What implications in response to exercise for patients with cirrhosis?
We encourage our pts with cirrhosis to keep active as much as their condition will allow. At Child A or low MELD they are likely not to be limited. The exception is when varices are seen or have bled. In these cases activities which lead to valsalva or grunting should be avoided. A limit of not lifting 25 pounds form the floor is sensible in most of these pts with varices. As their condition advances toward need for liver transplant their abilities will go down to the point close to transplant we usually suggest toning with minimal weights and walking.
Dear Alexandra
I totally agree with the previous answer (Thomas Riley)
According to ACSM's guidelines("ACSM's exercise management for persons with chronic diseases and disabilities" by Durstine JL, Moore GE), patients with liver failure have reduced VO2 peak, decrease in muscle mass & strength and alcoholic myopathy. Special considertions during exercise: avoid Valsalva (d/t esophageal or gastric varices), and be aware of potential bleeding (d/t coagulation disorders - so avoid contact exercise, and ensure safe environment). Exercise intensity - fatigue dependent so monitor RPE.
Not at all. Moderate exercise is important in chronic encephalopathy because amonium is metabolized in muscle and in general it is associated with less falls in these patients. Exception probability in Child C patients with a bad performance status.
Child-Pugh C is a score, means a very bad hepatic function, with ascites, jaundice, hepatic encephalopaty and poor liver function.
No, it is a clear benefit of exercise on sarcopenia, hepatic encephalopaty, falls, nutrition and humor. Obviously, it should be adapted to phisical conitions of patients.
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