Alyson J Littman1, Jodie K Haselkorn2, David E Arterburn3, Edward J Boyko4. 1. Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, United States; Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research and Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, United States; Department of Epidemiology, University of Washington, Seattle, WA, United States. Electronic address: alyson.littman@va.gov. 2. Department of Epidemiology, University of Washington, Seattle, WA, United States; Multiple Sclerosis Center of Excellence West, VA Puget Sound Health Care System, United States; Department of Rehabilitation, University of Washington, Seattle, WA, United States. Electronic address: Jodie.haselkorn@va.gov. 3. Kaiser Permanente Washington Research Institute, Kaiser Permanente Washington, Seattle, WA, United States; Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, United States. Electronic address: David.E.Arterburn@kp.org. 4. Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, United States; Department of Epidemiology, University of Washington, Seattle, WA, United States; Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, United States. Electronic address: Edward.boyko@va.gov.
Abstract
BACKGROUND: Obesity and inactivity are common and burdensome for people with lower extremity amputation (LEA). The extent to which home-based physical activity/weight management programs are effective and safe for people with LEA is unknown. Translating effective interventions for understudied disability groups is needed. OBJECTIVE: To test the feasibility, acceptability, and safety of a weight management and physical activity intervention and obtain preliminary efficacy estimates for changes in weight, body composition, and physical functioning. METHODS:Eligibility criteria included: LEA ≥1 year prior, 18-69 years of age, overweight or obese and living in the Seattle area. The intervention arm received self-monitoring tools (e.g., pedometer, scale) and written materials, a single exercise counseling home visit by a physical therapist, and up to 11 telephone calls from a health coach over 20 weeks that involved motivational interviewing to set specific, attainable, and measurable goals. The self-directed control group received the same tools and materials but no home visit or coaching calls. RESULTS:Nineteen individuals consented to participate, 15 were randomized (meanage = 56, 73% male, 80% transtibial amputation) and 11 completed 20-week follow-up assessments. The intervention was acceptable and safe. Coached participants had greater decreases in waist circumference (mean difference between groups over 20 weeks, baseline values carried forward: -4.3 cm, 95% CI -8.2, -0.4, p = 0.03) and fat mass (-2.1 kg, 95% CI -3.8, -0.4, p = 0.02). CONCLUSIONS: The home-based intervention was promising in terms of efficacy, safety and acceptability. Inclusion of multiple trial centers and increased use of technology may facilitate recruitment and retention.
RCT Entities:
BACKGROUND: Obesity and inactivity are common and burdensome for people with lower extremity amputation (LEA). The extent to which home-based physical activity/weight management programs are effective and safe for people with LEA is unknown. Translating effective interventions for understudied disability groups is needed. OBJECTIVE: To test the feasibility, acceptability, and safety of a weight management and physical activity intervention and obtain preliminary efficacy estimates for changes in weight, body composition, and physical functioning. METHODS: Eligibility criteria included: LEA ≥1 year prior, 18-69 years of age, overweight or obese and living in the Seattle area. The intervention arm received self-monitoring tools (e.g., pedometer, scale) and written materials, a single exercise counseling home visit by a physical therapist, and up to 11 telephone calls from a health coach over 20 weeks that involved motivational interviewing to set specific, attainable, and measurable goals. The self-directed control group received the same tools and materials but no home visit or coaching calls. RESULTS: Nineteen individuals consented to participate, 15 were randomized (mean age = 56, 73% male, 80% transtibial amputation) and 11 completed 20-week follow-up assessments. The intervention was acceptable and safe. Coached participants had greater decreases in waist circumference (mean difference between groups over 20 weeks, baseline values carried forward: -4.3 cm, 95% CI -8.2, -0.4, p = 0.03) and fat mass (-2.1 kg, 95% CI -3.8, -0.4, p = 0.02). CONCLUSIONS: The home-based intervention was promising in terms of efficacy, safety and acceptability. Inclusion of multiple trial centers and increased use of technology may facilitate recruitment and retention.
Authors: Katherine Froehlich-Grobe; Andrea C Betts; Simon J Driver; Danielle N Carlton; Amber Merfeld Lopez; Jaehoon Lee; M Kaye Kramer Journal: Am J Prev Med Date: 2020-11-05 Impact factor: 5.043
Authors: Alix Chadwell; Laura Diment; M Micó-Amigo; Dafne Z Morgado Ramírez; Alex Dickinson; Malcolm Granat; Laurence Kenney; Sisary Kheng; Mohammad Sobuh; Robert Ssekitoleko; Peter Worsley Journal: J Neuroeng Rehabil Date: 2020-07-14 Impact factor: 4.262
Authors: Jasmijn F M Holla; Lizanne E van den Akker; Tessa Dadema; Sonja de Groot; Michael Tieland; Peter J M Weijs; Marije Deutekom Journal: PLoS One Date: 2020-01-31 Impact factor: 3.240