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. 2019 Jan 31;2019(1):CD012424. doi: 10.1002/14651858.CD012424.pub2

Morrison 2018.

Methods Study design: RCT
Number of study arms: 2
Length of follow‐up: 3 months
Participants Setting: Virginia, USA
Number of participants: 65
Number analysed: 46
Number lost to follow‐up: 19
Sample: community‐dwelling
Age (years): mean 66.99 (SD 5.42)
Sex: 48% female
Inclusion criteria: Type 2 diabetes
Exclusion criteria: significant cardiovascular disease, unstable proliferative retinopathy, end‐stage renal disease, or uncontrolled hypertension; no balance or resistance training during the previous year
Interventions 1. Group‐based balance training: balance and postural control exercises closely mimicking the type of training performed during unsupervised (Wii Fit) training. a) warm‐up (lower‐limb stretching); b) mostly balance exercises including heel‐toe walking. calf raises, forward leans, single‐leg balance, and basic yoga stretches (the yoga stretches selected were the same as those offered within the Wii program); 40‐minute sessions, 3 a week for 12 weeks
2. Home‐based strength, balance and aerobic Wii Fit programme: aerobics, yoga, strength training, and balance using the Wii Fit Balance System and software programme. 1‐hour interactive tutorial on using the equipment, exercised unsupervised at home, 40‐minute sessions, 3 a week for 12 weeks
Outcomes 1. Rate of falls
2. Number of people who experienced 1 or more falls
Duration of the study 12 weeks
Adherence Not reported
Notes Source of funding: American Diabetes Association
Economic information: not reported
Email communication to obtain fall data, response received, data included in review (there were no falls)
 Data could not be analysed due to zero events for falls (and thus fallers)
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Used a random‐number table
Allocation concealment (selection bias) Unclear risk Concealment not specified
Blinding of participants and personnel (performance bias) 
 All outcomes Unclear risk Blinding not specified
Blinding of outcome assessment (detection bias) 
 Falls Unclear risk Falls was measured using the same measures in all groups. Blinding not specified
Blinding of outcome assessment (detection bias) 
 Fractures Unclear risk Not applicable
Blinding of outcome assessment (detection bias) 
 Hospital admission, medical attention and adverse events Unclear risk Not applicable
Blinding of outcome assessment (detection bias) 
 Health related quality of life (self report) Unclear risk Not applicable
Incomplete outcome data (attrition bias) 
 Falls and fallers High risk Large loss (> 20%) to follow‐up
Selective reporting (reporting bias) High risk Fall outcome prespecified but fall data not presented
Method of ascertaining falls (recall bias) High risk Quote: "Individuals were instructed to record the number of falls they had during the 12‐week exercise intervention"