van Ginneken Berbke T J, van den Berg-Emons Rita J G, Kazemier Geert, Metselaar Herold J, Tilanus Hugo W, Stam Henk J
Department of Rehabilitation Medicine, Erasmus University Medical Center Rotterdam, The Netherlands.
Eur J Appl Physiol. 2007 Jun;100(3):345-53. doi: 10.1007/s00421-007-0435-6. Epub 2007 Mar 16.
Fatigue is often experienced after liver transplantation. The aims of this cross-sectional study were to assess physical fitness (cardiorespiratory fitness, neuromuscular fitness, body composition) in liver transplant recipients and to explore whether physical fitness is related to severity of fatigue. In addition, we explored the relationship between physical fitness and health-related quality of life. Included were 18 patients 1-5 years after transplantation (aged 48.0 +/- 11.8 years) with varying severity of fatigue. Peak oxygen uptake during cycle ergometry, 6-min walk distance, isokinetic muscle strength of the knee extensors, body mass index, waist circumference, skinfold thickness, severity of fatigue, and health-related quality of life were measured. Cardiorespiratory fitness in the liver transplant recipients was on average 16-34% lower than normative values (P <or= 0.05). Furthermore, the prevalence of obesity seemed to be higher than in the general population (17 vs. 10%). We found no deficit in neuromuscular fitness. Cardiorespiratory fitness was the only fitness component that was related with severity of fatigue (r (s )= -0.61 to r (s )= -0.50, P <or= 0.05). Particularly cardiorespiratory fitness was related with several aspects of health-related quality of life (r (s )= 0.48 to r (s )= 0.70, P <or= 0.05). Results of our study imply that cardiorespiratory fitness and body composition are impaired in liver transplant recipients and that fitness is related with severity of fatigue (only cardiorespiratory fitness) and quality of life (particularly cardiorespiratory fitness) in this group. These findings have implications for the development of rehabilitation programs for liver transplant recipients.
肝移植后患者常感到疲劳。这项横断面研究的目的是评估肝移植受者的身体素质（心肺功能、神经肌肉功能、身体成分），并探讨身体素质是否与疲劳严重程度相关。此外，我们还探究了身体素质与健康相关生活质量之间的关系。研究纳入了18例移植后1至5年的患者（年龄48.0±11.8岁），其疲劳严重程度各不相同。测量了患者在蹬车测力试验中的最大摄氧量、6分钟步行距离、膝关节伸肌等速肌力、体重指数、腰围、皮褶厚度、疲劳严重程度以及健康相关生活质量。肝移植受者的心肺功能平均比正常参考值低16%至34%（P≤0.05）。此外，肥胖患病率似乎高于一般人群（分别为17%和10%）。我们未发现神经肌肉功能存在缺陷。心肺功能是唯一与疲劳严重程度相关的身体素质指标（斯皮尔曼相关系数r(s)= -0.61至r(s)= -0.50，P≤0.05）。尤其是心肺功能与健康相关生活质量的多个方面相关（r(s)= 0.48至r(s)= 0.70，P≤0.05）。我们的研究结果表明，肝移植受者的心肺功能和身体成分受损，且该群体的身体素质与疲劳严重程度（仅心肺功能）和生活质量（尤其是心肺功能）相关。这些发现对肝移植受者康复计划的制定具有启示意义。
