Morrison 2018.
Methods | Study design: RCT Number of study arms: 2 Length of follow‐up: 3 months |
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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 |
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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 |
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Outcomes | 1. Rate of falls 2. Number of people who experienced 1 or more falls |
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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) |
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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" |