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Patient and Caregiver Attitudes and Practices of Exercise in Candidates Listed for Liver Transplantation

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Abstract

Background

Impaired physical capacity increases peri-liver transplant complications. Patient perceptions regarding exercise prior to transplantation are not known.

Aims

This study aimed to assess patient and caregiver activity levels, perceptions of willingness to exercise, and of provider advice.

Methods

Consecutive patients listed for liver transplant and caregivers presenting for routine outpatient visits were evaluated over a 3-month interval. Anonymous surveys adapted to patients and caregivers addressed the importance and safety of exercise, type and duration of exercise performed, barriers, willingness to wear a monitoring device, and perceived provider recommendations. Responses were logged on a Likert scale from 1 to 5.

Results

Three hundred and sixty-eight responses were received. Most participants perceived exercise as important. Patients exercised three times per week for 30 min. Eighty percent endorsed walking (median response: 2—agree; IQR 1–2). Most did not jog, swim, cycle, or strength train. Fatigue, reported by 70%, was the major barrier (2, IQR 1–3). Over 90% of caregivers endorsed exercise as important (1—strongly agree, IQR 1–2) and encouraged exercise (median response 2, IQR 1–2). Over 60% of patients (median response 2, IQR 1–3) and caregivers (median response 2, IQR 2–3) felt providers encouraged exercise.

Conclusions

Patients and caregivers are willing to exercise to optimize physical fitness prior to liver transplantation.

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Abbreviations

FLEXIT:

Fitness, life enhancement, and exercise in transplantation

LT:

Liver transplant

MELD:

Model for end-stage liver disease

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Funding

Funding was provided by National Institute on Aging (Grant No. K23AG048337).

Author information

Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Mayo Clinic in Arizona, 5777 E. Mayo Blvd, Phoenix, AZ, 85054, USA

    David M. Chascsa & Elizabeth J. Carey

  2. Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, CA, USA

    Jennifer C. Lai

  3. Center for Liver Diseases, Pittsburgh Liver Research Center and Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA

    Michael A. Dunn

  4. Division of Gastroenterology and Liver Unit, University of Alberta, Edmonton, AB, Canada

    Aldo J. Montano-Loza

  5. Division of Gastroenterology and Hepatology, Duke University, Durham, NC, USA

    Matthew R. Kappus

  6. Division of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA

    Srinivasan Dasarathy

Authors
  1. David M. Chascsa
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  2. Jennifer C. Lai
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  3. Michael A. Dunn
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  4. Aldo J. Montano-Loza
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  5. Matthew R. Kappus
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  6. Srinivasan Dasarathy
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  7. Elizabeth J. Carey
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Contributions

J. Lai, M. Dunn, A. Montano-Loza, M. Kappus, and E. Carey designed the study, collected the data, and provided significant input regarding manuscript composition. D. Chascsa analyzed the data and composed the manuscript. S. Dasarathy assisted in study design and provided significant input regarding manuscript composition.

Corresponding author

Correspondence to David M. Chascsa.

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The authors declare that they have no conflict of interest.

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Chascsa, D.M., Lai, J.C., Dunn, M.A. et al. Patient and Caregiver Attitudes and Practices of Exercise in Candidates Listed for Liver Transplantation. Dig Dis Sci 63, 3290–3296 (2018). https://doi.org/10.1007/s10620-018-5271-5

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  • DOI: https://doi.org/10.1007/s10620-018-5271-5

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