%0 Journal Article
%T Effect of a monitored exercise protocol in cerebral and hepatic hemodynamics in patients with cirrhosis and portal hypertension.
%A Macías-Rodríguez RU
%A Ruiz-Margáin A
%A Román-Calleja B
%A Cantú-Brito C
%A Flores-Silva F
%A Gabutti-Thomas A
%A Aguilar-Nájera O
%A Cruz-Contreras M
%A Weber-Sangri L
%A Ríos-Torres S
%A Delgadillo AT
%A Aguilar-Salinas CA
%A Kershenobich-Stalnikowitz D
%J Dig Liver Dis
%V 56
%N 5
%D 2024 May 25
%M 38008698
%F 5.165
%R 10.1016/j.dld.2023.11.011
%X <B>BACKGROUND: </B>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.<BR><B>OBJECTIVE: </B>To evaluate the effects of a PE program (LFN-exercise protocol) in hepatic/cerebral hemodynamics.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>The LFN-exercise protocol improves portal hypertension, cerebral hemodynamics and cognitive function, as well as nutritional status and quality of life.<BR><B>RESULTS: </B><BR><B>UNASSIGNED: </B>NCT03932552.