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

Gu, Yu; Dennis, Sarah

doi:10.1016/j.jdiacomp.2016.10.004

Cited by 58 publications

(42 citation statements)

References 56 publications

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“…Falls risk should be assessed and where appropriate, preventive measures implemented. A systematic review demonstrated that falls prevention programmes in subjects with T2DM and peripheral neuropathy improved balance and walking without risk of serious adverse events, although there are insufficient data to assess any impact on the frequency of falls . Similar results were reported in a meta‐analysis of the effectiveness of falls prevention programmes in older adults with diabetes .…”

Section: Pathogenesis Of Fractures Associated With T2dmmentioning

confidence: 61%

Type 2 diabetes mellitus and bone

2018

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Type 2 diabetes (T2DM) is a rapidly growing public health problem. It is associated with an increased risk of fracture, particularly of the hip, despite normal or high bone mineral density. Longer duration of disease and poor glycaemic control are both associated with higher fracture risk. The factors underlying increased fracture risk have not been clearly established, but increased falls risk, obesity, sarcopenia and co‐morbidities are likely to contribute. The basis for reduced bone strength despite higher bone mineral density remains to be fully elucidated. Bone turnover is reduced in individuals with T2DM, with evidence of impaired bone formation. Most studies indicate normal or superior trabecular bone structure although reduced lumbar spine trabecular bone score (TBS) has been reported. Deficits in cortical bone structure have been demonstrated in some, but not all, studies whilst reduced bone material strength index (BMSi), as assessed by microindentation, has been a consistent finding. Accumulation of advanced glycation end products in bone may also contribute to reduced bone strength. The use of FRAX in individuals with T2DM underestimates fracture probability. Clinical management should focus on falls prevention strategies, avoidance of known risk factors, maintenance of good glycaemic control and bone protective intervention in individuals at high risk of fracture. Dietary and surgical strategies to reduce weight have beneficial effects on diabetes but may have adverse effects on skeletal health. Future research priorities include better definition of the mechanisms underlying increased fracture risk in T2DM and optimal strategies for identifying and treating those at high risk.

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Section: Pathogenesis Of Fractures Associated With T2dmmentioning

confidence: 61%

Type 2 diabetes mellitus and bone

2018

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“…Severe neuropathy with motor changes may affect safety and may necessitate intervention to mitigate balance deficits and to enhance gait and stability [38]. A comprehensive falls prevention program is an effective strategy that should be proactively implemented to improve functioning [39,40]. Providing assistive devices and/or orthoses may be required to maintain patient safety.…”

Section: Safety Considerations With Antineoplastic Treatment Adverse mentioning

confidence: 99%

A Focused Review of Safety Considerations in Cancer Rehabilitation

Maltser

Cristian

Silver

et al. 2017

PM&R

117

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Cancer and its treatments introduce various adverse effects that may impact survivors’ physical, cognitive and psychological functioning. Frequently both tolerance to activity and exercise are affected as well. Rehabilitation providers should have substantive knowledge about the effect of cancer progression and common side effects associated with anti-neoplastic treatment to safely integrate rehabilitation interventions. Rehabilitation may mitigate loss of function and disability; however, these patients are among the most medically complex that providers treat. This report provides a focused review that synthesizes the current evidence regarding disease progression and oncology-directed treatment side effects within the context of safety considerations for rehabilitation interventions throughout the continuum of cancer care. Descriptive information regarding the evidence for precautions and contraindications is provided so that rehabilitation providers can promote a safe plan of rehabilitation care. It is incumbent upon but also challenging for rehabilitation providers to stay up to date on the many advances in cancer treatment, and there are many gaps in the literature regarding safety issues. Although further research is needed to inform care, this review provides clinicians with a framework to assess patients with the goal of safely initiating rehabilitation interventions.

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“…Gangguan keseimbangan dapat disebabkan oleh adanya disfungsi somatosensoris. Disfungsi somatosensoris dapat memicu instabilitas postural yang berdampak pada risiko jatuh (Gu & Dennis, 2016). Hiperglikemia merupakan salah satu penyebab terjadinya disfungsi somatosensoris melalui mekanisme kerusakan saraf perifer.…”

Section: Pendahuluanunclassified

Latihan Keseimbangan dan Stimulasi Somatosensoris Meningkatkan Keseimbangan Statis pada Penderita Diabetes Neuropati

Sativani

2019

QJK

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Gangguan keseimbangan pada penderita diabetes neuropati dapat disebabkan oleh disfungsi somatosensoris. Disfungsi somatosensoris dapat memicu instabilitas postural yang berdampak pada peningkatan risiko jatuh. Salah satu penyebab terjadinya disfungsi somatosensoris adalah hiperglikemia melalui mekanisme kerusakan saraf perifer. Latihan keseimbangan merupakan salah satu latihan yang dapat meningkatkan keseimbangan. Namun, belum terdapat cukup bukti bahwa keseimbangan statis mengalami peningkatan setelah melakukan kombinasi latihan keseimbangan dan stimulasi somatosensoris pada penderita diabetes neuropati. Penelitan ini bertujuan untuk membuktikan pengaruh kombinasi latihan keseimbangan dan stimulasi somatosensoris terhadap keseimbangan statis pada penderita diabetes neuropati. Penelitian eksperimental, dilakukan selama 3 minggu, 12 subyek penderita diabetes mellitus tipe 2 dengan onset > 10 tahun, dipilih secara acak dan dikelompokkan. Kelompok 1 perlakuan (n=6) mendapatkan latihan keseimbangan dan stimulasi somatosensoris selama 5x seminggu. Kelompok 2 kontrol (n=6) mendapatkan edukasi 2x. Hasil uji t berpasangan UPST sebelum dan sesudah perlakuan pada kelompok 1 menunjukkan adanya perbedaan bermakna sedangka kelompok 2 cenderung tidak berubah. Hasil uji t bebas menunjukkan bahwa terdapat perubahan signifikan pada delta UPST dengan p value 0,000. Kombinasi latihan keseimbangan dan stimulasi somatosensoris dapat meningkatkan keseimbangan statis pada penderita diabetes neuropati. Kata Kunci : diabetes, diabetes neuropati, keseimbangan statis, stimulasi somatosensoris.

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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

Cited by 58 publications

References 56 publications

Type 2 diabetes mellitus and bone

Type 2 diabetes mellitus and bone

A Focused Review of Safety Considerations in Cancer Rehabilitation

Latihan Keseimbangan dan Stimulasi Somatosensoris Meningkatkan Keseimbangan Statis pada Penderita Diabetes Neuropati

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