Home-Based Physical Activity and Diet Intervention to Improve Physical Function in Advanced Liver Disease: A Randomized Pilot Trial. Digestive diseases and sciences Chen, H. W., Ferrando, A., White, M. G., Dennis, R. A., Xie, J., Pauly, M., Park, S., Bartter, T., Dunn, M. A., Ruiz-Margain, A., Kim, W. R., Duarte-Rojo, A. 2020

Abstract

INTRODUCTION: A decline in physical function is highly prevalent and a poor prognostic factor in cirrhosis. We assessed the benefits of a home-based physical activity program (HB-PAP) in patients with cirrhosis with a randomized pilot trial.METHODS: All participants received a personal activity tracker to monitor daily activities and were given 12g/day of an essential amino acid supplement. The HB-PAP intervention consisted of biweekly counseling sessions to increase physical activity for 12weeks. Six-minute walk test (6MWT) and cardiopulmonary exercise testing (CPET) assessed changes in aerobic fitness. Different anthropometric measuring tools were used for skeletal muscle and adiposity assessment.RESULTS: Seventeen patients (60% male; 29% nonalcoholic steatohepatitis/cryptogenic, 29% hepatitis C, 24% alcohol, 18% other) were randomized, 9 to HB-PAP group. There were no significant differences in MELD-sodium between HB-PAP and controls at baseline or after the 12-week intervention. By the end of study, there was a significant between-group difference in daily step count favoring the active group (2627 [992-4262], p=0.001), with less sedentary patients in the active group (33-17% vs. 25-43%, p=0.003). The 6MWT improved in the HB-PAP group (423±26m vs. 482±35m), while the controls had a nonsignificant drop (418±26m vs. 327±74m) with a significant between-group difference. CPET did not change. Other than an improvement in psoas muscle index, there were no differences in anthropometry, or in quality of life.CONCLUSIONS: HB-PAP maintained physical performance and improved aerobic fitness according to 6MWT but not CPET, supporting the use of personal activity trackers to monitor/guide home-based prehabilitation programs in cirrhosis.

View details for DOI 10.1007/s10620-019-06034-2

View details for PubMedID 31907774