Ping-Pong Outperforms Other Racket Sports in Elderly Functional Health Due to Scarce Evidence

Researchers evaluating exercise interventions for older adults have found that while table tennis, badminton, and tennis are frequently grouped together, existing scientific literature disproportionately focuses on table tennis, leaving significant gaps in comparative data across racket sports.

Network Meta-Analysis Highlights Table Tennis Outcomes

A network meta-analysis examining physical and cognitive indicators in adults aged 60 and older reviewed 13 trials containing 14 reports, with 10 randomized controlled trials comprising 469 participants forming the primary analysis, according to findings. The research tracked five distinct functional domains: muscle strength, balance, cognitive function, aerobic capacity, and flexibility. Among the three racket sports evaluated, table tennis emerged as the only discipline with more than one trial providing comparative data against control groups.

Data showed that table tennis interventions outperformed non-exercise control groups across four of the five tested domains, registering standardized mean differences ranging from 0.82 to 1.42 in merged evidence. Furthermore, table tennis demonstrated superiority over active motion control groups in muscle strength, with a standardized mean difference of 0.89 and a 95% confidence interval spanning 0.28 to 1.50, as well as in cognitive function, where it recorded a standardized mean difference of 1.16 and a 95% confidence interval from 0.69 to 1.64.

Evidence Gaps Limit Comparison Between Racket Sports

While table tennis data showed relative stability in estimable sensitivity analyses despite low certainty in network estimates for muscle strength, balance, and cognition, the evidence base for badminton and tennis remained severely constrained. Badminton-related data proved sparse, while findings for tennis derived entirely from a single trial involving only 16 male participants and lacking a non-exercise control group. Consequently, all tennis comparisons to non-exercise controls relied on indirect evidence, which researchers noted was insufficient to support definitive conclusions.

The analysis revealed that no trials directly compared different racket sports against each other in head-to-head randomized controlled formats. The single inter-sport comparison that excluded a zero effect—evaluating table tennis against badminton regarding cognitive function—yielded an indirect evidence standardized mean difference of 0.83 with a 95% confidence interval of 0.24 to 1.43. However, this estimate carried very low certainty and lacked robustness across sensitivity testing.

Methodological Framework and Future Study Requirements

The study, registered under PROSPERO tracking number CRD420251148095, employed the GRADE system to assess the certainty of evidence across direct, indirect, and merged comparisons. Muscle strength, balance, and cognitive function were evaluated via random-effects network meta-analysis, while aerobic capacity and flexibility relied on pairwise analysis due to a lack of independent indirect evidence.

Study authors concluded that while participating in racket sports correlates with improvements across multiple functional metrics in older populations, current data cannot establish whether one specific racket sport delivers superior outcomes compared to another. Researchers emphasized that this limitation stems from sparse and uneven distribution of existing evidence rather than proven equivalence between the disciplines, highlighting an urgent need for adequately powered, head-to-head randomized controlled trials.