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Exercise as an intervention for patients with end-stage liver disease: systematic review |
Locklear CT, Golabi P, Gerber L, Younossi ZM |
Medicine 2018 Oct;97(42):e12774 |
systematic review |
BACKGROUND: Various etiologies of chronic liver disease often result in cirrhosis. Beside obvious liver-related complications, cirrhosis also leads to loss of muscle mass and decreased exercise capacity. In this study, our aim was to conduct a systematic review of literature to investigate the efficacy of exercise interventions in patients with cirrhosis. METHOD: PubMed was used to perform the literature search. The MeSH terms used were the following: liver and cirrhosis and (exercise or (exercise therapy)). The following terms were excluded: non-alcoholic fatty liver disease (NAFLD). The search was limited to the English language and human research. The initial search was conducted on December 6, 2016 and re-reviewed May 2017. RESULTS: Seven studies met selection criteria. Training interventions ranged between 4 and 14 weeks in duration with an exercise frequency of 3 to 5 days per week. Most studies demonstrated an increase in maximal oxygen consumption using gas exchange techniques. Two of 3 studies demonstrated increased distance covered in the 6-minute walk test. One study showed a clinically significant decrease in hepatic venous pressure gradient, while another showed a transient increase only during exercise. There were no adverse effects of the exercise program reported. CONCLUSIONS: Exercise in selected patients with cirrhosis can have potential benefit in endurance and functional outcome measures without adverse effect from exercise.
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