Exercise Training in Patients with Cirrhosis

  • Graeme M. Purdy
  • Kenneth J. Riess
  • Kathleen P. Ismond
  • Puneeta TandonEmail author


Cirrhosis is a progressive chronic disease that leads to dysfunction in multiple organ systems, resulting in significant deconditioning, sarcopenia, and frailty. Exercise is a promising therapy for patients living with liver disease as it promotes muscle development and cardiopulmonary conditioning. Exercise is currently recommended for patients living with cirrhosis; however it is important to note that current evidence focuses largely on patients with compensated cirrhosis and is limited by small sample size. Future large-scale studies including decompensated patients are necessary to confirm exercise safety and efficacy across the spectrum of patients with cirrhosis. Based on current evidence, patients should aim to achieve 150+ minutes/week of moderate intensity exercise involving both aerobic and resistance training. Patients should also include balance and flexibility exercise, particularly if they have functional limitations. Patient function and contraindications should be assessed prior to exercise initiation. Practitioners can use the practical exercise recommendations in this chapter to design a safe and effective patient exercise training programme.


Exercise Physical activity Sedentary behaviour Deconditioning Safety 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Graeme M. Purdy
    • 1
  • Kenneth J. Riess
    • 1
    • 2
  • Kathleen P. Ismond
    • 3
  • Puneeta Tandon
    • 3
    • 4
    Email author
  1. 1.Department of Physical Therapy, Faculty of Rehabilitation MedicineUniversity of AlbertaEdmontonCanada
  2. 2.School of Health and Life Sciences, Northern Alberta Institute of TechnologyEdmontonCanada
  3. 3.Division of Gastroenterology, Department of Medicine, Faculty of Medicine and Dentistry, University of AlbertaEdmontonCanada
  4. 4.Department of Medicine, Cirrhosis Care Clinic, University of AlbertaEdmontonCanada

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