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Liver transplant patients benefit from moderate, high intensity exercise

Combined resistance and aerobic training at moderate to high intensity improved aerobic capacity, maximal strength and health-related quality of life in liver transplant patients, according to a recently published study.

“An adequate recovery together with an improvement in the patient fitness and indirect understanding of the relevance of exercise in [health-related quality of life] may result in the long-term in a reduced incidence of metabolic complications,” Diego Moya-Nájera, MsC, from the University of Valencia, Spain, and colleagues wrote. “Indeed, diseases associated with metabolic complications are emerging as the first cause of death after liver transplantation.”

Between July 2011 and February 2013, the researchers enrolled 54 patients who had undergone liver transplantation to one of two study groups: the intervention group took part in two 75-minute supervised training sessions per week, while the control group followed usual care recommendations such as low intensity walking at home.

The training sessions for the intervention group consisted of walking for aerobic training, elastic bands for resistance training, and extension exercises for muscle strength. On average, patients adhered to 45 of 48 sessions. Researchers tested all patients at 6 months and 12 months posttransplant. While the dropout rates were higher in the intervention group, the researchers associated this with aggressive hepatitis C recurrent disease.

The intervention group, when tested at 12 months, had an average 15% increase in maximal oxygen consumption from 6 months, compared with an increase of 7% in the control group (P = .04). The intervention group also had more significant maximal strength change in hip extension (P < .001) and elbow flexion (P = .004).

While there were no significant differences in the other changes measured individually, the intervention group achieved a 31% maximal global strength improvement compared with 9% in the control group (P = .001). Additionally, the intervention group had great changes in physical functioning and vitality (P = .03).

“[This training] can be easily replicated in other centers given that the training program was designed with the intention to be easy to do anywhere at a cheap cost,” the researchers wrote. “The only requirements were indeed an open space and elastic bands with different resistances. Homebased exercise programs can be applied but supervision of the training sessions by a professional is recommended to enhance adherence and control that the subjects perform the exercises well, with a proper technique.”

Disclosure: The researchers report no relevant financial disclosures.