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Telehealth Weight Management Intervention for Adults with Physical Disabilities: A Randomized Controlled Trial

Rimmer, James H. PhD; Wang, Edward PhD; Pellegrini, Christine A. PhD; Lullo, Carolyn PhD; Gerber, Ben S. MD, MPH

American Journal of Physical Medicine & Rehabilitation: December 2013 - Volume 92 - Issue 12 - p 1084–1094
doi: 10.1097/PHM.0b013e31829e780e
Original Research Articles

Objective Weight reduction programs are not generally designed or adapted for people with physical disabilities. This study examined the effect of a 9-months remote, telephone-based weight management program for people with physical disabilities using a Web-based system (Personalized Online Weight and Exercise Response System [POWERS]).

Design A total of 102 participants (mean ± SD age, 46.5 ± 12.7 yrs; body mass index, 32.0 ± 5.8 kg/m2) with a physical disability (spinal cord injury, multiple sclerosis, spina bifida, cerebral palsy, stroke, or lupus) were randomized to one of three conditions: physical activity only (POWERS), physical activity plus nutrition (POWERSplus), and control. The POWERS group received a physical activity tool kit and regular coaching telephone calls. The POWERSplus group received an intervention identical to that of the POWERS group plus nutritional information. The control group received the physical activity tool kit and self-guided health promotion resources at the completion of the trial but no coaching.

Results Postintervention differences in body weight were found between the groups. There was a significant group × time interaction (P < 0.01) in postintervention body weight, with both the POWERS and POWERSplus groups demonstrating greater reduction in body weight compared with the control group (POWERS: −2.1 ± 5.5 kg, −2.4 ± −5.9%; POWERSplus: −0.5 ± 5.0 kg, −0.6 ± 4.3%; control: +2.6 ± 5.3 kg, 3.1 ± 7.4%).

Conclusions A low-cost telephone intervention supported with a Web-based remote coaching tool (POWERS) can be an effective strategy for assisting overweight adults with physical disabilities in maintaining or reducing their body weight.

From the University of Alabama at Birmingham and Lakeshore Foundation (JHR); University of Illinois at Chicago (EW, CL); Northwestern University, Chicago, Illinois (CAP); and Center for Management of Complex Chronic Care, Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois (BSG).

All correspondence and requests for reprints should be addressed to: James H. Rimmer, PhD, School of Health Professions Bldg, Room 331, University of Alabama at Birmingham, 1705 University Blvd, Birmingham, AL 35294-1212.

Dr Rimmer is Lakeshore Foundation Endowed Chair in Health Promotion and Rehabilitation Sciences and director of the Lakeshore Foundation/University of Alabama at Birmingham Research Collaborative.

Funded by the Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Human Development and Disability, grant R01/DD000134. The contents of this publication do not necessarily represent the policy of the Centers for Disease Control and Prevention, or the Department of Veterans Affairs or endorsement of the federal government.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2013 by Lippincott Williams & Wilkins