A prospective analysis of factors associated with decreased physical activity in patients with cirrhosis undergoing transplant evaluation.

TitleA prospective analysis of factors associated with decreased physical activity in patients with cirrhosis undergoing transplant evaluation.
Publication TypeJournal Article
Year of Publication2015
AuthorsCruz AChristina, Vilchez V, Kim S, Barnes B, Ravinuthala A, Zanni A, Galuppo R, Sourianarayanane A, Patel T, Maynard E, Shah MB, Daily MF, Uhl TL, Esser K, Gedaly R
JournalClin Transplant
Volume29
Issue11
Pagination958-64
Date Published2015 Nov
ISSN1399-0012
KeywordsAdult, Aged, Case-Control Studies, End Stage Liver Disease, Female, Follow-Up Studies, Hand Strength, Humans, Liver Cirrhosis, Liver Transplantation, Male, Middle Aged, Motor Activity, Prognosis, Prospective Studies, Risk Factors, Severity of Illness Index
Abstract

BACKGROUND: Physical activity (PA) has been associated with improved recovery time after transplantation. Handgrip strength has been related to post-transplant outcomes.

AIM: To evaluate predictors of PA and grip strength in patients with cirrhosis undergoing liver transplant evaluation.

METHODS: Single-center, prospective analysis.

RESULTS: One hundred patients were evaluated (54% male, mean age 53 ± 9). Common etiologies of liver disease were non-alcoholic steatohepatitis (27%), hepatitis C (22%) and alcoholic liver disease (21%). Mean model of end-stage liver disease (MELD) score was 13.5. Forty-one percent had a history of smoking. Ninety-three patients completed the International Physical Activity Questionnaire (IPAQ). The median total PA score was 33 metabolic equivalent (MET)-min/wk. The mean total grip strength was 62.1 ± 22 lb. Total grip strength was found to be an independent predictor of low-moderate PA (OR 4.7, 95% CI 1.4-16.2, p = 0.038), and smoking was the only significant factor associated with reduced grip strength (OR 3.4, 95% CI 1.4-8, p = 0.005).

CONCLUSIONS: Patients with end-stage liver disease undergoing liver transplant evaluation have reduced total PA by IPAQ. Total grip strength was found to be a significant predictor of low-moderate PA in patients with cirrhosis. Smoking is a risk factor for reduced grip strength, an important indicator of muscle wasting in cirrhotics.

DOI10.1111/ctr.12602
Alternate JournalClin Transplant
PubMed ID26263921
PubMed Central IDPMC4624476
Grant ListR01 AR061939 / AR / NIAMS NIH HHS / United States