Is Exercise Beneficial and Safe in Patients with Cirrhosis and Portal Hypertension?

Tapper, Elliot B.; Martinez-Macias, Roberto; Duarte‐Rojo, Andrés

doi:10.1007/s11901-018-0404-z

Cited by 6 publications

(3 citation statements)

References 44 publications

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“…Multiple clinical trials have shown that exercise interventions are feasible, safe, and effective in reversing the metrics of frailty among patients with ESLD and LT candidates. (10)(11)(12) An expert consensus endorsed by the American Society of Transplantation recommended exercise to combat frailty, proposing prehabilitation programs as a strategy to reduce waitlist removal and improve LT outcomes. (13) The concern of transplant providers is, however, the lack of availability of prehabilitation programs specific for LT candidates with or without frailty.…”

Section: Original Article | 503mentioning

confidence: 99%

Introducing EL‐FIT (Exercise and Liver FITness): A Smartphone App to Prehabilitate and Monitor Liver Transplant Candidates

et al. 2020

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Preserved physical function is key for successful liver transplantation (LT); however, prehabilitation strategies are underdeveloped. We created a smartphone application (app), EL-FIT (Exercise and Liver FITness), to facilitate exercise training in end-stage liver disease (ESLD). In this feasibility study, we tested EL-FIT app usage and the accuracy of physical activity data transfer and obtained feedback from initial users. A total of 28 participants used the EL-FIT app and wore a physical activity tracker for 38 ± 12 days (age, 60 ± 8 years; 57% males; Model for End-Stage Liver Disease-sodium, 19 ± 5). There was fidelity in data transfer from the tracker to the EL-FIT app. Participants were sedentary (1957 [interquartile range, 873-4643] steps/day) at baseline. Level of training assigned by the EL-FIT app agreed with that from a physical therapist in 89% of cases. Participants interacted with all app features (videos, perceived exertion, and gamification/motivational features). We rearranged training data to generate heart rate-validated steps as a marker of performance and showed that 35% of the participants had significant increases in their physical performance. Participants emphasized their interest in having choices to better engage in exercise, and they appreciated the sense of community the EL-FIT app generated. We showed that patients with ESLD are able to use and interact with the EL-FIT app. This novel smartphone app has the potential of becoming an invaluable tool for home-based prehabilitation in LT candidates.

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Section: Original Article | 503mentioning

confidence: 99%

Introducing EL‐FIT (Exercise and Liver FITness): A Smartphone App to Prehabilitate and Monitor Liver Transplant Candidates

et al. 2020

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“…Also, exercise increases very‐low‐density‐lipoprotein clearance enabling the liver to export triglycerides, 160 improves appetite‐control 161 and counteracts sarcopenia, which has been identified as independent risk factor for NAFLD and fibrosis 162,163 . Thus, exercise is also recommended and is safe in patients with NASH cirrhosis and portal hypertension improving physical function, sarcopenia and even portal hypertension 164 …”

Section: Physical Activity and Exercisementioning

confidence: 99%

“… 162 , 163 Thus, exercise is also recommended and is safe in patients with NASH cirrhosis and portal hypertension improving physical function, sarcopenia and even portal hypertension. 164 …”

Section: Physical Activity and Exercisementioning

confidence: 99%

Diet and exercise in NAFLD/NASH: Beyond the obvious

Semmler

Datz

Reiberger

et al. 2021

Liver International

104

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Lifestyle represents the most relevant factor for non‐alcoholic fatty liver disease (NAFLD) as the hepatic manifestation of the metabolic syndrome. Although a tremendous body of clinical and preclinical data on the effectiveness of dietary and lifestyle interventions exist, the complexity of this topic makes firm and evidence‐based clinical recommendations for nutrition and exercise in NAFLD difficult. The aim of this review is to guide readers through the labyrinth of recent scientific findings on diet and exercise in NAFLD and non‐alcoholic steatohepatitis (NASH), summarizing “obvious” findings in a holistic manner and simultaneously highlighting stimulating aspects of clinical and translational research “beyond the obvious”. Specifically, the importance of calorie restriction regardless of dietary composition and evidence from low‐carbohydrate diets to target the incidence and severity of NAFLD are discussed. The aspect of ketogenesis—potentially achieved via intermittent calorie restriction—seems to be a central aspect of these diets warranting further investigation. Interactions of diet and exercise with the gut microbiota and the individual genetic background need to be comprehensively understood in order to develop personalized dietary concepts and exercise strategies for patients with NAFLD/NASH.

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Frailty and Sarcopenia in the Critically Ill Patient with Cirrhosis

Hassan

Tapper

2019

The Critically Ill Cirrhotic Patient

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Is Exercise Beneficial and Safe in Patients with Cirrhosis and Portal Hypertension?

Cited by 6 publications

References 44 publications

Introducing EL‐FIT (Exercise and Liver FITness): A Smartphone App to Prehabilitate and Monitor Liver Transplant Candidates

Introducing EL‐FIT (Exercise and Liver FITness): A Smartphone App to Prehabilitate and Monitor Liver Transplant Candidates

Diet and exercise in NAFLD/NASH: Beyond the obvious

Frailty and Sarcopenia in the Critically Ill Patient with Cirrhosis

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