Clinical observation of physical exercise with low intensity in patients with cirrhosis_West China Medical Journal

Authors：

XIANG Qian , CHEN Xia , TAN Guangxiu ,  CHEN Xuping

Department of Gastroenterology, the Sixth People’s Hospital of Chengdu, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

CHEN Xuping, Email: cxuping1011@163.com

Keywords：

Cirrhosis; Malnutrition; Sarcopenia; Physical exercise

DOI：

10.7507/1002-0179.201606031

Video：

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Objective To evaluate the efficiency and security of physical exercise with low intensity against malnutrition and sarcopenia in patients with cirrhosis. Methods Between December 2014 and October 2015, 37 patients with cirrhosis were divided into two groups according to their willings, with 19 in the exercise group and 18 in the control group. Endurance of the exercise for 3 months were recorded. Mid-arm circumference, " up and go” time, width of portal vein and Child-Pugh score were compared before and after the research between the two groups. Results Three months later, the mid-arm circumference and the " up and go” time of the exercise group [(33.99±2.15) cm, (9.17±0.35) s] were better than those before the exercise [(32.09±2.58) cm, (9.77±0.46) s] and those in the control group [(31.93±2.04) cm, (9.76±0.30) s], and the differences above were all statistically significant (P<0.05). The change of the width of portal vein was positively correlated with pre-exercise body mass index in overweight patients (r=0.93, P=0.007). Conclusions Physical exercise with low intensity is safe and effective against malnutrition and sarcopenia in patients with cirrhosis. Overweitht patiens or malnutrition at the early stage may benefit more.

Citation： XIANG Qian, CHEN Xia, TAN Guangxiu, CHEN Xuping. Clinical observation of physical exercise with low intensity in patients with cirrhosis. West China Medical Journal, 2017, 32(9): 1370-1374. doi: 10.7507/1002-0179.201606031 Copy

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5.	García-Pagàn JC, Santos C, Barberá JA, et al. Physical exercise increases portal pressure in patients with cirrhosis and portal hypertension. Gastroenterology, 1996, 111(5): 1300-1306.
6.	Fukui H, Saito H, Ueno Y, et al. Evidence-based clinical practice guidelines for liver cirrhosis 2015. J Gastroenterol, 2016, 51(7): 629-650.
7.	中华医学会肠外肠内营养学分会. 成人口服营养补充专家共识. 中华胃肠外科杂志, 2017, 20(4): 361-365.
8.	Dubé PA, Imbeau D, Dubeau D, et al. Prediction of work metabolism from heart rate measurements in forest work: some practical methodological issues. Ergonomics, 2015, 58(12): 2040-2056.
9.	Viccaro LJ, Perera S, Studenski SA. Is timed up and go better than gait speed in predicting health, function, and falls in older adults?. J Am Geriatr Soc, 2011, 59(5): 887-892.
10.	Liu S, Brown JD, Stanya KJ, et al. A diurnal serum lipid integrates hepatic lipogenesis and peripheral fatty acid use. Nature, 2013, 502(7472): 550-554.
11.	Qiu J, Thapaliya S, Runkana A, et al. Hyperammonemia in cirrhosis induces transcriptional regulation of myostatin by an NF-κB-mediated mechanism. Proc Natl Acad Sci USA, 2013, 110(45): 18162-18167.
12.	Glass C, Hipskind P, Tsien C, et al. Sarcopenia and a physiologically low respiratory quotient in patients with cirrhosis: a prospective controlled study. J Appl Physiol, 2013, 114(5): 559-565.
13.	中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南. 临床肝胆病杂志, 2015, 31(12): 1941-1960.
14.	Soriano G, Román E, Córdoba J, et al. Cognitive dysfunction in cirrhosis is associated with falls: a prospective study. Hepatology, 2012, 55(6): 1922-1930.
15.	Berzigotti A, Albillos A, Villanueva CA, et al. Lifestyle intervention by a 16-week programme of supervised diet and physical exercise ameliorates portal hypertension in patients with cirrhosis and obesity: the Sport Diet study. Hepatology, 2014, 60(1, SI): 253A.
16.	Román E, García-Galcerán C, Torrades T, et al. Effects of an exercise programme on functional capacity, body composition and risk of falls in patients with cirrhosis: a randomized clinical trial. PLoS One, 2016, 11(3): e0151652.

1. Dasarathy S. Consilience in sarcopenia of cirrhosis. J Cachexia Sarcopenia Muscle, 2012, 3(4): 225-237.
2. Dasarathy S. Cause and management of muscle wasting in chronic liver disease. Curr Opin gastroenterol, 2016, 32(3): 159-165.
3. Merli M, Giusto M, Lucidi C, et al. Muscle depletion increases the risk of overt and minimal hepatic encephalopathy: results of a prospective study. Metab Brain Dis, 2013, 28(2): 281-284.
4. Periyalwar P, Dasarathy S. Malnutrition in cirrhosis: contribution and consequences of sarcopenia on metabolic and clinical responses. Clin Liver Dis, 2012, 16(1): 95-131.
5. García-Pagàn JC, Santos C, Barberá JA, et al. Physical exercise increases portal pressure in patients with cirrhosis and portal hypertension. Gastroenterology, 1996, 111(5): 1300-1306.
6. Fukui H, Saito H, Ueno Y, et al. Evidence-based clinical practice guidelines for liver cirrhosis 2015. J Gastroenterol, 2016, 51(7): 629-650.
7. 中华医学会肠外肠内营养学分会. 成人口服营养补充专家共识. 中华胃肠外科杂志, 2017, 20(4): 361-365.
8. Dubé PA, Imbeau D, Dubeau D, et al. Prediction of work metabolism from heart rate measurements in forest work: some practical methodological issues. Ergonomics, 2015, 58(12): 2040-2056.
9. Viccaro LJ, Perera S, Studenski SA. Is timed up and go better than gait speed in predicting health, function, and falls in older adults?. J Am Geriatr Soc, 2011, 59(5): 887-892.
10. Liu S, Brown JD, Stanya KJ, et al. A diurnal serum lipid integrates hepatic lipogenesis and peripheral fatty acid use. Nature, 2013, 502(7472): 550-554.
11. Qiu J, Thapaliya S, Runkana A, et al. Hyperammonemia in cirrhosis induces transcriptional regulation of myostatin by an NF-κB-mediated mechanism. Proc Natl Acad Sci USA, 2013, 110(45): 18162-18167.
12. Glass C, Hipskind P, Tsien C, et al. Sarcopenia and a physiologically low respiratory quotient in patients with cirrhosis: a prospective controlled study. J Appl Physiol, 2013, 114(5): 559-565.
13. 中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南. 临床肝胆病杂志, 2015, 31(12): 1941-1960.
14. Soriano G, Román E, Córdoba J, et al. Cognitive dysfunction in cirrhosis is associated with falls: a prospective study. Hepatology, 2012, 55(6): 1922-1930.
15. Berzigotti A, Albillos A, Villanueva CA, et al. Lifestyle intervention by a 16-week programme of supervised diet and physical exercise ameliorates portal hypertension in patients with cirrhosis and obesity: the Sport Diet study. Hepatology, 2014, 60(1, SI): 253A.
16. Román E, García-Galcerán C, Torrades T, et al. Effects of an exercise programme on functional capacity, body composition and risk of falls in patients with cirrhosis: a randomized clinical trial. PLoS One, 2016, 11(3): e0151652.

West China Medical Journal

Clinical observation of physical exercise with low intensity in patients with cirrhosis

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