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Permanent link (DOI): https://doi.org/10.7939/R3KH0F56T

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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

Descriptions

Other title
Subject/Keyword
aerobic exercise
muscle mass
cirrhosis
oxygen consumption
quality of life
Type of item
Thesis
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
Department of Medicine
Specialization
Experimental Medicine
Date accepted
2014-07-09T14:33:15Z
Graduation date
2014-11
Degree
Master of Science
Degree level
Master's
Abstract
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.
Language
English
DOI
doi:10.7939/R3KH0F56T
Rights
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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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