Randomized Pilot Study: Effects of an Exercise Programme and Leucine Supplementation in Patients with Cirrhosis
- 1.2k Downloads
Physical exercise could improve functional limitations, muscle mass, and health-related quality of life (HRQoL) in patients with cirrhosis.
The purpose of this study was to evaluate the efficacy and safety of an exercise programme and leucine supplementation to increase exercise capacity, muscle mass, and HRQoL in patients with cirrhosis.
Patients and Methods
Seventeen outpatients with cirrhosis were randomized to an exercise group (n = 8) or a control group (n = 9) in a pilot study. The programme of moderate exercise was performed for 12 weeks under supervision of a physiotherapist. All patients received oral leucine (10 g/day) during the study. At baseline and at the end of the study, we determined exercise capacity (6-min walk and 2-min step tests), anthropometric measurements, and HRQoL by Short Form-36 (SF-36) questionnaire. We also analyzed safety regarding complications of cirrhosis, liver and renal function, inflammatory response and oxidative stress.
In the exercise group, exercise capacity improved, as shown by the increase in the 6-min walk test from 365 (160–420) to 445 m (250–500) (p = 0.01), and in the 2-min step test (p = 0.02). Lower thigh circumference also increased, from 41 (34–53) to 46 cm (36–56) (p = 0.02), and the domains of SF-36 general health (p = 0.03), vitality (p = 0.01) and social function (p = 0.04) improved significantly. In the control group, no statistically significant changes were observed in any of the parameters. We did not observe complications of cirrhosis in either group during the study.
A programme of moderate physical exercise together with leucine supplements in patients with cirrhosis is safe and improves exercise capacity, leg muscle mass and HRQoL.
KeywordsCirrhosis Branched-chain amino acids Muscle mass Effort tolerance
S.V. was supported by “Fondo de Investigaciones Sanitarias” and participant in the Program for Stabilization of Investigators of the “Direcció d’Estrategia i Coordinació del Departament de Salut de la Generalitat de Catalunya”. This study has been supported in part by a grant of Fundación MAPFRE, Madrid, Spain. The authors thank Carolyn Newey for revising the English, Ignasi J. Gich from the Clinical Epidemiology Department of Hospital de la Santa Creu i Sant Pau for assistance with statistical analysis, and SHS-Nutricia for kindly providing the leucine supplements.
Conflict of interest
- 32.ATS Committee on Proficiency Standards for Clinical Pulmonary. Function laboratories. ATS statement: guideline for the six-minute walk test. Am J Respir Crit Care Med. 2002;166:111–117.Google Scholar
- 40.Alonso J, Prieto L, Antó JM. The Spanish version of the SF-36 Health Survey (the SF-36 health questionnaire): an instrument for measuring clinical results. Med Clin (Barc). 1995;104:771–776.Google Scholar
- 43.Centers for Disease Control and Prevention. Target Heart Rate and Estimated Maximum Heart Rate. Atlanta, GA, USA. 2011. http://www.cdc.gov/physicalactivity/everyone/measuring/heartrate.html. Accessed 27 February 2014.
- 47.Packer N, Hoffman-Goetz L, Ward G. Does physical activity affect quality of life, disease symptoms and immune measures in patients with inflammatory bowel disease? A systematic review. J Sports Med Phys Fit. 2010;50:1–44.Google Scholar