Effect of balance strategies on fall risk in type 2 diabetes mellitus with peripheral neuropathy: a systematic review and meta-analysis

Gupta, Garima, Maiya, G. Arun, Bhat, Shayamsunder N., Hande, Manjunatha, Jude, Edward and Reeves, Neil D ORCID: https://orcid.org/0000-0001-9213-4580 (2022) Effect of balance strategies on fall risk in type 2 diabetes mellitus with peripheral neuropathy: a systematic review and meta-analysis. Critical Reviews in Physical and Rehabilitation Medicine, 34 (4). pp. 1-22. ISSN 0896-2960

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Abstract

Individuals with type 2 diabetes mellitus with peripheral neuropathy are at a high risk of developing unsteadiness and falls. This systematic review and meta-analysis evaluated the effect of balance strategies on fall risk in these conditions. Records from six electronic databases were reviewed. Only randomized control trials focusing on balance strategies and outcomes linked to fall risk were included. Preferred reporting items for systematic reviews and meta-analyses guidelines were followed. Of 2,373 studies, 8 were in-cluded. Risk-of-bias analysis showed that 6 were of good quality, 1 was fair, and 1 was of poor. Meta-analysis of 4 outcome measures was conducted. A meta-analysis of the Berg balance scale (MD 1.08, 95% CI 0.42, 3.19), the functional reach test in centimeters (MD 3.82, 95% CI 0.82, 6.83), the timed up and go test in seconds (MD −1.41, 95% CI −2.14, −0.69), and the one-leg stance test in seconds (right eye open: MD 7.86, 95% CI 1.97, 13.94; left eye open: MD 6.14, 95% CI 2.64, 9.64; right eye closed: MD 2.45, 95% CI 0.61, 4.28; and left eye closed: MD 1.80, 95% CI 0.86, 2.75) It suggested that balance strategies improve fall risk in diabetic neuropathy. The meta-analysis also showed low to very low evidence of a large effect on all the outcomes. The findings of this review show that balance strategies positively influence balancing abilities and reduce fall risk in type 2 diabetes mellitus with peripheral neuropathy.