Outcomes Of A 12-month Weight-loss Intervention For Adults Post Stroke (GLB-CVA)

PURPOSE: The aims of this study were to take the evidence-based Diabetes Prevention Program Group Lifestyle Balance program (DPP-GLB), modified for people post stroke (GLB-CVA), and examine feasibility and efficacy of the program (6-month randomized controlled trial [RCT] data and 12-month combined group data). METHODS: Adults (18-85 years of age), >12 months post stroke, and body mass index (BMI) ≥25 kg/m2 were included in this study. Using cluster randomization, 65 people were assigned to either the GLB-CVA intervention or a 6-month wait-list control (WLC). Participants completed the 12-month, 22 session GLB-CVA intervention, with attendance and assessment of weight, anthropometric, biomarker, functional, and patient reported outcome data collected at baseline, 3, 6, and 12 months. RESULTS: High attendance (90%) and dietary and activity tracking (71%) suggest that the program is feasible to deliver. 6-month RCT data indicates significant weight-loss (p = 0.005) in the GLB-CVA group (7.4 ± 13.6 lbs., 3.65%) compared to the WLC (0.1 ± 10.1 lbs., 0%), and improvements in arm circumference (p = 0.04), HDL cholesterol (p = 0.028), 8-year diabetes risk (p = 0.011), and pain interference (p < 0.001). Combined 12-month data showed participants lost 10.1 ± 16.8 lbs. (4.88%) and improved waist circumference (p = 0.001), HbA1c (3.6%), diastolic blood pressure (p < 0.001). CONCLUSIONS: Data indicate that for individuals who are overweight or obese following stroke, engagement in the GLB-CVA can result in weight loss and improved health. Future efforts Running Head: GLB CVA RCT 2 should examine the effectiveness of participation in real-world settings and focus on knowledge translation efforts including training materials on delivery of the modified curriculum. The contents of this manuscript were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90IFRE0021). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this manuscript do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.