title: Effects of an Exercise Programme on Functional Capacity, Body Composition and Risk of Falls in Patients with Cirrhosis: A Randomized Clinical Trial.
abstract: Patients with cirrhosis often have functional limitations, decreased muscle mass, and a high risk of falls. These variables could improve with exercise. The aim was to study the effects of moderate exercise on functional capacity, body composition and risk of falls in patients with cirrhosis. Twenty-three cirrhotic patients were randomized to an exercise programme (n = 14) or to a relaxation programme (n = 9). Both programmes consisted of a one-hour session 3 days a week for 12 weeks. At the beginning and end of the study, we measured functional capacity using the cardiopulmonary exercise test, evaluated body composition using anthropometry and dual energy X-ray absorptiometry, and estimated risk of falls using the Timed Up&Go test. In the exercise group, cardiopulmonary exercise test showed an increase in total effort time (p<0.001) and ventilatory anaerobic threshold time (p = 0.009). Upper thigh circumference increased and mid-arm and mid-thigh skinfold thickness decreased. Dual energy X-ray absorptiometry showed a decrease in fat body mass (-0.94 kg, 95%CI -0.48 to -1.41, p = 0.003) and an increase in lean body mass (1.05 kg, 95%CI 0.27 to 1.82, p = 0.01), lean appendicular mass (0.38 kg, 95%CI 0.06 to 0.69, p = 0.03) and lean leg mass (0.34 kg, 95%CI 0.10 to 0.57, p = 0.02). The Timed Up&Go test decreased at the end of the study compared to baseline (p = 0.02). No changes were observed in the relaxation group. We conclude that a moderate exercise programme in patients with cirrhosis improves functional capacity, increases muscle mass, and decreases body fat and the Timed Up&Go time.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01447537.
authors.affiliation: Gastroenterology Department, Institut de Recerca-IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.|Escola Universitària d'Infermeria EUI Sant Pau, Barcelona, Spain.|Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.|CIBERehd, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Román
authors.affiliation: Gastroenterology Department, Institut de Recerca-IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: García-Galcerán
authors.affiliation: Physical Medicine and Rehabilitation Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Torrades
authors.affiliation: Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Herrera
authors.affiliation: Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Marín
authors.affiliation: Cardiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Maite
authors.initials: M
authors.lastname: Doñate
authors.affiliation: Gastroenterology Department, Institut de Recerca-IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Edilmar
authors.initials: E
authors.lastname: Alvarado-Tapias
authors.affiliation: Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Malouf
authors.affiliation: Gastroenterology Department, Institut de Recerca-IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Nácher
authors.affiliation: Cardiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Ricard
authors.initials: R
authors.lastname: Serra-Grima
authors.affiliation: Gastroenterology Department, Institut de Recerca-IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.|Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.|CIBERehd, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Guarner
authors.affiliation: Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.|CIBERehd, Instituto de Salud Carlos III, Madrid, Spain.|Liver Unit, Internal Medicine Department, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Cordoba
authors.affiliation: Gastroenterology Department, Institut de Recerca-IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.|Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.|CIBERehd, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: German
authors.initials: G
authors.lastname: Soriano
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D001823:Body Composition; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000150:complications / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000473:pathology / Q000503:physiopathology