Lower-limb risk factors for falls in older adults with diabetes mellitus

Falls are more common in older people with Diabetes Mellitus (DM) than without the condition. Falls cause significant morbidity and mortality among older adults, draining the finite resources of the National Health Service (NHS). Life expectancy of the general population is increasing and a shift in numerous social and environmental factors contribute to ever-increasing recorded cases of DM. As such, identification of risk factors for falls in the DM population is paramount. Previous research has identified intrinsic risk factors for falls in the older population however little research has been conducted specifically in people with DM with regards to primary falls prevention in this 'at risk' group. This study assessed key risk factors for falls in two patient groups; 60 older adults (over the age of 55) with DM and 60 age and gender matched control participants. Logistic regression analysis identified gait velocity, ankle dorsiflexion strength and symptoms of neuropathy (NSS) to be the key predictors of falls in the DM population. Building on the ~ identification of these risk factors, a further study (n=20, 9 males and 11 females, age range 57 - 82) investigated the effect of exercise on these risk factors, comparing the effect of an exercise class, a Nintendo Wii Fit intervention and a control group (no exercise). Interventions were provided x2 p/w for 1 hour duration. This exploratory exercise intervention (pseuso-RCT) demonstrated that individuals allocated to the exercise group achieved the most improvement in risk factors for falls in this study, with significant improvements in Neuropathy Disability Score, right step length and ankle strength for all muscle groups tested. The risk factors for falls in patients with DM are similar to those of the general population; however are more pronounced in those with DM. As such, early identification and strategic intervention such as the implementation of a structured exercise regime are critical to effective falls prevention and management, for people with DM.EThOS - Electronic Theses Online ServiceGBUnited Kingdo