# Table Tennis as a Sustainable Health Intervention: A Meta-Analysis of Its Effects on Balance and Cognitive Functions

## TL;DR

Table tennis can improve balance and cognitive functions, making it a sustainable and accessible health intervention for people of different ages and health conditions.

## Contribution

This study provides a meta-analysis showing table tennis as an effective, low-cost intervention for improving balance and cognition.

## Key findings

- Table tennis significantly improves balance with a standardized mean difference of 0.78.
- Cognitive functions show a larger improvement with a standardized mean difference of 2.05.
- Benefits are consistent across age groups and health statuses, with longer interventions yielding greater cognitive gains.

## Abstract

Background: Physical inactivity is linked to falls, cognitive decline, and reduced independence, underscoring the need for accessible interventions that enhance balance and cognitive functions. In this context, sustainability refers to affordability, accessibility, feasibility, and potential for long-term adherence. Table tennis, an open-skill sport requiring motor coordination and cognitive engagement, may help improve balance and cognitive functions. This meta-analysis synthesized available evidence to investigate the effects of table tennis interventions on balance and cognitive functions. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and PROSPERO registration, six electronic databases were searched. A meta-analysis was conducted with 14 randomized controlled trials comprising 1565 participants in total. Additionally, subgroup analyses were conducted based on intervention participants, health status, intervention duration, and session length. Results: Pooled analyses showed that individuals who received table tennis interventions demonstrated significantly improved balance (standardized mean difference [SMD] = 0.78, 95% confidence interval [CI] [0.57, 0.98]) and cognitive (SMD = 2.05, 95% CI [1.27, 2.83]) functions than those who did not. Subgroup analyses indicated consistent benefits across different age groups and health statuses, along with larger cognitive function effects with longer interventions. Despite considerable heterogeneity across studies and limited evidence for some subgroups, sensitivity analyses supported the robustness of the results. Conclusions: Table tennis appears to be a feasible and low-cost intervention that can effectively enhance balance and cognition functions, with potential applicability in community, educational, and rehabilitation settings. However, considering the observed heterogeneity and methodological limitations, the findings should be interpreted with caution.