title: Strength and balance training for adults with peripheral neuropathy and high risk of fall: current evidence and implications for future research.
abstract: OBJECTIVE
  To evaluate the evidence for strength- and balance-training programs in patients at high risk for falls, discuss how results of existing studies might guide clinical practice, and discuss directions for additional research.
  
  
  METHODS
  A search of PubMed and CINAHL® databases was conducted in June 2011 using the terms strength, balance training, falls, elderly, and neuropathy. Only clinical trials conducted using specific strength- or balance-training exercises that included community-dwelling adults and examined falls, fall risk, balance, and/or strength as outcome measures were included in this review.
  
  
  RESULTS
  One matched case-control study and two randomized, controlled studies evaluating strength and balance training in patients with diabetes-related peripheral neuropathy were identified. Eleven studies evaluating strength and balance programs in community-dwelling adults at high risk for falls were identified.
  
  
  CONCLUSIONS
  The findings from the reviewed studies provide substantial evidence to support the use of strength and balance training for older adults at risk for falls, and detail early evidence to support strength and balance training for individuals with peripheral neuropathy.
  
  
  CONCLUSIONS
  The evidence demonstrates that strength and balance training is safe and effective at reducing falls and improving lower extremity strength and balance in adults aged 50 years and older at high risk for falls, including patients with diabetic peripheral neuropathy. Future studies should evaluate the effects of strength and balance training in patients with cancer, particularly individuals with chemotherapy-induced peripheral neuropathy.
authors.affiliation: College of Nursing, University of South Florida, Tampa, FL, USA. ctofthag@health.usf.edu
authors.forename: Cindy
authors.initials: C
authors.lastname: Tofthagen
authors.forename: Constance
authors.initials: C
authors.lastname: Visovsky
authors.forename: Donna L
authors.initials: DL
authors.lastname: Berry
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D016022:Case-Control Studies; D018592:Cross-Over Studies; D019317:Evidence-Based Medicine; D005081:Exercise Therapy; D005260:Female; D005544:Forecasting; D020233:Gait Disorders, Neurologic / Q000534:rehabilitation* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D008928:Mitochondria / Q000473:pathology; D018908:Muscle Weakness / Q000534:rehabilitation; D010525:Peripheral Nerves / Q000098:blood supply / Q000648:ultrastructure; D010523:Peripheral Nervous System Diseases / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D004856:Postural Balance; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data*; D055070:Resistance Training; D012307:Risk Factors; D014650:Vasa Nervorum / Q000473:pathology; D035862:Vulnerable Populations