Strength training improves quality of life in cirrhotic patients

The strength training intervention (STRIVE), a home-based structured exercise programme for patients with cirrhosis, appears to substantially improve quality of life, according to a study. However, improvement in the Liver Frailty Index (LFI) is minimal.

Adult patients with cirrhosis (median age 61 years, 43 percent women) at three sites were randomized to 12 weeks of STRIVE (n=58), which included a 30-minute strength training video plus a health coach, or to standard of care (SOC; n=25). Physical function and quality of life were evaluated using the LFI and Chronic Liver Disease Questionnaire (CLDQ), respectively.

Patients had a Model for End-Stage Liver Disease Sodium score of 14, and 54 percent were Child-Pugh B/C. Baseline characteristics were similar between the STRIVE and SOC groups, except for the rates of hepatic encephalopathy (19 percent vs 36 percent, respectively).

At 12 weeks, 43 STRIVE and 20 SOC participants had available LFI. The median LFI improved in both groups, from 3.8 to 3.6 (ΔLFI −0.1) in the STRIVE arm and from 3.7 to 3.6 (ΔLFI −0.1) in the SOC arm (p=0.65 for ΔLFI difference). CLDQ scores also improved in STRIVE participants from 4.6 to 5.2 (ΔCLDQ 0.38) but did not change in SOC participants (4.2–4.2; ΔCLDQ −0.03; p=0.09 for ΔCLDQ difference).

One patient in the SOC arm died of bleeding. Of note, only 14 percent of STRIVE participants adhered to the strength training video for 10–12 weeks. No adverse events were reported in the intervention arm.