Physical Activity, Physical Fitness for Hearing Loss in Adults: A Systematic Review

OBJECTIVES: Adequate physical activity is essential for maintaining health. Recent studies suggest that physical activity may serve as a protector against hearing loss in adults. This review aims to explore and synthesize the evidence on the association between physical activity, physical fitness, and hearing loss in adults. DATA SOURCES AND REVIEW METHODS: English-language articles on the relationships between physical activity, physical fitness, and hearing outcomes in adults were identified by searching five scientific databases (Web of Science, PubMed, CINAHL, SPORT-Discus, and EMBASE) from the time of library construction to February 8, 2025. A best-evidence synthesis was performed to summarize the results. RESULTS: Searches yielded 3017 studies after removing duplicates, with 13 publications in the final review. Most of the included studies were assessed as high or moderate quality, and one study was considered low quality. Strong evidence suggested that adequate exercise, cardiorespiratory endurance, and muscle strength were consistently associated with a reduced risk of hearing loss and improved pure-tone thresholds. Moderate evidence indicated that higher physical function or mobility was linked to hearing loss incidence in older adults. Better body composition and balance were protective factors against hearing loss, although the evidence was limited. CONCLUSIONS: This review highlights a positive link between higher levels of physical activity/physical fitness and more favorable hearing outcomes in adults, particularly in relation to cardiorespiratory endurance and muscle strength. However, well-designed RCTs are urgently needed to accurately clarify causal relationships. LEVEL OF EVIDENCE: NA.