Balance Training May Reduce Fall Risk in Older Adults With T2D

Balance training may help to reduce the risk for falls in older adults with type 2 diabetes (T2D) by improving reaction times, lower limb proprioception, and postural sway, according to a study published in the Journal of the American Medical Directors Association.¹

Patients with T2D are at a greater risk for falls because of decreased muscle strength, slower reactions, diminished sensory input, pain, and impaired vision, among other reasons.^2-4 Few studies have evaluated the effect of balance training in reducing falls in patients with T2D.^5,6

Therefore, researchers recruited 65 older adults with T2D and randomly assigned them into 2 groups: supervised balance training or unsupervised at-home training, using the Nintendo Wii Fit balance board for 12 weeks.¹ The participants were required to complete three 40-minute sessions per week, for a total of 36 sessions.

The researchers found that both training programs led to a significant decrease in falls risk (P <.05) that was attributable to a significant change in reaction times for the hand (P <.05), foot (P <.01), lower-limb proprioception (P <.01), and postural sway (P <.05). These improvements were not reflected by significant changes in lower limb strength, indicating that balance training may help enhance intrinsic risk factors related to balance control instead.

There are often barriers to continued participation in supervised exercise programs as well as adherence to home-based exercise activities.⁷ In this study, less than 5% of patients in the supervised training group dropped out, but more than 50% of patients in the Wii-based group failed to appropriately complete the training or all sessions of the intervention.¹

The investigators concluded that, “Overall, our results highlight that training interventions to reduce falls risk that target intrinsic risk factors related to balance control (over muscle strength) can have positive benefits for the older adult with [T2D] at risk for falls.”¹

References

1. Morrison S, Simmons R, Colberg SR, Parson HK, Vinik AI. Supervised balance training and Wii fit-based exercises lower falls risk in older adults with type 2 diabetes [published online December 27, 2017]. J Am Med Dir Assoc. doi: 10.1016/j.jamda.2017.11.004
2. Volpato S, Leveille SG, Blaum C, Fried LP, Guralnik JM. Risk factors for falls in older disabled women with diabetes: The women’s health and aging study. J Gerontol A Biol Sci Med Sci. 2005;60:1539-1545.
3. Maurer MS, Burcham J, Cheng H. Diabetes mellitus is associated with an increased risk of falls in elderly residents of a long-term care facility. J Gerontol A Biol Sci Med Sci. 2005;60:1157-1162.
4. Vinik AI, Vinik EJ, Colberg SR, Morrison S. Falls risk in older adults with type 2 diabetes. Clin Geriatr Med. 2015;31:89-99.
5. Chapman A, Meyer C, Renehan E, Hill KD, Browning CJ. Exercise interventions for the improvement of falls-related outcomes among older adults with diabetes mellitus: A systematic review and meta-analyses. J Diabetes Complications. 2017;31:631-645.
6. Gu Y, Dennis SM. 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. J Diabetes Complications. 2017;31:504-516.
7. Jansons PS, Haines TP, O’Brien L. Interventions to achieve ongoing exercise adherence for adults with chronic health conditions who have completed a supervised exercise program: Systematic review and meta-analysis. Clin Rehabil. 2017;31:465-477.