Are falls prevention programs effective at reducing the risk factors for falls in people with type-2 diabetes mellitus and peripheral neuropathy: A systematic review with narrative synthesis.
BACKGROUND
Diabetic peripheral neuropathy (DPN) is a common complication of type-2 diabetes mellitus (T2DM) that predisposes the elderly to a higher falls risk. Falls prevention programs with a component of weight-bearing exercises are effective in decreasing future falls in the elderly. However, weight-bearing exercise was only recently recommended in guidelines for exercise for people with T2DM and DPN. Since then, there have been an increasing number of studies to evaluate the effectiveness of falls prevention programs on this targeted population.


OBJECTIVE
A systematic literature review was undertaken to determine the effectiveness of falls prevention programs for people with T2DM and DPN.


RESULTS
Nine published studies that investigated the effect of exercise training on falls risk among people with T2DM and DPN were included in the review. Interventions included lower limb strengthening, balance practice, aerobic exercise, walking programs, and Tai Chi.


CONCLUSIONS
The preliminary evidence presented in this review suggests that people with T2DM and DPN can improve their balance and walking after a targeted multicomponent program without risk of serious adverse events. There is insufficient long-term follow-up data to determine whether the improvements in balance or strength resulted in a decrease falls risk in the community setting.
Faculty of Health Sciences, University of Sydney, 75 East Street, Lidcombe, NSW 2141. Electronic address: yugu5468@uni.sydney.edu.au.
Yu
Y
Gu
Faculty of Health Sciences, University of Sydney, 75 East Street, Lidcombe, NSW 2141. Electronic address: dennis@sydney.edu.au.
Sarah M
SM
Dennis
D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003929:Diabetic Neuropathies / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D019317:Evidence-Based Medicine; D015444:Exercise; D006801:Humans; D004856:Postural Balance; D017410:Practice Guidelines as Topic; D055070:Resistance Training; D012307:Risk Factors; D026302:Tai Ji; D016138:Walking
Diabetic peripheral neuropathy; Exercise training; Falls prevention; T2DM; Type-2 diabetes mellitus