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.

Trial registration: ClinicalTrials.gov NCT01447537.

Conflict of interest statement

Competing Interests: Specifically, the authors do not have any competing interest with Decathlon Foundation, and the funding the authors received from Decathlon Foundation does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1. Flowchart of the study.

Fig 2. Changes in body composition by dual energy X-ray absorptiometry (DXA) between baseline and end of the study in patients from the exercise group.

Results are expressed as difference and 95%CI.

Fig 3

Correlations between changes in anthropometric measurements and changes in body composition assessed by dual energy x-ray absorptiometry (DXA): (A) mid-arm skinfold thickness and fat body mass, (B) upper thigh circumference and lean leg mass. Results are expressed as % change.

Fig 4. Risk of falls evaluated using the Timed Up&Go test at baseline and at the end of the study (12 weeks) in both groups.

Results are expressed as mean±standard error of the mean.