Balance tends to decline with age, and many kinds of exercise are said to help. A large review published in August in Ageing Research Reviews set out to compare them side by side.
What the researchers did
A team from the School of Exercise and Health at Shanghai University of Sport searched five databases for randomised controlled trials of exercise in adults aged 60 and over, leaving out trials that recruited people with a specific disease. They included 423 trials with 33,901 participants, and used a statistical method called a network meta-analysis to compare 19 types of exercise with each other and with no exercise.
What they found
Compared with control groups, 18 of the 19 types of exercise improved overall balance; stretching on its own showed no clear benefit. The largest estimates for overall balance were for perturbation training, which trains the body to recover from an unexpected loss of balance, followed by sensory training, dance and agility stepping.
The researchers also looked at different kinds of balance separately:
- Global balance (combined measures): tai chi had the largest estimate.
- Static balance (staying steady while still): perturbation training.
- Dynamic balance (staying steady while moving): Pilates.
- Proactive balance (preparing for a planned movement): agility stepping or aquatic exercise.
The researchers’ own caution
The authors are careful to say that these estimates “do not establish superiority”: the review does not show that any one kind of exercise is best for everyone. Their conclusion is that “exercise improves balance, but modality choice should consider balance domain”.
In short
The review adds to a large body of research on exercise in later life. For Pilates, its strongest showing was in balance while moving, one of several kinds of balance the researchers measured.
Original articleExercise modalities for overall and domain-specific balance performance in older adults: A systematic review and Bayesian network meta-analysis (opens in a new tab)Ageing Research Reviews, 14 August 2026