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Randomized Pilot Study: Effects of an Exercise Programme and Leucine Supplementation in Patients with Cirrhosis

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Abstract

Background

Physical exercise could improve functional limitations, muscle mass, and health-related quality of life (HRQoL) in patients with cirrhosis.

Aim

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.

Results

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.

Conclusions

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.

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Acknowledgments

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

None.

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Mas Casanovas 90, 08041, Barcelona, Spain

    Eva Román, Carlos Guarner & Germán Soriano

  2. Institut de Recerca-IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    Eva Román, Juan Camilo Nieto, Sílvia Vidal, Cándido Juárez, Carlos Guarner & Germán Soriano

  3. Hospital de la Santa Creu i Sant Pau, Escola Universitària d’Infermeria EUI-Sant Pau, Barcelona, Spain

    Eva Román

  4. Department of Physical Medicine and Rehabilitation, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    Mª Teresa Torrades, Mª Josep Nadal & Helena Bascuñana

  5. Department of Immunology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    Juan Camilo Nieto, Sílvia Vidal & Cándido Juárez

  6. Department of Internal Medicine-Liver Unit, Hospital Vall d’Hebron, Barcelona, Spain

    Guillem Cárdenas & Juan Córdoba

  7. Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain

    Eva Román, Juan Camilo Nieto, Sílvia Vidal, Carlos Guarner, Juan Córdoba & Germán Soriano

  8. Instituto de Salud Carlos III, CIBERehd, Madrid, Spain

    Eva Román, Carlos Guarner, Juan Córdoba & Germán Soriano

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  1. Eva Román
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  2. Mª Teresa Torrades
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  3. Mª Josep Nadal
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  4. Guillem Cárdenas
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  9. Carlos Guarner
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  10. Juan Córdoba
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  11. Germán Soriano
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Corresponding author

Correspondence to Germán Soriano.

Additional information

In Memoriam: We dedicate this article to the memory of Juan Córdoba. We will always remember him for his insight and wisdom, but especially for his humility and generosity.

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Román, E., Torrades, M.T., Nadal, M.J. et al. Randomized Pilot Study: Effects of an Exercise Programme and Leucine Supplementation in Patients with Cirrhosis. Dig Dis Sci 59, 1966–1975 (2014). https://doi.org/10.1007/s10620-014-3086-6

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  • DOI: https://doi.org/10.1007/s10620-014-3086-6

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