Biopsychosocial Factors Related to Weight Loss for Adults with Acquired Brain Injury in the Diabetes Prevention Program Group Lifestyle Balance

Research Objectives: To (a) describe demographic and injury-related differences between DPP-GLB program responders (≥5% weight-loss) and non-responders ( < 5%) at baseline for adults with ABI; (b) examine differences in physiological and self-reported outcomes between program responders and non-responders at 3, 6, and 12 months of a GLB trial for adults with ABI.

Design: Retrospective study.

Setting: The study sessions took place in a rehabilitation hospital with general community and after COVID it became an E-health intervention.

Participants: Participants with TBI were 18-64 years of age, had a moderate to severe brain injury, were at least 6 months post-injury, and had a BMI ≥25kg/m2. Participants with stroke/CVA were 18-85 years of age, had any type of stroke (e.g., hemorrhagic, anoxic), were at least 12 months post-injury, and had a BMI ≥25kg/m2

Interventions: Participants were recruited from Baylor Scott & White Institute for Rehabilitation (BSWIR) system through flyers, calls, and emails, as well as through outpatient CVA/TBI support groups, and the Texas Woman’s University Stroke Center, and other collaborating centers. The exclusion criteria included conditions in which physical activity is contraindicated (e.g., uncontrolled hypertension), not being fluent in English, low cognitive functioning, and taking type 2 diabetes medication.

Main Outcome Measures: Weight is the primary outcome measure.

Results: There were 69 (45 CVA, 24 TBI) participants who completed 12-month follow-up in their respective study with 33 (78%) [18 (38%) CVA, 16 (67%) TBI] classified as responders. There was a greater proportion of responders with a TBI diagnosis (p=0.02), but no additional statistically significant differences were detected (all p>0.05). Evaluation of the group x time interaction shows that there were no statistically significant differences in how these measures changed over time for the responders vs. non-responders.

Conclusions: The study did not identify statistically significant differences between responders and non-responders to the DPP-GLB program among adults with ABI, but there are several important trends that emerged. The higher baseline body weight among responders, along with their younger age and greater time since injury, suggests potential factors/traits that influence individual responses to the program. The observed improvements in physiological and self-reported outcomes, although not always statistically significant, underscore the clinical relevance of the intervention in improving multiple health outcomes for this population. Future investigations may benefit from analyzing participants diagnosed with TBI and CVA separately, rather than combining them, to better understand their distinct responses to interventions and tailor strategies accordingly.

Author(s) Disclosures: Shahad Alrawi
Enrico Quilico
Evan McShan
Simon Driver