Effects of eight weeks of aerobic exercise training versus usual care on peak oxygen consumption, muscle mass, distance walked in six minutes and health related quality of life in Child Pugh clas A and B patients with cirrhosis Open Access
- Other title
quality of life
- Type of item
- Degree grantor
University of Alberta
- Author or creator
Zenith, Laura M
- Supervisor and department
Tandon, Puneeta (Medicine)
- Examining committee member and department
Bain, Vincent (Medicine)
Tandon, Puneeta (Medicine)
Haykowsky, Mark (Physical Therapy)
Haennel, Robert (Physical Therapy)
Department of Medicine
- Date accepted
- Graduation date
Master of Science
- Degree level
Patients with cirrhosis have reduced peak exercise oxygen uptake (peak VO2) that is associated with decreased survival. The effect of aerobic exercise training (AET) on peak VO2 has not been well studied in cirrhosis. The purpose of this investigation was to evaluate the safety and efficacy of eight weeks of supervised AET or usual care (UC) on peak VO2, quadriceps muscle thickness, distance walked in six minutes (6MWD), and health related quality of life in this population.
Nineteen clinically stable patients between 18 and 70 years of age with Child Pugh class A and B cirrhosis were randomly assigned to AET or UC. Seventy-nine percent of patients were male with a mean age of 57.6 ± 6.7 years and mean Model for End-Stage Liver Disease (MELD) score of 10 ± 2.2. Supervised AET was performed on a cycle ergometer three days per week for eight weeks at 60 to 80% of baseline peak VO2. Peak VO2, quadriceps muscle thickness (measured by ultrasound), thigh circumference, Chronic Liver Disease Questionnaire (CLDQ), EuroQol-Visual Analogue Scale (EQ-VAS), 6MWD, and MELD score were evaluated at baseline and eight weeks. Statistical analysis was performed using analysis of covariance.
Compared to UC, peak VO2 improved by 5.3 mL/kg/min (95% CI: 2.9 to 7.8,p=0.001) after eight weeks of AET. Thigh circumference (p=0.001), thigh muscle thickness (p=0.01), EQ-VAS determined self-perceived health status (p=0.01) and the fatigue sub-score of the CLDQ (p=0.01) improved with AET. No adverse events occurred during cardiopulmonary exercise testing or training.
In conclusion, eight weeks of supervised AET is an effective therapy to improve peak VO2, muscle mass and symptoms of fatigue in compensated patients with cirrhosis. No relevant adverse effects were observed. These promising data support the performance of larger trials in this population.
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- Citation for previous publication
Zenith, L., Meena, N., Ramadi, A., Yavari, M., Harvey, A., Carbonneau, M., Ma, M., Abraldes, J., Paterson, I., Haykowsky, M., Tandon, P. "Eight weeks of exercise training increases aerobic capacity and muscle mass and reduce fatigue in patients wih cirrhosis." Clin Gastroenterol Hepatol. Epub 2014 Apr 24.
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