title: Personalized adapted physical activity before liver transplantation: acceptability and results.
abstract: BACKGROUND
  Altered aerobic capacity and muscular strength among patients suffering from cirrhosis are poor prognosis factors of the overall survival after liver transplantation (LT). A program of adapted physical activity (APA) is recommended in patients awaiting solid organ transplantation. However, there is no standard program in LT, and therefore none is applied.
  
  
  METHODS
  Prospective pilot study to evaluate the acceptability of a 12-week personalized APA and its impact on aerobic capacity, muscle strength, and quality of life before LT.
  
  
  RESULTS
  Thirteen patients (six men, seven women) were included. Five patients interrupted the program: two for personal convenience, two were transplanted before the end of the program, and one for deterioration of the general condition. Eight patients (mean age, 51 ± 12 years; mean Child Pugh, 7 ± 3; and mean model for end-stage liver disease score, 13 ± 6) completed the program. The mean VO2 peak values increased from 21.5 ± 5.9 mL/kg per min at baseline to 23.2 ± 5.9 mL/kg per min after 12 weeks of training (P<0.008). The maximum power (P=0.02), the 6-min walk distance (P<0.02), the strength testing of knee extensor muscles (P=0.008), and the ventilatory threshold power (P=0.02) were also significantly increased. Quality of life scale showed a global trend to improvement. No adverse event was observed.
  
  
  CONCLUSIONS
  A personalized and standardized APA is acceptable, effective and safe in patients awaiting LT. It positively influences the index of fitness and quality of life. Its promising impact on the posttransplantation period, duration of hospitalization, and 6-month survival needs to be prospectively evaluated in a large randomized study.
authors.affiliation: 1 Service d'Hépato-gastroentérologie, CHU Limoges, 2, Avenue Martin Luther-King 87000 Limoges, France. 2 Service d'explorations Fonctionnelles Physiologiques, CHU Limoges, France. 3 Centre d'Epidémiologie de Biostatistique et de Méthodologie de la Recherche, Faculté de Médecine de Limoges, Limoges, France. 4 APHP-Hôpital Paul Brousse, Centre Hépato-biliaire Villejuif, France. 5 Université de Paris sud, Villejuif, France. 6 Université de Limoges, Inserm, Faculté de Médecine 2, rue du Dr Marcland 87025 Limoges, France.
authors.forename: Marilyne
authors.initials: M
authors.lastname: Debette-Gratien
authors.forename: Tessa
authors.initials: T
authors.lastname: Tabouret
authors.forename: Marie-Thérèse
authors.initials: MT
authors.lastname: Antonini
authors.forename: François
authors.initials: F
authors.lastname: Dalmay
authors.forename: Paul
authors.initials: P
authors.lastname: Carrier
authors.forename: Romain
authors.initials: R
authors.lastname: Legros
authors.forename: Jérémie
authors.initials: J
authors.lastname: Jacques
authors.forename: François
authors.initials: F
authors.lastname: Vincent
authors.forename: Denis
authors.initials: D
authors.lastname: Sautereau
authors.forename: Didier
authors.initials: D
authors.lastname: Samuel
authors.forename: Véronique
authors.initials: V
authors.lastname: Loustaud-Ratti
mesh_terms: D000328:Adult; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D053580:Muscle Strength; D010101:Oxygen Consumption; D010349:Patient Compliance; D010809:Physical Fitness; D010865:Pilot Projects; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists