Exercise interventions for the improvement of falls-related outcomes among older adults with diabetes mellitus: A systematic review and meta-analyses

• Published in: Journal of diabetes and its complications 2017-03, Vol.31 (3), p.631-645
• Main Authors: Chapman, Anna, Meyer, Claudia, Renehan, Emma, Hill, Keith D, Browning, Colette J
• Format: Article
• Language: English
• Subjects: Accidental Falls - prevention & control; Aged; Aged, 80 and over; Aging; Balance training; Diabetes; Diabetes mellitus; Diabetic Neuropathies - physiopathology; Diabetic Neuropathies - prevention & control; Endocrinology & Metabolism; Evidence-Based Medicine; Exercise; Exercise interventions; Falls; Foot diseases; Gait Disorders, Neurologic - complications; Gait Disorders, Neurologic - physiopathology; Gait Disorders, Neurologic - prevention & control; Humans; Lower Extremity; Meta-analysis; Muscle Weakness - complications; Muscle Weakness - physiopathology; Muscle Weakness - prevention & control; Nervous system; Older; Older people; Performance evaluation; Postural Balance; Posture; Public health; Randomized Controlled Trials as Topic; Sensation Disorders - complications; Sensation Disorders - physiopathology; Sensation Disorders - prevention & control; Studies; Systematic review; Velocity
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2016.09.015

Abstract Introduction Falls as a complication of diabetes mellitus (DM) can have a major impact on the health of older adults. Previous reviews have demonstrated that certain exercise interventions are effective at reducing falls in older people; however, no studies have quantified the effectiveness of exercise interventions on falls-related outcomes among older adults with DM. Methods A systematic search for all years to September 2015 identified available literature. Eligibility criteria included: appropriate exercise intervention/s; assessed falls-related outcomes; older adults with DM. Effect sizes were pooled using a random effects model. Positive effect sizes favoured the intervention. Results Ten RCTs were eligible for the meta-analyses. Exercise interventions were more effective than the control condition for static balance (0.53, 95% CI 0.13 to 0.93), lower-limb strength (0.63, 95% CI: 0.09 to 1.18), and gait (0.59, 95% CI 0.22 to 0.96). No RCTs assessed falls-risk; one RCT reported 12 month falls-rates, with no differential treatment effect observed. Conclusion Exercise interventions can improve certain falls-related outcomes among older adults with DM. Substantial heterogeneity and limited numbers of studies should be considered when interpreting results. Among older adults, where DM burden is increasing, exercise interventions may provide promising approaches to assist the improvement of falls-related outcomes.