Fatigue and Physiotherapy In Liver Transplant Recipients Fatigue and Physiotherapy

Abstract

Liver transplantation surgery is a life-saving treatment option for life-threatening end-stage liver diseases and acute liver failure. While the healthrelated quality of life of liver transplant recipients is related to the success of the transplantation procedure; fatigue, malnutrition, loss of muscle mass, decrease in exercise capacity, negative respiratory and metabolic changes as the findings of organ failure are among the causes of functional loss in the posttransplant period. The prevalence of the fatigue, as the frequently experienced symptom in the end-stage liver diseases, varies depending on the specific forms of liver disease and it adversely affects pre and postoperative functional levels of the patients, liver transplantation results and also survival. The severity of the fatigue decreases after the transplantation surgery, but it continues to be seen as the most compelling clinical symptom experienced during the postoperative first year. Current literature data emphasize the necessity of physiotherapy programs and active early mobilization which applied in the early period in the intensive care unit following transplantation surgery and physiotherapy and rehabilitation approaches including strength and endurance training contributes to the functional level in this population. These findings suggest that there is a need for structured physiotherapy programs to increase muscle strength and exercise capacity and prevent fatigue.

Exercise Capacity and Functional Status in Liver Transplant Candidates: Identifying perceived determinants and consequences

“…However, self-assessment and provider-assessment could differ in indicating the actual performance of PA. (27). Individualized and standardized PA programs might be necessary to increase daily activity participation in patients awaiting LT (29). This study has strengths and limitations.…”

Mental Health and Well-Being of Solid Organ Transplant Donors. The Forgotten Sacrifices

“…Only the OPTN provided additional recommendations to monitor socioeconomic concerns of donor, who may face loss of income due to time needed to recover from their organ donations [34,35]. Other possible gaps in donor care include lack of recommendations on post-transplant physical rehabilitation which has been shown to aid in reconditioning while reducing fatigue [44,45], as well as insufficient psychological provisions for potential candidates who fail to donate due to clinical reasons or personal preferences. Lastly, there remains room for improvement to advocate for lifelong follow-up of donors, with most practices implementing two years follow-up duration [35,36] despite studies suggesting key complications arising many years post-transplant [35].…”

“…Similarly, poorly managed pain is known to have detrimental impacts on psychological outcomes [61], such as a two-fold increase in the risk of suicide mortality among individuals suffering from chronic pain [62]. In order to mitigate these risks among donors, physical screening should be conducted using the functional assessment of chronic illness therapy-fatigue subscale (FACIT-F), brief pain inventory (BPI) or physical component score (PCS) of the SF-36 [24], followed by physiotherapy which aids with fatigue [44], respiratory muscle tone [63] and immune function [45]. For pain management, epidural (levobupivacaine) or intravenous (morphine) analgesia may be used at controlled doses for acute pain during post-operative stay while pregabalin may be used to alleviate chronic pain [64].…”

The mediating effect of social functioning on the relationship between social support and fatigue in middle-aged and young recipients with liver transplant in China

“…To date, no specific pharmacological strategies have been identified to improve fatigue symptoms ( Xu et al, 2017 ). Among the non-pharmacological interventions, physical activity and psychological therapy remain the primary methods to alleviate fatigue in LT recipients ( van den Berg-Emons et al, 2006 , 2014 ; Ergene et al, 2019 ). Therefore, exploring how to increase physical activity and reduce negative emotions is the key to alleviate fatigue symptoms.…”