title: Changes in Muscle Strength and Six-Minute Walk Distance Before and After Living Donor Liver Transplantation.
abstract: BACKGROUND
  Impaired exercise capacity and muscle weakness are important characteristics of liver transplantation recipients. Perioperative rehabilitation has been introduced to promote early mobilization of patients and to prevent postoperative pulmonary complications. However, it is unknown how physical status recovers during the hospital stay after a liver transplant. The purpose of this study was to evaluate the changes in clinical indicators that represent the functional exercise capacity and muscle strength before and after living donor liver transplantation (LDLT).
  
  
  METHODS
  We retrospectively reviewed 21 consecutive patients who underwent LDLT with perioperative rehabilitation from April 2014 to December 2015. Twelve patients who were tested for 6-minute walk distance, hand-grip strength, and isometric knee extensor muscle strength before and 4 weeks after LDLT were enrolled.
  
  
  RESULTS
  At the preoperative baseline, the 6-minute walk distance significantly correlated with the Model for End-stage Liver Disease score and pulmonary functions (vital capacity, forced vital capacity, and forced expiratory volume in 1 second of predictive values). Comparisons between the preoperative and postoperative values revealed significant decreases in weight, Barthel Index, hand-grip strength, and isometric knee extensor muscle strength. Changes in hand-grip strength and isometric knee extensor muscle strength after LDLT correlated with the preoperative Model for End-stage Liver Disease score.
  
  
  CONCLUSIONS
  Physical functional status had not been fully recovered 4 weeks after LDLT. Further investigation regarding developing a strategy for prevention of muscle atrophy before LDLT and recovery of physical fitness after LDLT would be helpful.
authors.affiliation: Department of Rehabilitation, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Mizuno
authors.affiliation: Department of Rehabilitation, Nagoya University School of Medicine, Nagoya, Japan; Respiratory Medicine, Nagoya University School of Medicine, Nagoya, Japan. Electronic address: itori@med.nagoya-u.ac.jp.
authors.forename: S
authors.initials: S
authors.lastname: Ito
authors.affiliation: Department of Rehabilitation, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hattori
authors.affiliation: Department of Rehabilitation, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Nagaya
authors.affiliation: Department of Rehabilitation, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Department of Rehabilitation, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Nishida
authors.affiliation: Transplantation Surgery, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Onishi
authors.affiliation: Transplantation Surgery, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kamei
authors.affiliation: Transplantation Surgery, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Kurata
authors.affiliation: Respiratory Medicine, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Hasegawa
authors.affiliation: Transplantation Surgery, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ogura
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005541:Forced Expiratory Volume; D018737:Hand Strength; D006801:Humans; D007717:Knee / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000503:physiopathology* / Q000534:rehabilitation / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods / Q000534:rehabilitation*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D010809:Physical Fitness / Q000502:physiology; D011184:Postoperative Period; D057234:Preoperative Period; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014797:Vital Capacity; D000070857:Walk Test