title: Exercise interventions for the improvement of falls-related outcomes among older adults with diabetes mellitus: A systematic review and meta-analyses.
abstract: BACKGROUND
  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 12month falls-rate, with no differential treatment effect observed.
  
  
  CONCLUSIONS
  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.
authors.affiliation: RDNS Institute, Victoria 3182, Australia; School of Primary Health Care, Monash University, Victoria 3168, Australia. Electronic address: achapman1@rdns.com.au.
authors.forename: Anna
authors.initials: A
authors.lastname: Chapman
authors.affiliation: RDNS Institute, Victoria 3182, Australia; Centre for Health Communication, School of Public Health and Human Biosciences, La Trobe University, Victoria 3086, Australia. Electronic address: cmeyer@rdns.com.au.
authors.forename: Claudia
authors.initials: C
authors.lastname: Meyer
authors.affiliation: RDNS Institute, Victoria 3182, Australia. Electronic address: erenehan@rdns.com.au.
authors.forename: Emma
authors.initials: E
authors.lastname: Renehan
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, Western Australia 6102, Australia. Electronic address: keith.hill@curtin.edu.au.
authors.forename: Keith D
authors.initials: KD
authors.lastname: Hill
authors.affiliation: RDNS Institute, Victoria 3182, Australia; School of Primary Health Care, Monash University, Victoria 3168, Australia. Electronic address: cbrowning@rdns.com.au.
authors.forename: Colette J
authors.initials: CJ
authors.lastname: Browning
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003929:Diabetic Neuropathies / Q000503:physiopathology / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D015444:Exercise; D020233:Gait Disorders, Neurologic / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D035002:Lower Extremity; D018908:Muscle Weakness / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control; D004856:Postural Balance; D016032:Randomized Controlled Trials as Topic; D012678:Sensation Disorders / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control*
keywords: Balance training; Diabetes mellitus; Exercise interventions; Falls; Older; Systematic review