Enhancing Mobility and Psychosocial function in Obese Veterans following stroke via Weight loss and ExeRcise (EMPOWER)

NIH Pandemic-Era Grants

Pandemic Era Grants

2024

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Principal Investigator: Chris  Gregory
Organization: RALPH H JOHNSON VA MEDICAL CENTER
Fiscal Year: 2024
Funding agency: Veterans Affairs

More than 2 million stroke survivors currently living in the U.S. are obese. Obesity is known to exacerbate age-
related declines in function in these individuals and is associated with poorer clinical outcomes and quality of
life. Weight-loss interventions are well-studied in neurologically healthy individuals and are shown to be effective
for attenuating functional decline and improving quality of life. Despite these established benefits, there is
currently an absence of studies investigating the effects of intentional weight loss on physical and/or
psychosocial function in individuals following stroke. We propose a trial aimed at Enhancing Mobility and
Psychosocial function in Obese Veterans following stroke via Weight loss and ExeRcise (EMPOWER). This trial
leverages a 15-week multidisciplinary approach to weight loss, via an existing lifestyle and weight management
program, including caloric restriction, with or without concurrent supervised exercise training, as the catalyst by
which remediation of physical and psychosocial impairments promote enhanced recovery in obese Veteran
survivors of stroke. We posit that successful weight loss will result in improvements in physical and psychosocial
function (compared to control subjects) and that concurrent exercise will result in improved outcomes when
compared to weight loss alone. The VHA 2010 Management of Stroke Rehabilitation Guidelines recommends
that patients receive a formal rehabilitation assessment, the results of which should be used to determine the
appropriate level of care and develop evidence-based interventions. However, without information regarding the
effects of obesity and weight management on physical and psychosocial function as well as data on the long-
term benefits of the program, evidence to guide decisions regarding the most appropriate approach to post-
stroke rehabilitation for obese Veteran stroke survivors will remain elusive and recommendations for best
available treatment cannot be met. Data from the proposed trial will have important clinical significance by
determining the extent to which this type of program improves (or not) physical and psychosocial outcomes in
Veterans following stroke and will provide a foundation for future studies aimed at establishing effectiveness of
this approach to post-stroke care for Veterans.

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