ACSM Neuromotor Exercise Recommendation
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ACSM's 2011 position stand recommends neuromotor exercise — balance, agility, coordination, gait, and proprioceptive work — on 2–3 days per week for 20–30 minutes or more, especially for older adults, as the fourth pillar alongside aerobic, resistance, and flexibility training.
Detail
In its 2011 position stand on the quantity and quality of exercise (Garber et al.), the American College of Sports Medicine added neuromotor exercise training (functional fitness training) as a recommended component of a complete program, alongside cardiorespiratory (Cardiorespiratory Conditioning Guidelines (Peterson & Bryant / ACSM)), resistance, and flexibility (Flexibility Guidelines (ACSM)) training.
The recommendation:
- Frequency: ≥ 2–3 days per week.
- Duration: ≥ 20–30 minutes per session may be needed. Studies that improved outcomes mostly used 2–3 sessions a week of 20–30 minutes or more, for a total of at least 60 minutes per week.
- Content: motor-skill work — balance, agility, coordination, and gait — plus proprioceptive exercise training and multifaceted activities such as tai chi (Tai Chi — Principles & Basic Forms) and yoga (Yoga (Overview)).
- Population emphasis: particularly recommended for older adults, to improve balance, agility, and muscle strength and to reduce fall risk (see Fall Prevention for Older Adults (Overview)). For younger and middle-aged adults ACSM judged the benefit probable but not established.
WHO 2020 gives a related, firmer target for adults aged 65+: as part of weekly activity, do varied multicomponent physical activity that emphasises functional balance and strength training at moderate or greater intensity on 3 or more days a week, to improve function and prevent falls.
ACSM states that an effective intensity, the optimal volume and pattern, and methods of progression for neuromotor exercise are not yet known; the 2–3 day/week, 20–30+ minute figure reflects the studies that worked. Neuromotor work integrates readily into other sessions (see Programming Neuromotor Work into a Session) and follows the balance progression principles (see Balance Training Progression).
Key facts
- ACSM 2011 position stand: neuromotor exercise is a recommended fourth component.
- Frequency: ≥ 2–3 days/week.
- Duration: ≥ 20–30 min per session; effective studies totalled ≥ 60 min/week.
- WHO 2020 (age 65+): multicomponent balance + strength activity, moderate or greater intensity, ≥ 3 days/week.
- Content: balance, agility, coordination, gait + proprioceptive training + tai chi/yoga.
- Emphasis on older adults for fall-risk reduction; precise dose less well established than other components.
Connections
- Neuromotor Fitness — defines the component this doses.
- Balance Training Progression — how to fill the sessions.
- Programming Neuromotor Work into a Session — fitting it into a week/session.
- Cardiorespiratory Conditioning Guidelines (Peterson & Bryant / ACSM), Flexibility Guidelines (ACSM) — sibling ACSM pillars.
- Tai Chi — Principles & Basic Forms, Yoga (Overview) — recommended multimodal activities.
Sources
- Position standGarber CE et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 2011;43(7):1334–1359 Published 2011 · DOI 10.1249/MSS.0b013e318213fefb · Accessed 2026-10-13
- GuidelineBull FC et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med 2020;54(24):1451–1462 Published 2020 · DOI 10.1136/bjsports-2020-102955 · Accessed 2026-10-13
Corrections (2)
- 2026-10-13 — Reconciled against the full text of the ACSM 2011 position stand (Garber et al.), still ACSM's current statement on aerobic, flexibility and neuromotor exercise (the 2026 ACSM stand covers resistance training only). Frequency 2–3 days/week or more and 20–30 min or more per session confirmed; the '~60 min/week' figure is now attributed precisely (studies that improved outcomes mostly used at least 60 min/week in total). Removed the unverifiable '2014 guidance' attribution and the secondary news/textbook links.
- 2026-10-13 — Added the current WHO 2020 recommendation for older adults (multicomponent physical activity emphasising functional balance and strength training at moderate or greater intensity on 3 or more days a week) alongside the ACSM figure.
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Educational content only — not medical advice. Always consult a qualified professional for individualized guidance, especially around injury, pregnancy, or medical conditions.