Introduction
This study examines the feasibility and effectiveness of an intensive lifestyle intervention
adapted for people with impaired mobility.
Study design
This was a randomized, wait-list controlled trial. The experimental group immediately
received the 12-month weight loss program; the wait-list control group received it
after a 6-month delay. Between-group comparisons were conducted for the 6-month RCT
study design. Repeated measures were conducted for both groups combined after receiving
the 12-month intervention. Data were collected August 2015–February 2017 and analyzed
in 2017.
Setting/participants
A community-based sample received 23, group-based sessions via a mix of telephone
and in-person sessions in a hospital-based setting. Participants with impaired mobility
(n=66) were middle-aged (49.80 [SD=11.37] years), mostly White (66.7%), female (66.7%),
and most commonly had spinal cord injury (47.0%).
Intervention
The 12-month intervention delivered 23 group-based sessions that promoted weight loss
through reducing caloric intake and increasing physical activity.
Main outcome measures
Primary outcomes were effectiveness measured as change in weight and time spent in
moderate physical activity. Feasibility was assessed in 12-month combined group analyses,
measured as retention, attendance, and dietary self-monitoring.
Results
The 6-month RCT results showed that the immediate and delayed groups differed significantly
(p<0.05) in weight (−1.66 [SD=4.42] kg loss vs 0.05 [SD=4.15] kg gain) and moderate
physical activity (52.93 [SD=90.74] minutes/week increase vs −14.22 [SD=96.02] minutes/week
decrease), accounting for baseline weight, time with disability, and age of onset.
The 12-month results with groups combined demonstrated 74.2% retention and 77.7% core
session attendance. Self-monitoring was higher in the delayed group (77.3%), who used
a smartphone app, than the immediate group (47.3%), who mostly used paper trackers.
Participants achieved significant 12-month weight loss of 3.31 (SD=10.13) kg (d=0.33)
in mixed modeling analyses with groups combined yet did not significantly increase
moderate physical activity.
Conclusions
Group Lifestyle Balance Adapted for Individuals with Impaired Mobility is a feasible,
effective approach to teach healthy lifestyle skills to individuals with mobility
impairment, yielding modest weight loss and enhanced self-efficacy.
Trial registration
This study is registered at www.clinicaltrials.gov NCT03307187.
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Article Info
Publication History
Published online: November 04, 2020
Identification
Copyright
© 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.