Original article
Impact of a Home-Based Activity and Dietary Intervention in People With Slowly Progressive Neuromuscular Diseases

https://doi.org/10.1016/j.apmr.2005.07.288Get rights and content

Abstract

Kilmer DD, Wright NC, Aitkens S. Impact of a home-based activity and dietary intervention in people with slowly progressive neuromuscular diseases.

Objective

To determine whether a home-based activity and dietary intervention can increase activity level, reduce caloric intake, and impact positively components of metabolic syndrome in a disabled population.

Design

Testing occurred at 3 points during the 6-month intervention period (baseline, 3mo, 6mo) and at 6 months postintervention. Each test point included laboratory testing of anthropometric and metabolic variables and 3 days of home-based activity and dietary monitoring. A personally tailored activity and dietary prescription based on baseline testing was implemented during the 6-month intervention period.

Setting

Human performance laboratory of a university and each subject’s home.

Participants

Twenty adult volunteer ambulatory subjects with several types of slowly progressive neuromuscular disease (NMD).

Intervention

Using a pedometer, subjects were instructed to increase number of steps by 25% over their baseline determined from home monitoring. An individualized dietary prescription was provided focusing on problematic issues identified from the baseline dietary profile.

Main Outcome Measures

Body composition, physical activity, dietary intake, energy expenditure, gait efficiency, metabolic variables, and quality of life.

Results

At the end of the protocol, mean step count increased approximately 27% above baseline (P=.001) and caloric intake decreased over 300kcal/d (P=.002). Body fat percentage significantly decreased (from 33.3%±1.5% to 32.6%±1.6%, P=.032). Gait efficiency did not change, and metabolic variables did not show statistically significant improvement, although 2 of the 5 subjects originally meeting the criteria for metabolic syndrome at baseline no longer met the criteria at the end of the intervention period. Six months after completing the protocol, caloric intake remained significantly reduced (P=.02), but although mean step count remained elevated, it was not statistically significant.

Conclusions

Using a home-based protocol, people with NMD can increase activity and reduce caloric intake. Although this 6-month program showed positive changes, it was insufficient to affect risk factors associated with metabolic syndrome. It remains to be seen if a program longer than 6 months or a more rigorous program could lead to a reduction in the risk factors associated with metabolic syndrome.

Section snippets

Subject Selection

Adults with slowly progressive NMD who were followed up by the NMD clinic at the University of California, Davis (UCD) Medical Center were invited to participate in this interventional study. Diagnoses for the 20 subjects who participated in this study included 8 with limb girdle syndrome, 4 with myotonic dystrophy, 2 with hereditary motor and sensory neuropathy, 2 with fascioscapulohumeral muscular dystrophy, 2 with Becker’s muscular dystrophy, 1 with Kennedy’s muscular dystrophy, and 1 with

Demographic Data

Baseline demographic data are displayed in table 1. Subjects using medications related to hypertension (n=3) or T2D (n=1) at baseline were excluded from results relating to change of these variables.

Because the purpose of the 3-month testing was to ensure that no untoward effects of the exercise protocol existed and none were identified, we do not include these intermediate data in the Results section.

Physical Activity and Energy Expenditure

During the intervention period, subjects were instructed to increase the number of steps above

Discussion

In this population of disabled people with NMD, we found that the combination of a modest activity prescription and dietary intervention produced modest improvements in physical activity, caloric intake, and body fat percentage. However, components associated with metabolic syndrome were not affected. At baseline, this was an inactive population, and we were conservative with the activity prescription. Because of this, absence of a training effect (reduced V̇o2 at a given level of exertion) is

Conclusions

This study provides evidence that a simple, home-based 6-month activity/dietary intervention may significantly increase activity and reduce caloric intake in people with NMD without a significant impact on components of metabolic syndrome. Some lifestyle changes appear to be sustainable over a longer time period. Future investigations should examine methods to provide greater impact on secondary conditions associated with inactivity and excessive caloric intake. For some physical disabilities,

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  • Cited by (0)

    Supported by the National Institute on Disability and Rehabilitation Research (grant nos. H133B031118, H133B980008).

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

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