Weak lower body strength and balance impairments increase the risk of mobility issues and falls, which can be improved through physical activity (PA). While previous meta-analyses have focused on adults aged 65 and above, this systematic review aims to explore the effects of PA on middle-aged adults. The study identified 66 relevant studies involving 3387 participants, demonstrating that structured PA interventions in middle-aged adults can improve strength and balance outcomes. Strength training, including strength-aerobic and 3D training, showed positive effects on muscle strength and postural balance. However, more long-term trials are needed to assess the preventive potential of PA on strength, balance, and falls in this age group.

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