Use of Six-Minute Walk Test to Measure Functional Capacity After Liver Transplantation

VanWagner, Lisa B.; Uttal, Sarah; Lapin, Brittany; Lee, Joshua; Jichlinski, Amanda; Subramanian, Tanvi; Heldman, Madeleine R.; Poole, Brian; Rodríguez, Eduardo Bustamante; Gunasekaran, Suvai; Tapia, Christopher S.; Veerappan, Annapoorani; Wong, She Yan; Levitsky, Josh

doi:10.2522/ptj.20150376

Cited by 22 publications

(21 citation statements)

References 43 publications

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“…Their results indicated that patients had impaired physical function with low expected (predictive) values. VanWagner et al (7) studied PC using 6MWT over a long period (one, three, six, and 12 months) after surgery, and found that patients showed a gradual improvement in each stage of evaluation, but the values were lower than predictive values at all evaluation times. This may be due to some factors.…”

Section: Discussionmentioning

confidence: 99%

“…This may be due to some factors. The first factor is the immunosuppression medication used over a long period that may have led to the impairment of the musculoskeletal, cardiovascular, and respiratory systems and metabolic disorders (7). The second factor is that patients with end-stage liver disease present muscle mass loss that may affect peripheral and respiratory muscle, leading to chronic fatigue and protein wasting possibly remaining for up to one year after surgery (1).…”

Section: Discussionmentioning

confidence: 99%

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Improvement of Physical Capacity and Quality of Life After Liver Transplantation: A Longitudinal Study

Silva

Corcha

et al. 2019

Hepat Mon

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Improvement of Physical Capacity and Quality of Life After Liver Transplantation: A Longitudinal Study

Silva

Corcha

et al. 2019

Hepat Mon

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“…Some retrospective cohort studies have reported that physical capacity could be expected to improve after liver transplantation. 10,16) They sought to describe the influence of orthotopic liver transplantation on the physical fitness of the recipient after transplantation. In this manner, improvements in liver function could influence the relationship with functional capacity.…”

Section: Discussionmentioning

confidence: 99%

Association Between Liver Function and Peak Oxygen Uptake in Heart Failure Patients: A Retrospective Observational Study

Hanada¹,

Kudo

Kanzaki³

et al. 2017

PRM

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Objective: With respect to liver function and heart failure, 46% of acute decompensated heart failure patients exhibit abnormal liver function. However, there have been no reports of the association between liver function and functional capacity in these patients. Our aim was to clarify the relationship between liver function and functional capacity using the peak oxygen uptake (VO 2 ). Methods: We retrospectively identified 36 heart failure patients who were referred to our rehabilitation laboratory. These patients underwent cardiopulmonary exercise testing (CPX). Furthermore, we investigated the correlations between peak VO 2 , blood measurements [e.g., total bilirubin (T-bil) and brain natriuretic peptide], and echocardiographic parameters. Finally, multivariate regression analysis was performed to investigate the independent variables related to peak VO 2 . Results: The mean peak VO 2 was 10.7±2.9 ml/kg/min. Peak VO 2 during CPX correlated inversely with T-bil [r=-0.379, 95% confidence intervals (CI): −0.654 to −0.014, P=0.043], aspartate transaminase (r=-0.426, 95% CI: −0.685 to −0.07, P=0.021), and peak heart rate (r=0.391, 95% CI: 0.029 to 0.663, P=0.036). The significant independent factors associated with peak VO 2 were treatment with statin (β=-3.19, P=0.015) and T-bil levels (β=-4.27, P=0.002). Conclusion: Our findings demonstrated that liver function may contribute to the functional capacity in heart failure patients.

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“…However, as the majority of the physiological improvements were reported within 6 months of liver transplantation, it is difficult to evaluate how much of this was due to natural recovery after curative surgery for CLD versus exercise intervention alone. For example, VanWagner et al demonstrated a spontaneous improvement of 52 metres in the 6MWT in the first 12 months after liver transplantation without any formal exercise intervention. To a certain extent the largest RCT to date from the United States addresses the independent impact of exercise in the recovery after liver transplantation, as almost twice the amount of patients achieved their age‐predicted VO 2 peak after 4 months of aerobic exercise (commenced 2 months after liver transplantation) as compared to the control group (26.7% vs 14%; P = .02).…”

Section: Adherence To Exercisementioning

confidence: 99%

Review article: impact of exercise on physical frailty in patients with chronic liver disease

Williams

Berzigotti

Lord

et al. 2019

Aliment Pharmacol Ther

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Summary Background Physical frailty is common in chronic liver disease and the setting of liver transplantation. It is associated with poor quality of life, increased hospitalisation and mortality. Despite this, the impact of exercise in these patients remains poorly understood. Aim To summarise the impact of physical exercise on physical frailty in patients with chronic liver disease until after liver transplantation. Methods A MEDLINE and PubMed search was undertaken using the terms; “physical activity”, “functional capacity”, “exercise”, “prehabilitation”, “frailty”, “liver cirrhosis”, “liver failure”, “liver transplantation” “chronic liver disease” and “end‐stage liver disease” from January 1990 to June 2019. Results Eleven studies (five randomised controlled, five observational, one case study) demonstrated that exercise improves VO2 peak, anaerobic threshold, 6‐minute walk distance, muscle mass/function and quality of life in patients with compensated and decompensated cirrhosis. Improvements were most significant with a combination of aerobic and resistance exercises at moderate‐high intensity. The studies were small (n = 1‐50) and mainly focused on supervised, hospital‐based exercises, excluding patients with significant liver failure (MELD > 12). Seven studies (four randomised controlled and three observational) demonstrated that predominantly supervised (only one home‐based) aerobic exercise after liver transplantation improves aerobic capacity, muscle mass/strength and quality of life. There was marked heterogeneity in timing, intensity and type of exercises. Conclusion Exercise improves key components of physical frailty (functional/aerobic capacity, sarcopenia) and quality of life in chronic liver disease and after liver transplantation. Understanding the type, compliance, intensity and duration of exercise and its impact on hard clinical outcomes should be the focus of future large controlled clinical trials.

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Use of Six-Minute Walk Test to Measure Functional Capacity After Liver Transplantation

Abstract: The 6MWT is a simple test of physical functioning but may be difficult to apply in LT recipients. The 6MWT performance improved following LT but was lower than expected, suggesting a low level of fitness up to 1 year following LT.

Cited by 22 publications

References 43 publications

Improvement of Physical Capacity and Quality of Life After Liver Transplantation: A Longitudinal Study

Improvement of Physical Capacity and Quality of Life After Liver Transplantation: A Longitudinal Study

Association Between Liver Function and Peak Oxygen Uptake in Heart Failure Patients: A Retrospective Observational Study

Review article: impact of exercise on physical frailty in patients with chronic liver disease

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