Morrison, Steven , PhD
Impact of supervised vs. home-based exercise training on gait, balance, and falls risk in Type 2 Diabetes
General Research Subject: Type 2 Diabetes
Focus: Complications, Complications\Neuropathy, Exercise, Exercise\Human
Type of Grant: Clinical Translational Research
Project Start Date: July 1, 2012
Project End Date: June 30, 2015
Falls are a serious health problem for older people with more than one third of people over 65 suffering a fall at least once a year and many suffering multiple falls. Given that older persons with type 2 diabetes mellitus (T2DM) are more likely to suffer a fall than a healthy person of a similar age, further studies are needed to increase the understanding of falls and what impact everyday activities have on balance and falls risk. However, simply identifying those variables that can predict increased risk and how they change as a consequence of activity is only part of preventing a fall.
From a clinical perspective it is essential to better understand how factors that contribute to increased falls risk can be translated into effective intervention strategies. This study has been designed to address these issues by determining the main factors predicting falls risk, how these change with walking, and the effectiveness of supervised training and home-based exercise training (using the Nintendo Wii) to improve posture and decrease falls risk. In particular, we will assess whether supervised or unsupervised activities can both produce the same reduction and how effective any balance training intervention is for those diabetic individuals at highest risk of falling. From our research, falls risk predictors based on physiological profiles and dynamic stability during walking and balance will be developed. Additionally, by assessing the relative merits of these balance training protocols, we will gain insight as to most suitable falls prevention intervention for individuals with diabetes.
What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes?
This project will assess general balance, walking ability and falls risk for individuals with type 2 diabetes mellitus (T2DM). The main goals of this project will be to gain a better understanding of what factors lead to falls and what form of activity is best for reducing the risk of such an adverse event. The reason for addressing is this problem is that falls are a serious health issue for the older population in general, with over one-in-three over the age of 65 likely to suffer a fall. This risk of falling is greatly increased for older individuals with T2DM who are more than 5 times likely to suffer a fall than a healthy person of a similar age.
Our research plan is designed to develop a better understanding of falls and what impact everyday activities have on balance and falls risk. However, simply identifying what factors can lead to a fall and how they change as a consequence of activity is only part of preventing a fall. What is essential for the T2DM individual at risk, is to intervene in some meaningful way in order to prevent a future fall. Consequently, this research project has been designed to also determine how effective different forms of activity (i.e., supervised training and home-based exercise training using the Nintendo Wii) are for improving balance and decreasing falls risk. The findings from this line of research will be used to develop better measures for assessing the likelihood of a future fall. Additionally, by examining the relative merits of these two activity protocols, we will gain insight as to most suitable falls prevention intervention for individuals with diabetes.
If a person with diabetes were to ask you how your project will help them in the future, how would you respond?
Unfortunately, falls are a common event in many peoples live and most individuals who have approached me about research have some personal knowledge of either falling themselves or having an older relative/friend who has suffered a fall at some point in their life. Consequently, many people have some personal experience with what falls actually represent and how they can affect a given person. When approached by any individual, I also explain (simply) that falling is a huge problem for the older population as a whole, especially those with diabetes. However, while I would outline the risk of falls, I am quick to point out that many falls can be prevented. The key is to first understand and determine what the reason is for the fall and then, look at ways to effectively intervene to reduce the risk of a future event. For example, if we assessed someone and they had weak leg muscles, then a first response is to encourage the person to increase their level of physical activity (in a safe environment of course). The endpoint for this line of research is education about activity and falls and the prevention of future adverse events. I would emphasis to any person I came in contact with that I believe that this line of research will provide meaningful and practical benefits for a large proportion of those people with Diabetes.
Why is it important for you, personally, to become involved in diabetes research? What role will this award play in your research efforts?
Examining and understanding how people move is a central theme of my research. In particular, I am interested in what changes in motor function can be seen with aging and diseases such as diabetes. As I developed more of an understanding of the effect age and disease has on balance and gait, and the horrific statistics related to falls and fall-related injury, I realized this area would be a key research interest. This award will play a major role in my research development. It will provide me (and my research team) the opportunity to address what we believe are critical and essential question relating to balance control and falls risk for older people with T2DM. This population group is at an increased risk of falling compared to healthy adults of a similar age and so this research will allow us to tackle an area of real significance. It will also allow me to focus on this one area of clinical importance and, I believe, significantly improve our understanding of this are and the risk related to falling.
In what direction do you see the future of diabetes research going?
I believe the future of diabetes research has great potential. With the (unfortunate) increasing incidence of diabetes around the world, people are becoming more aware of the need to better understand all aspects and outcome of this disease process. Whether it be related to gaining greater insight as to the mechanism which lead to this disease, the development of better treatments or intervening to improve quality of life and everyday function, there is no doubt that there is an increased drive and awareness to collectively challenge and build upon our current body of knowledge. With greater knowledge and insight, I can see great steps forward in research relating to Diabetes.
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