Lower Extremity Amputation Clinical Trial
Official title:
Home-based Weight Loss Intervention for Individuals With Lower Extremity Amputation
The purpose of this study is to pilot test a program to help overweight and obese individuals
with a lower extremity amputation (LEA) lose weight and become more physically active. The
investigators will randomize approximately 30 individuals to either a self-directed weight
loss program (n=15) or a coached weight loss program (n=15). The primary purpose of this
pilot study is to determine if a home-based weight loss/physical activity (PA) intervention
is feasible in individuals with a LEA. MOVE-LEAP is a 20-week program that involves 11 phone
calls from a health coach and a single home visit by a physical therapist.
This pilot study aims to:
1. test the feasibility of recruiting overweight/obese individuals with LEA into a
randomized trial;
2. assess whether the intervention can be delivered with high fidelity, and
3. evaluate whether the intervention is acceptable to and safe as determined by participant
feedback, participation and retention for outcome measures.
Participants randomized to the intervention arm will receive (1) a home visit by an exercise
specialist and (2) a 20-week telephone-delivered weight loss program, modeled on the VA's
Telephone Lifestyle Coaching Program (MOVE!TLC). All participants (both the coached arm and
self-directed arm) will be mailed a MOVE-LEAP packet [containing eating and physical activity
logs, information on how to set weight loss goals, suggestions for physical
activity/exercise, dietary guides, etc.), a MOVE-LEAP handout booklet, calories counting
book, a pedometer, exercise digital versatile disc (DVD), and a flip-booklet with exercises
("Exercise Guide for Persons with Limb Loss"). A bathroom scale will be provided for
participants who do not already own one.
Participants in the coached arm will receive a home visit by an exercise specialist. This
visit will occur 1-3 weeks after randomization. The exercise specialist will assess the
participant's capabilities and interest regarding physical activity as well as his/her home
environment for physical activity. Since each participant may have different physical
capabilities and limitations, the type and intensity of physical activity will be tailored to
each participant's preferences and their home and neighborhood/community environment and
resources. If the participant is interested in performing physical activity outside their
home, study staff will provide them with information about community resources for physical
activities.
Participants in the coached arm will receive 11 calls by a study health coach. During the
phone calls (weekly initially and then every other week), the health coach will review
progress and help the participant to set "SMART" goals (Specific, Measurable, Attainable,
Relevant and Time-limited) and will use motivational interviewing techniques to help the
participant achieve those goals. Motivational interviewing is a style of counseling meant to
increase participant engagement through strategic use of open-ended questions, reflective
listening and positive affirmations. The study staff will review the participant's progress
on his or her goals and help him or her problem solve to resolve challenges and modify goals
as needed. During each session, the coach will discuss an educational topic relating to
weight loss. Written materials on each topic are included the booklet.
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