Personalized Adapted Physical Activity Before Liver... : Transplantation (original) (raw)

Clinical Science

Acceptability and Results

Debette-Gratien, Marilyne1; Tabouret, Tessa1; Antonini, Marie-Thérèse2; Dalmay, François3; Carrier, Paul1; Legros, Romain1; Jacques, Jérémie1; Vincent, François2; Sautereau, Denis1; Samuel, Didier4,5; Loustaud-Ratti, Véronique1,6

1 Service d’Hépato-gastroentérologie, CHU Limoges, 2, Avenue Martin Luther-King 87000 Limoges, France.

2 Service d’explorations Fonctionnelles Physiologiques, CHU Limoges, France.

3 Centre d’Epidémiologie de Biostatistique et de Méthodologie de la Recherche, Faculté de Médecine de Limoges, Limoges, France.

4 APHP-Hôpital Paul Brousse, Centre Hépato-biliaire Villejuif, France.

5 Université de Paris sud, Villejuif, France.

6 Université de Limoges, Inserm, Faculté de Médecine 2, rue du Dr Marcland 87025 Limoges, France.

Received 16 January 2014. Revision requested 14 February 2014.

Accepted 15 April 2014.

The authors declare no conflicts of interest.

Correspondence: Tessa Tabouret, MD, Service Hépato-Gastroentérologie CHU Dupuytren 2, Avenue Martin Luther King 87942 Limoges Cedex, France; Véronique Loustaud-Ratti, MD, PhD, Service Hépato-Gastroentérologie, CHU Dupuytren, 2, Avenue Martin Luther King 87042 Limoges Cedex, France. ([email protected]; [email protected])

M.D.-G. participated in research design, in the writing of the article and data analysis. T.T. participated in research design, in the writing of the article, and data analysis. M.-T.A. participated in research design, in the writing of the article, and data analysis. F.D. participated in data analysis. P.C. participated in research design, in the writing of the article and data analysis. R.L. participated in research design. J.J. participated in research design. No conflict of interest in the subject matter. F.V. participated in research design. D.S. participated in research design. D.S. participated in research design. V.L.-R. participated in research design, in the writing of the article and data analysis.

Accepted September 3, 2014

Background

Altered aerobic capacity and muscular strength among patients suffering from cirrhosis are poor prognosis factors of the overall survival after liver transplantation (LT). A program of adapted physical activity (APA) is recommended in patients awaiting solid organ transplantation. However, there is no standard program in LT, and therefore none is applied.

Methods

Prospective pilot study to evaluate the acceptability of a 12-week personalized APA and its impact on aerobic capacity, muscle strength, and quality of life before LT.

Results

Thirteen patients (six men, seven women) were included. Five patients interrupted the program: two for personal convenience, two were transplanted before the end of the program, and one for deterioration of the general condition. Eight patients (mean age, 51±12 years; mean Child Pugh, 7±3; and mean model for end-stage liver disease score, 13±6) completed the program. The mean VO2 peak values increased from 21.5±5.9 mL/kg per min at baseline to 23.2±5.9 mL/kg per min after 12 weeks of training (P<0.008). The maximum power (_P_=0.02), the 6-min walk distance (P<0.02), the strength testing of knee extensor muscles (_P_=0.008), and the ventilatory threshold power (_P_=0.02) were also significantly increased. Quality of life scale showed a global trend to improvement. No adverse event was observed.

Conclusion

A personalized and standardized APA is acceptable, effective and safe in patients awaiting LT. It positively influences the index of fitness and quality of life. Its promising impact on the posttransplantation period, duration of hospitalization, and 6-month survival needs to be prospectively evaluated in a large randomized study.