Home Exercise Training Improves Exercise Capacity in Cirrhosis Patients: Role of Exercise Adherence

• Published in: Scientific reports Vol. 8; no. 1; p. 99
• Main Authors: Kruger, Calvin, McNeely, Margaret L., Bailey, Robert J., Yavari, Milad, Abraldes, Juan G., Carbonneau, Michelle, Newnham, Kim, DenHeyer, Vanessa, Ma, Mang, Thompson, Richard, Paterson, Ian, Haykowsky, Mark J., Tandon, Puneeta
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 08.01.2018; Nature Publishing Group
• Subjects: 692/4020; 692/4020/4021/1607/1604; 692/700; Adult; Cirrhosis; Comorbidity; Exercise; Exercise Therapy - adverse effects; Exercise Therapy - methods; Exercise Tolerance; Female; Fitness training programs; Humanities and Social Sciences; Humans; Liver cirrhosis; Liver Cirrhosis - diagnosis; Liver Cirrhosis - epidemiology; Liver Cirrhosis - therapy; Male; Middle Aged; multidisciplinary; Outcome Assessment (Health Care); Patient compliance; Physical training; Quality of life; Randomized Controlled Trials as Topic; Science; Science (multidisciplinary); Severity of Illness Index; Treatment Adherence and Compliance
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-017-18320-y

Cirrhosis patients have reduced peak aerobic power (peak VO 2 ) that is associated with reduced survival. Supervised exercise training increases exercise tolerance. The effect of home-based exercise training (HET) in cirrhosis is unknown. The objective was to evaluate the safety and efficacy of 8 weeks of HET on peak VO 2 , 6-minute walk distance (6MWD), muscle mass, and quality of life in cirrhosis. Random assignment to 8 weeks of HET (moderate to high intensity cycling exercise, 3 days/week) or usual care. Exercise adherence defined as completing ≥80% training sessions. Paired t-tests and analysis of covariance used for comparisons. Forty patients enrolled: 58% male, mean age 57 y, 70% Child Pugh-A. Between group increases in peak VO 2 (1.7, 95% CI: −0.33 to 3.7 ml/kg/min, p = 0.09) and 6MWD (33.7, 95% CI: 5.1 to 62.4 m, p = 0.02) were greater after HET versus usual care. Improvements even more marked in adherent subjects for peak VO 2 (2.8, 95% CI: 0.5–5.2 mL/kg/min, p = 0.02) and 6MWD (46.4, 95% CI: 12.4–80.5 m, p = 0.009). No adverse events occurred during testing or HET. Eight weeks of HET is a safe and effective intervention to improve exercise capacity in cirrhosis, with maximal benefits occurring in those who complete ≥80% of the program.