Multimodel Exercise and Weight Loss in Older Obese Veterans With Dysmobility



Status:Recruiting
Conditions:Obesity Weight Loss
Therapuetic Areas:Endocrinology
Healthy:No
Age Range:60 - Any
Updated:12/8/2018
Start Date:October 3, 2016
End Date:October 3, 2020
Contact:Leslie I Katzel, MD PhD
Email:Leslie.Katzel@va.gov
Phone:(410) 605-7248

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Obesity is a major risk factor for mobility problems in older adults and many older adults
use a walking aid to help with their mobility. The use of a walking aid changes normal
walking patterns and makes walking harder, leading people to have more functional problems.
The purpose of this study is to test the effects of 12 months of a multi-modal balance
intervention (MMBI) with supervised weight loss compared to MMBI only on fitness, functional
performance, balance, and economy of gait. Participants will be one of 120 participants in
the VAMHCS. Participation in this study is voluntary. The research will be conducted at the
VAMHCS. The entire study will take approximately 4 years to complete. Subjects' participation
in the study will last 24 months.

Older obese adults suffer disproportionately from walking mobility limitations. Sedentary,
obese older adults are at an increased risk for having or developing difficulties with
mobility. These individuals are often excluded from studies due to their advanced mobility
limitations. A number of studies have compared the effects of weight loss alone, exercise
alone, or weight loss in combination with exercise on functional performance in older adults,
but none of the studies have specifically targeted subjects who use walking assistive
devices. The purpose of this study is to test the effects of a 12 month multi-modal exercise
rehabilitation intervention with a nutrition program versus a nutrition program only on
fitness, functional performance, mobility, and muscle mass. The results of this study will
lead to new and more effective interventions that could reduce disability, fall risk,
injury-related hospitalization and death in older Veterans.

Inclusion Criteria:

- Age >= 60

- BMI >= 30 kg/m2

- Dysmobility as define by 1 or more of the following: Use of or prescribed an assistive
walking device, measured gait speed < 1.0 m/s, Four Square Step Test >/= 12 secs OR
inability to complete the Four Square Step Test, and/or self-reported difficulty
walking 1 km.

- Community dwelling

Exclusion Criteria:

- Unable to walk >0.2 mph on a treadmill for 2 minutes

- Poorly controlled hypertension >180 systolic or >100 diastolic

- Episodes of acute coronary syndrome, coronary revascularization, or major
cardiac/vascular procedures within the prior 6 months

- NYHA Class 3 or 4 heart failure

- Symptomatic angina at rest or during exercise

- Syncope within the past 12 months without known cause or resolution

- Chronic lung disease required oxygen dependency

- Severe spinal stenosis limiting ambulation

- Known dementia

- Mini Mental State Exam score <24

- Transtibial or above the knee amputation

- Currently enrolled and active in Gerofit or MOVE

- Poorly controlled diabetes as defined by HbA1C >10% or frequent hypoglycemic episodes

- Currently undergoing chemotherapy and/or radiation therapy for cancer treatment
We found this trial at
1
site
Baltimore, Maryland 21201
Principal Investigator: Leslie Ira Katzel, MD PhD
Phone: (410) 605-7248
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mi
from
Baltimore, MD
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