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.
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。