Strength and balance training for older adults: recommendations and what research says

The national clinical guidance on fall prevention from the Norwegian Directorate of Health states that everyone over 65 should train strength and balance, and that health professionals should encourage this when they meet patients and users [1]. The advice is given as strength and balance training at least two to three times a week as part of the weekly activity [1].

With a low risk of falling, the training can be done on your own, in organised group training or as a combination, with or without supervision. With a moderate or high risk, the training should be based on an individual assessment of physical function and medical condition [1][2].

In addition to strength and balance, the Directorate recommends that older people are physically active each week for at least 150 to 300 minutes at moderate intensity, or at least 75 to 150 minutes at high intensity, or a combination of these. Older people should also compensate for a lot of sitting by being extra active the rest of the time [3].

About a third of people over 65 fall at least once a year, and women fall more often than men [5]. A previous fall or known bone fragility increases the risk of injury, especially fractures of the wrist, hip or spine [5]. The Cochrane review also describes that at least a third of people over 65 living at home fall every year [4].

NHI describes that strength training slows age-related loss of muscle mass and strength and benefits the skeleton, while training balance and mobility can improve posture and movement and reduce the risk of falls [5].

The 2019 Cochrane review included 108 randomised trials with 23,407 participants over 60 who lived at home. The average age was 76 years, and 77 percent were women. The exercise programmes led to 23 percent fewer falls (rate ratio 0.77), and the proportion who fell at least once was 15 percent lower. The certainty of the evidence was rated as high for both outcomes [4].

Programmes with balance and functional training led to 24 percent fewer falls, and programmes that combined balance, function and strength led to 34 percent fewer falls. Tai chi led to 19 percent fewer falls, but with lower certainty. For strength training alone, dance and walking, the effect on falls was uncertain [4].

Exercise may also reduce the proportion who sustain a fracture, but the certainty of this finding is low. Most of the studies had unclear or high risk of bias, and the figures apply to the average in the studies, not to the individual [4]. Adverse effects were reported in 27 studies. Most were mild and concerned musculoskeletal problems, and there were two serious events [4].

NHI suggests strength training two to three days a week for the large muscle groups in the legs, hips, back, abdomen, chest, shoulders and arms, using weights, machines or resistance bands. Everyday activities such as carrying groceries and heavy gardening also count. Balance training is suggested three days a week, and can be placed on days without strength or flexibility training [6].

NHI points out that a physiotherapist or a fitness instructor can help set up a programme [6].

Exercise is one of several measures. NHI mentions that some medicines can cause dizziness and unsteadiness, and that a review of medication with a doctor is relevant. Poor vision affects balance, and vision should be checked. At home, good lighting and removing or securing loose rugs and door thresholds can make things safer [5].

The Norwegian Directorate of Health recommends that the risk of further falls is assessed in people over 65 who have fallen, or who are in contact with the health and care services because of a fall [2]. People at high risk should be offered measures adapted to them individually [2]. If you have fallen or are unsure of your balance, you can raise it with your GP.

A physiotherapist can assess mobility, strength and balance and together with you plan a training programme that suits your situation. Read more about physiotherapy. Dr.Dropin also offers senior training in small groups.

How often should older adults train strength and balance?

The Norwegian Directorate of Health mentions at least two to three times a week as part of the weekly activity [1]. NHI suggests strength training two to three days and balance training three days a week [6].

Which type of exercise led to the fewest falls in the studies?

Programmes that combined balance, function and strength led to 34 percent fewer falls in the Cochrane review, and balance and functional training alone led to 24 percent fewer falls. The effect of strength training alone was uncertain [4].

What if I have a high risk of falling?

With a moderate or high risk, the training should be adapted after an individual assessment of physical function and medical condition [1][2].

How much physical activity should older adults get each week?

The Norwegian Directorate of Health recommends at least 150 to 300 minutes at moderate intensity, or at least 75 to 150 minutes at high intensity, or a combination [3].

Is strength training safe for older adults?

In the Cochrane review most adverse effects were mild and concerned musculoskeletal problems, and there were two serious events in 27 studies that reported adverse effects [4]. If you have conditions or problems that affect training, you can get advice from a doctor or physiotherapist.

The page on physical activity gives more on activity in everyday life. You can find more articles in the overview of articles.

This article was written by Dr.Dropin Fysikalske and is based on the sources listed below. It gives general information and does not replace an examination by a healthcare professional.

The websites were accessed and read on 22 October 2026.

1. Personer over 65 år bør få råd om styrke- og balansetrening minst 2-3 ganger per uke som en del av den ukentlige aktiviteten (People over 65 should be advised on strength and balance training at least 2-3 times a week as part of weekly activity). National clinical guidance, Fall prevention in older people. Norwegian Directorate of Health. Last professional update 16 January 2024. Link

2. Fallforebygging hos eldre (Fall prevention in older people). National clinical guidance. Norwegian Directorate of Health. Last professional update 16 May 2024. Link

3. Fysisk aktivitet i forebygging og behandling (Physical activity in prevention and treatment). National clinical guidance. Norwegian Directorate of Health. Last professional update 25 June 2026. Link

4. Sherrington C, Fairhall NJ, Wallbank GK, Tiedemann A, Michaleff ZA, Howard K, Clemson L, Hopewell S, Lamb SE. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2019;1:CD012424. doi:10.1002/14651858.CD012424.pub2. Link

5. Unngå fall (Avoiding falls). NHI.no. Last updated 19 December 2022. Link

6. Kvam M. Enkelt treningsprogram for eldre (A simple exercise programme for older people). NHI.no. Last updated 28 August 2017. Link