# Multimodal Exercise and Weight Loss in Older Veterans with Dysmobility

> **NIH VA I01** · BALTIMORE VA MEDICAL CENTER · 2020 · —

## Abstract

Background: Obesity is a major risk factor for mobility limitation in older adults. It is estimated that 11 million
older adults have mobility disability and > 4 million older adults use walking assistive devices. Mobility disability
results in decreased economy of gait, physical deconditioning and reduced peak aerobic capacity (VO2peak).
Impaired economy of gait and decreased physiological reserve may lead to increased fatigue, reduced
endurance, and ultimately contribute to reduced functional independence. The optimal intervention to improve
mobility limitations in older, obese adults is not known, particular in those who use walking assistive devices,
and there is limited information on whether improvements in physical function can be sustained over time.
Preliminary studies demonstrate that our novel progressive group multimodal balance intervention (MMBI),
focusing on lateral movements, lower extremity strengthening and dynamic obstacle negotiation can improve
gait, balance, and strength in mobility limited older adults. However, it is no known if weight loss in combination
with MMBI will provide additive or synergistic improvements in mobility limited older, obese Veterans.
We hypothesize that our MMBI program in combination with a hypocaloric nutritional intervention (Nutrition)
will be more effective than MMBI alone in improving muscle quality, physical function and economy of gait. In
addition, we hypothesize that the Nutrition + MMBI will be more effective than MMBI alone at improving self-
reported measures of function and disability.
Objective: We propose a randomized clinical trial in 120 older (age > 60 yr) community-dwelling obese (BMI
>30 kg/m2), Veterans with mobility limitations who use walking assistive devices in which we will:
Specific aim 1: Compare the effects of a 6-month MMBI intervention alone to a 6-month combination Nutrition
+ MMBI on physical functioning and economy of gait.
Specific aim 2: Compare the effects of the two interventions on body composition, muscle mass, strength and
relative sarcopenia.
Specific aim 3: Assess the effects of the two interventions at baseline, 6, 12 and 24 months on their self-
reported measures of function and disability using the Late-Life Function and Disability Instrument (LLFDI).
Methods: Veterans enrolled into the study will have baseline testing at the Baltimore GRECC and VAMHCS
Human Performance Laboratory consisting of 1) performance-based outcome measures include VO2peak, gait
speed (gait rite), chair stands, lateral mobility and balance (four square step test, figure eight), SPPB, handgrip
strength (dynamometry), and economy of gait (portable VO2 measurement during 6 minute walk) and
functional status (ADL, IADLs); 2) lower extremity strength testing, 3) total body DXA scan, and a CT scan of
the abdomen, hips and thighs for determination of lower extremity and core muscle composition; and 4)
biomarkers. After completion of baseline testing, the Veterans will be randomized to o...

## Key facts

- **NIH application ID:** 9786077
- **Project number:** 5I01RX001813-04
- **Recipient organization:** BALTIMORE VA MEDICAL CENTER
- **Principal Investigator:** Leslie I. Katzel
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2016-10-01 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9786077

## Citation

> US National Institutes of Health, RePORTER application 9786077, Multimodal Exercise and Weight Loss in Older Veterans with Dysmobility (5I01RX001813-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9786077. Licensed CC0.

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