips, L. J., & Brown, M. (2017). Physical activity intervention effects on physical function among community-dwelling older adults: A systematic review and meta-analysis. Journal of Aging and Physical Activity, 25(1), 149-170. https://doi.org/10.1123/japa.2016-0040
Choudhary, P. K., Choudhary, S., Saha, S., Katanić, B., İlbak, İ., & Tornóczky, G. J. (2026). Effectiveness of balance- and strength-based exercise interventions for fall prevention in community-dwelling older adults: A systematic review of randomized controlled trials. Life, 16(1), 41. https://doi.org/10.3390/life16010041
Citozi, R., Xhebexhiu, K., & Geantă, V. A. (2025). Effects of the Otago exercise program on balance among nursing home residents: A 12-week quasi-experimental study. Sport Mont, 23(2), 71-77. https://doi.org/10.26773/smj.250611
Cruz-Jentoft, A. J., Baeyens, J. P., Bauer, J. M., Boirie, Y., Cederholm, T., Landi, F., et al. (2010). Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age and Ageing, 39(4), 412-423. https://doi.org/10.1093/ageing/afq034
Cui, J., Hao, Z., Tian, H., Yang, Y., Wang, J., & Lin, X. (2024). The effects of Tai Chi on standing balance control in older adults may be attributed to the improvement of sensory reweighting and complexity rather than reduced sway velocity or amplitude. Frontiers in Aging Neuroscience, 16, 1330063. https://doi.org/10.3389/fnagi.2024.1330063
Di Lorito, C., Long, A., Byrne, A., Harwood, R. H., Gladman, J. R. F., Schneider, S., et al. (2021). Exercise interventions for older adults: A systematic review of meta-analyses. Journal of Sport and Health Science, 10(1), 29-47. https://doi.org/10.1016/j.jshs.2020.06.003
Ekelund, U., Tarp, J., Steene-Johannessen, J., Hansen, B. H., Jefferis, B., Fagerland, M. W., et al. (2019). Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: Systematic review and harmonised meta-analysis. BMJ, 366, l4570. https://doi.org/10.1136/bmj.l4570
Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175-191. https://doi.org/10.3758/BF03193146
Foster, C., Armstrong, M., Hillsdon, M., Skelton, D. A., & Cavill, N. (2018). Muscle and bone strengthening and balance activities for general health benefits in adults and older adults: An expert review. Public Health England.
Franco, M. R., Tong, A., Howard, K., Sherrington, C., Ferreira, P. H., Pinto, R. Z., & Ferreira, M. L. (2015). Older people's perspectives on participation in physical activity: A systematic review and thematic synthesis of qualitative literature. British Journal of Sports Medicine, 49(19), 1268-1276. https://doi.org/10.1136/bjsports-2014-094015
Jantal, D., Tésits, R., & Prókai, J. (2026). Health awareness in female fitness training: Competitive and recreational perspectives. Sport Mont, 24(2), 3-12. https://doi.org/10.26773/smj.260607
Khan, M. J., Fong, K. N. K., Wong, T. W., Tsang, W. W., Chen, C., Chan, W. C., & Winser, S. J. (2025). Effectiveness of dual-task exercise in improving balance and preventing falls among older adults: Systematic review with meta-analysis and meta-regression. European Geriatric Medicine, 16(6), 2047-2083. https://doi.org/10.1007/s41999-025-01328-3
Liu-Ambrose, T., Davis, J. C., Best, J. R., Dian, L., Madden, K., Cook, W., et al. (2019). Effect of a home-based exercise program on subsequent falls among community-dwelling high-risk older adults after a fall: A randomized clinical trial. JAMA, 321(21), 2092-2100. https://doi.org/10.1001/jama.2019.5795
Liu, X. X., Wang, G., Zhang, R., Ren, Z., Wang, D., Liu, J., et al. (2024). Sensory reweighting and self-motion perception for postural control under single-sensory and multisensory perturbations in older Tai Chi practitioners. Frontiers in Human Neuroscience, 18, 1482752. https://doi.org/10.3389/fnhum.2024.1482752
Michel, J. P., & Ecarnot, F. (2019). Integrating functional ageing into daily clinical practice. Journal of Frailty, Sarcopenia and Falls, 4(2), 30-35. https://doi.org/10.22540/JFSF-04-030
Nohelova, D., Vuillerme, N., Bizovska, L., Janura, M., & Svoboda, Z. (2026). Changes in postural control in older adults: A five-year longitudinal study. Scientific Reports, 16(1), 7610. https://doi.org/10.1038/s41598-026-36592-1
Papalia, G. F., Papalia, R., Diaz Balzani, L. A., Torre, G., Zampogna, B., Vasta, S., et al. (2020). The effects of physical exercise on balance and prevention of falls in older people: A systematic review and meta-analysis. Journal of Clinical Medicine, 9(8), 2595. https://doi.org/10.3390/jcm9082595
Pšeničnik Sluga, S., & Kozinc, Z. (2024). Sensorimotor and proprioceptive exercise programs to improve balance in older adults: A systematic review with meta-analysis. European Journal of Translational Myology, 34(1), 12010. https://doi.org/10.4081/ejtm.2024.12010
Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., et al. (2019). Exercise for preventing falls in older people living in the community. The Cochrane Database of Systematic Reviews, 2019(1), CD012424. https://doi.org/10.1002/14651858.CD012424.pub2
Schneider, A., Leite, L. B., Teixeira, J., Forte, P., Barbosa, T. M., & Monteiro, A. M. (2025). Multicomponent exercise and functional fitness: Strategies for fall prevention in aging women. Sports, 13(6), 159. https://doi.org/10.3390/sports13060159
Wang, C., & Kim, S. M. (2025). The Otago Exercise Program's effect on fall prevention: A systematic review and meta-analysis. Frontiers in Public Health, 13, 1522952. https://doi.org/10.3389/fpubh.2025.1522952
Wang, J., Li, Y., Yang, G. Y., & Jin, K. (2024). Age-related dysfunction in balance: A comprehensive review of causes, consequences, and interventions. Aging and Disease, 16(2), 714-737. https://doi.org/10.14336/AD.2024.0124-1
Wiegmann, S., Felsenberg, D., Gast, U., Börst, H., Armbrecht, G., & Dietzel, R. (2019). Balance performance across the lifespan assessed by the Leonardo Mechanograph®: A cross-sectional study. Journal of Functional Morphology and Kinesiology, 5(1), 1. https://doi.org/10.3390/jfmk5010001
World Health Organization. (2020). WHO guidelines on physical activity and sedentary behaviour. https://www.who.int/publications/i/item/9789240015128
Yosef, T., Pasco, J. A., Tembo, M. C., & Holloway-Kew, K. L. (2026). Balance confidence predicts incident injurious falls in older adults: A longitudinal study. European Geriatric Medicine, 1-10. https://doi.org/10.1007/s41999-026-01426-w
Zhang, Y., Tao, Y., Wang, H., & Hao, M. (2026). The impact of the Otago exercise program on knee joint function recovery, balance, fall efficacy and functional capacity in patients undergoing total knee arthroplasty: A systematic review and meta-analysis. Geriatric Nursing, 69, 103880. https://doi.org/10.1016/j.gerinurse.2026.103880
Xie, K., Han, X., & Hu, X. (2023). Balance ability and all-cause death in middle-aged and older adults: A prospective cohort study. Frontiers in Public Health, 10, 1039522. https://doi.org/10.3389/fpubh.2022.1039522