Liver Cirrhosis and Exercise: The Power of PT

This week's article and video goes out to my hospital, acute, and SNF PTs. Liver cirrhosis is a devastating disease which often ends in cancer, transplant, other comorbidities, or even death. PT plays an integral role and here's more research to back up our services in these settings!

Enjoy the video (transcript below), here's the article, and if you like what you see here then know there is more in our 3 board-approved continuing education courses on Nutrition specific for Physical Therapists. Enroll today in our new bundled course offering and save 20%, a value of $60!

   Hey, Dr. Wells here from Nutritional Physical Therapy. Just coming with a research update today. Today will be a good one for our general physical therapists as well as our acute care physical therapists.

This article is published by Hasih et al. It's published in 2024 in the Journal of Digestive Diseases and Science. Effectively, it was a meta-analysis looking at the effect of exercise on body measurements, including BMI, fat-free mass, thigh circumference, and thigh muscle thickness, as well as other capacities like exercise capacity, fatigue, and quality of life.

This is specifically for individuals that have liver cirrhosis. Obviously, physical therapists play a big role, particularly in hospital and outpatient settings as well for these individuals that have had liver cirrhosis from either primary means or secondary means. The impact of the liver obviously affects their energy metabolism, their function, cardiometabolic outcomes, and usually there's a lot of comorbidities involved as well.

So exercise is a big component. In this meta-analysis, they looked at eight different randomized control trials, basically five that accompanied aerobic exercise, one that used resistance training, and then two trials that combined those two interventions. In the two trials, there was some essential amino acid supplemented, but the comparator overall was just no exercise.

Typical intervention range was around eight to 14 weeks. Overall, the studies found that the exercise improved their functional capacity, their thigh circumference, their thigh muscle thickness, and also improved fatigue. Interestingly enough, it did not affect fat mass, it did not affect BMI, and it didn't improve quality of life.

So it makes me wonder as a physical therapist whether these exercises were dosed appropriately. Also, it makes me wonder too if there was any nutritional components because we know that nutrition can impact liver function. Obviously, alcohol directly impacts the liver, but we also know that certain fats can also challenge the liver and the bile ducts and can be more problematic.

So it'd be interesting to see some of these trials and studies done again with the combined effort of nutrition with physical therapy and see if those outcomes are more improved compared to just nutrition alone. Anyhow, if you liked this research update, like, subscribe, and check out our board-approved continuing education courses for physical therapists, and have a great day.

 Keywords: liver cirrhosis, exercise, physical therapy, muscle mass, bone mineral density, GLP-1 inhibitors, weight loss, metabolism, CEU