Associations of Leisure-Time Physical Activity With Balance and Lower Extremity Strength: A Validation of the Neuromuscular Part of the Physical Activity Pie

in Journal of Physical Activity and Health
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The importance of neuromuscular-type exercise (NME) has been recognized in recent recommendations for public health. However, the knowledge on associations and dose response of different types of leisure-time physical activity (LTPA) with musculoskeletal fitness and health is incomplete. This study evaluated the validity of the NME recommendation for public health introduced by the Physical Activity Pie.


Engagement in LTPA and health-related fitness were assessed in 2 consecutive studies with the same adult population age 30 to 69 years (n = 575). Cross-sectional associations between different LTPA types and motor and musculoskeletal fitness were examined by logistic-regression models.


Engagement in NME was associated with good static and dynamic balance and lower extremity strength. The highest odds ratios (OR) were found between brisk NME and static balance (most vs least ft OR = 2.39, moderate vs least ft OR = 1.94) and brisk NME and leg strength (more vs least ft OR = 2.10). Some associations were also found between brisk aerobic exercise and good balance.


This cross-sectional study suggests that the recommendation for NME in the Physical Activity Pie is valid in terms of balance and leg strength, the 2 major fitness factors related to mobility functioning, especially among aging adults.

Lindström and Nygård are with the Tampere School of Public Health, University of Tampere, Tampere, Finland. Suni is with the UKK Institute for Health Promotion Research, Tampere, Finland.