Abstract：
BACKGROUND: Physical exercise (PE) has been proven to be beneficial in patients with cirrhosis; effects in cognitive function and cerebral hemodynamics, are yet to be explored.
OBJECTIVE: To evaluate the effects of a PE program (LFN-exercise protocol) in hepatic/cerebral hemodynamics.
METHODS: Randomized open clinical trial in patients with cirrhosis; Control: Diet(n = 13),Intervention: Diet + exercise(n = 14) for 12 weeks. Patients received an educational session, mental exercises (printed book and sudoku), and high-protein diet. Exercise intervention consisted of walking 4 times/week with an intensity rated between 12 and 14 on the Borg scale, monitored through bracelet accelerometers. Patients received weekly text messages to encourage adherence and had monthly in-person visits.
RESULTS: Patients were mainly Child-Pugh A(88.9 %), median MELD 8(8-10), mean age 53±8 years. In the exercise group the number of steps increased from 9667±3008 to 11,931±4463 (p = 0.002), vs 8004±3224 to 8903±3504 (p = 0.053) in controls. Exercise decreased HVPG from 11(8-14) to 8(6-11)mmHg (p = 0.032) vs no change in the control group from 14(12-16) to 15(11-17)mmHg (p = 0.959). Intervention group showed better cerebral hemodynamics, cognitive function, nutritional status and quality of life after the intervention. Adherence was >90 %, with no adverse events.
CONCLUSIONS: The LFN-exercise protocol improves portal hypertension, cerebral hemodynamics and cognitive function, as well as nutritional status and quality of life.
RESULTS:
UNASSIGNED: NCT03932552.
OBJECTIVE: To evaluate the effects of a PE program (LFN-exercise protocol) in hepatic/cerebral hemodynamics.
METHODS: Randomized open clinical trial in patients with cirrhosis; Control: Diet(n = 13),Intervention: Diet + exercise(n = 14) for 12 weeks. Patients received an educational session, mental exercises (printed book and sudoku), and high-protein diet. Exercise intervention consisted of walking 4 times/week with an intensity rated between 12 and 14 on the Borg scale, monitored through bracelet accelerometers. Patients received weekly text messages to encourage adherence and had monthly in-person visits.
RESULTS: Patients were mainly Child-Pugh A(88.9 %), median MELD 8(8-10), mean age 53±8 years. In the exercise group the number of steps increased from 9667±3008 to 11,931±4463 (p = 0.002), vs 8004±3224 to 8903±3504 (p = 0.053) in controls. Exercise decreased HVPG from 11(8-14) to 8(6-11)mmHg (p = 0.032) vs no change in the control group from 14(12-16) to 15(11-17)mmHg (p = 0.959). Intervention group showed better cerebral hemodynamics, cognitive function, nutritional status and quality of life after the intervention. Adherence was >90 %, with no adverse events.
CONCLUSIONS: The LFN-exercise protocol improves portal hypertension, cerebral hemodynamics and cognitive function, as well as nutritional status and quality of life.
RESULTS:
UNASSIGNED: NCT03932552.
摘要：
背景：体育锻炼（PE）已被证明对肝硬化患者有益；对认知功能和脑血流动力学的影响，还有待探索。
目的：评估PE计划（LFN运动方案）对肝/脑血流动力学的影响。
方法：肝硬化患者的随机开放临床试验；对照：饮食（n=13），干预：饮食+运动（n=14），持续12周。病人接受了教育，心理练习（印刷书籍和数独），和高蛋白饮食。运动干预包括每周行走4次，强度在博格量表上介于12和14之间。通过手镯加速度计监测。患者每周收到短信以鼓励依从性，并每月进行一次面对面访问。
结果：患者主要为Child-PughA（88.9％），中位数8（8-10），平均年龄53±8岁。在运动组中，步数从9667±3008增加到11,931±4463（p=0.002），对比对照中的8004±3224至8903±3504(p=0.053)。运动使HVPG从11（8-14）降至8（6-11）mmHg（p=0.032），而对照组从14（12-16）降至15（11-17）mmHg（p=0.959）。干预组表现出更好的脑血流动力学，认知功能,干预后的营养状况和生活质量。依从性>90%，没有不良事件。
结论：LFN运动方案改善门脉高压，脑血流动力学和认知功能，以及营养状况和生活质量。
结果：
■NCT03932552。
目的：评估PE计划（LFN运动方案）对肝/脑血流动力学的影响。
方法：肝硬化患者的随机开放临床试验；对照：饮食（n=13），干预：饮食+运动（n=14），持续12周。病人接受了教育，心理练习（印刷书籍和数独），和高蛋白饮食。运动干预包括每周行走4次，强度在博格量表上介于12和14之间。通过手镯加速度计监测。患者每周收到短信以鼓励依从性，并每月进行一次面对面访问。
结果：患者主要为Child-PughA（88.9％），中位数8（8-10），平均年龄53±8岁。在运动组中，步数从9667±3008增加到11,931±4463（p=0.002），对比对照中的8004±3224至8903±3504(p=0.053)。运动使HVPG从11（8-14）降至8（6-11）mmHg（p=0.032），而对照组从14（12-16）降至15（11-17）mmHg（p=0.959）。干预组表现出更好的脑血流动力学，认知功能,干预后的营养状况和生活质量。依从性>90%，没有不良事件。
结论：LFN运动方案改善门脉高压，脑血流动力学和认知功能，以及营养状况和生活质量。
结果：
■NCT03932552。
