Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; Liver fibrosis and Nutrition Lab (LFN-Lab), Mexico City, Mexico; MICTLAN-Network, Mexico City, Mexico.
Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; Liver fibrosis and Nutrition Lab (LFN-Lab), Mexico City, Mexico; MICTLAN-Network, Mexico City, Mexico.
Dig Liver Dis. 2024 May;56(5):827-835. doi: 10.1016/j.dld.2023.11.011. Epub 2023 Nov 25.
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.
To evaluate the effects of a PE program (LFN-exercise protocol) in hepatic/cerebral hemodynamics.
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.
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.
The LFN-exercise protocol improves portal hypertension, cerebral hemodynamics and cognitive function, as well as nutritional status and quality of life.
NCT03932552.
体育锻炼（PE）已被证明对肝硬化患者有益；但其对认知功能和脑血流动力学的影响尚待探索。
评估 LFN-运动方案（LFN-exercise protocol）对肝/脑血流动力学的影响。
对肝硬化患者进行随机开放临床试验；对照组：饮食（n = 13），干预组：饮食+运动（n = 14），共 12 周。患者接受教育课程、脑力锻炼（印刷书籍和数独）和高蛋白饮食。运动干预包括每周 4 次，强度在 Borg 量表上评分为 12-14 级，通过腕带加速度计进行监测。患者每周会收到鼓励坚持的短信，并每月进行一次面对面的访问。
患者主要为 Child-Pugh A（88.9%），中位 MELD 8（8-10），平均年龄 53±8 岁。运动组的步数从 9667±3008 增加到 11931±4463（p = 0.002），而对照组从 8004±3224 增加到 8903±3504（p = 0.053）。运动组的 HVPG 从 11（8-14）mmHg 下降到 8（6-11）mmHg（p = 0.032），而对照组无变化，从 14（12-16）mmHg 增加到 15（11-17）mmHg（p = 0.959）。干预组在干预后显示出更好的脑血流动力学、认知功能、营养状况和生活质量。依从性>90%，无不良事件。
LFN-运动方案可改善门静脉高压、脑血流动力学和认知功能，以及营养状况和生活质量。
GOV 编号：NCT03932552。
