Article Highlight | 6-Dec-2022

Group exercise boosts physical, mental health for older adults, MU study finds

Evidence-based benefits include improved muscle strength, balance, flexibility, sleep, social support, confidence and decreased risk of falls

University of Missouri-Columbia

COLUMBIA, Mo. -- Stephen Ball has dedicated his career to improving the health of older Missourians through exercise. In 2005, he launched the University of Missouri’s ‘Stay Strong Stay Healthy’ strength training program, which has reached more than 20,000 older adults since its inception.

For years, Ball has heard anecdotally about the physical and mental health benefits older adults have experienced from the eight-week strength training program — now he has scientific proof. According to a recent research study, adults over age 60 who participated in the group exercise program experienced improved muscle strength and flexibility, balance and coordination, sleep quality and overall self-confidence to increase physical activity, all while reducing the risk of falling and the expensive medical bills that may follow.

“This program embodies what MU is all about as a land-grant university,” said Ball, a professor in the MU School of Health Professions and a Missouri state fitness specialist with MU Extension. “We give undergraduates valuable hands-on experience in teaching exercise, conduct life-changing research in the lab and then with our partnerships through MU Extension, we go out in rural communities and implement the research to improve the health of everyday Missourians.”

In the study, Ball collaborated with Missouri Orthopedic Institute to evaluate the effectiveness of the ‘Stay Strong Stay Healthy’ strength training program in a group setting among adults over the age of 60. Participants in the instructor-led courses, which last one hour and are held twice a week for eight weeks, are taught how to safely complete strength training exercises, including squats and bicep curls.

By completing various baseline tests for strength, balance and flexibility before and after the program, the study found participants improved not only their physical health outcomes but also their self-confidence in their ability to exercise, which increased their physical activity in their daily lives and reduced the risk of falls, which is a major concern for aging adults.

“We help older adults maintain their independence as they age and reduce their risk of falling, which has huge financial implications as well as health implications,” Ball said. “We keep hearing from participants that in addition to feeling stronger, healthier and more active, another major reason they enjoy the group classes is the social aspect of making friends with others their age and engaging with community members in a stress-free environment.”

Ball earned a William T. Kemper Fellowship from MU in 2012 for his undergraduate teaching and extension work. With more than a dozen peer-reviewed studies highlighting the efficacy of the ‘Stay Strong Stay Healthy’ program since 2005, Ball said the strength training program has been approved by the Missouri Department of Health and Senior Services as an evidence-based program that can be implemented throughout the state. The program is now implemented by MU Extension faculty in Missouri, and through MU-trained facilitators in Oklahoma, Tennessee, Kansas, North Carolina and Nevada.

By building out even more peer-reviewed, evidence-based research findings on the physical and mental health benefits of the program, Ball’s body of literature may soon help the program receive national recognition as an evidence-based falls prevention program.

“I have heard from participants that the program saved their life, and it is very rewarding to be serving our community members and improving their health,” Ball said. “We have undergraduate students at MU that help instruct classes, we have graduate students that help with research and our MU Extension regional faculty implement the program across the state serving all 114 counties in Missouri, so it is a real team effort meeting all three missions of a land grant university.”

Older adults interested in participating in the ‘Stay Strong Stay Healthy’ program can learn more here or by emailing

“Efficacy of an 8-week resistance training program in older adults: A randomized controlled trial” was published in Journal of Aging and Physical Activity. Funding for the study was provided by MU Extension. Co-authors on the study include Breanne Baker, Kelsey Weitzel, Lisa Royse, Kristin Miller, Trent Guess and Dana Duren.


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