Effects of In-Hospital Physical Therapy on Activities of Daily Living in Patients with Hepatocellular Carcinoma

Abstract

Activities of daily living (ADL) are frequently impaired in patients with hepatocellular carcinoma (HCC). In this retrospective study, we aimed to investigate the effects of physical therapy on ADLs in patients with HCC during hospitalization for cancer treatment. Nineteen patients with HCC were enrolled. During hospitalization, patients performed a combination of resistance training, stretching, and aerobic exercise (20–60 min/day). ADLs were assessed using the functional independence measure (FIM). Changes in FIM were evaluated by before–after analysis. No significant difference was seen in Child–Pugh class before and after physical therapy. The bilateral knee extension strength and chair stand test were significantly increased after physical therapy compared with before physical therapy (p = 0.001 and p = 0.008, respectively). The total FIM score was significantly increased after physical therapy compared with that before physical therapy (p = 0.0156). Among the 18 indexes of FIM, the stairs index was significantly improved after physical therapy compared with that before physical therapy (5.9 vs. 6.4 points, p = 0.0241). We demonstrated that physical therapy improved muscle strength without worsening liver function. Furthermore, physical therapy improved FIM, especially in the stairs index, in patients with HCC. Thus, physical therapy may be beneficial in patients with HCC during cancer treatment.

Effects of strength exercise interventions on activities of daily living, motor performance, and physical activity in children and adolescents with leukemia or non-Hodgkin lymphoma: Results from the randomized controlled ActiveADL Study

“…The results of a study in a population of elderly people showed that sarcopenia, defined by physical performance, muscle mass and muscle strength, is associated with impairment of higher-level functional capacity in daily living ( 49 ). In a cohort of adult cancer patients, a combined in-hospital physical therapy with resistance, aerobic, and stretching exercises improved muscle strength and functional independence regarding ADLs ( 50 ). Also a retrospective analysis among pediatric cancer patients identified that functional limitations in ADLs could be reduced through an inpatient rehabilitation program, including strength training during treatment ( 51 ).…”

Lifestyle and Hepatocellular Carcinoma What Is the Evidence and Prevention Recommendations

“…The FIM score markedly increased after PA ( p = 0.0156), and especially the stairs index (5.9 vs. 6.4 points p = 0.024 before and after PA respectively). Thus PA improved muscle strength and ADL without worsening CLD [ 79 ]. In 2021, a multicenter study was conducted in Japan to assess the effect of in-hospital exercise on frailty in HCC patients.…”