Exercise in cirrhosis: Translating evidence and experience to practice

Area of Science:

• Hepatology
• Exercise Physiology
• Geriatrics

Background:

• Physical inactivity, sarcopenia, and frailty are significant predictors of poor outcomes in cirrhosis patients.
• Exercise training is a recommended intervention for various chronic diseases, with emerging evidence in liver disease.
• Current clinical practice often lacks structured exercise interventions for cirrhosis management.

Purpose of the Study:

• To advocate for the integration of exercise prescriptions into routine patient care for individuals with cirrhosis.
• To provide clinicians with practical tools and resources for implementing exercise programs in cirrhosis.
• To address the risks associated with sarcopenia and frailty in liver disease.

Main Methods:

• Systematic review of existing literature on exercise interventions in cirrhosis.
• Development of a practical implementation toolkit for clinicians, including patient and physician resources.
• Collaboration between hepatologists, exercise physiologists, physiotherapists, and knowledge translation experts.

Main Results:

• Exercise training shows promise in improving muscle health, functional capacity, and quality of life in cirrhosis.
• Studies report reductions in hepatic venous pressure gradient and no adverse events with exercise.
• The developed toolkit offers a feasible approach for integrating exercise into diverse clinical settings.

Conclusions:

• Routine exercise prescription should be a standard component of care for patients with cirrhosis.
• The developed resources facilitate the translation of evidence into clinical practice.
• Addressing sarcopenia and frailty through exercise can improve patient morbidity and mortality.