medigraphic.com
Órgano Oficial de la Asociación Mexicana de Hepatología

2018, Number 1

<< Back Next >>

Ann Hepatol 2018; 17 (1)

Exercise Capacity and Respiratory Profile in Patients after Orthopedic Liver Transplantation: a Follow-up Study

Magalhães CBA, P Garcia JH, Viana CFG, N Flor MJ, C de Bruin PF, B Pereira ED

Language: English
References: 29
Page: 98-103
PDF size: 188.65 Kb.


ABSTRACT

Introduction: We sought to describe: 1) The influence of orthotopic liver transplantation (OLT) on exercise capacity, pulmonary function and respiratory muscle strength after surgery, 2) The relationship between exercise capacity and symptoms of anxiety and depression. Material and methods. This is a prospective follow up study conducted with patients submitted to OLT. All patients were assessed before and 1 month after surgery through measurements: six minute walk test (6MWT), 6 min step test (6MST) and HADS (Hospital Anxiety and Depression Scale). FEV1% (forced expiratory volume), maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured in the pre-operative and on 1st, 3rd, 5th day and 1 month after surgery. Results. In 77 patients , 6MWD improved 20.2 m (95%CI 8.1-32.3) and 6MST improved 7.8 steps after surgery (95%CI 3.9-11.6). Change in 6 MWD and 6 MST did not correlated with change HADS. The FEV1% at each time point were 88.8 ± 21.3 before surgery, 32.9 ± 9.9 on 1st day, 39.6 ± 11.5 on 3rd day, 46 ± 12.1 on 5th day and 86.6 ± 21.1 one month after surgery. MIP and MEP values at each time point were -67.4 ± 23.2 and 79.7 ± 26 before surgery, -30.8 ± 12.3 and 36.4 ± 15.4 on 1st day, -38.6 ± 14.1 and 43.8 ± 17 on 3rd day, -45.8 ± 15.9 and 49.7 ± 18.7 on 5th day and -67.1 ± 29.4 and 80.9 ± 23.9 one month after surgery. Conclusion. Exercise capacity was modestly increased after OLT without any correlation with symptoms of anxiety and depression. Pulmonary function and respiratory muscle strength decreased immediately after liver transplantation, and progressively recovered, returning to baseline values after 1 month.


REFERENCES

  1. Alameri HF, Sanai FM, Dukhayil M, Azzam NA, Al-Swat KA, Hersi AS, Abdo AA. Six minute walk test to assess functional capacity in chronic liver disease patients. World J Gastroenterol 2007; 13: 3996-4001.

  2. Carey EJ, Steidley DE, Aqel BA, Byrne TJ, Mekeel KL, Rakela J, Vargas HE, et al. Six-Minute Walk Distance Predicts Mortality in Liver Transplant Candidates. Liv Transplant 2010; 16: 1373-8.

  3. Foroncewicz B, Mucha K, Szparaga B, Raczy ska J, Ciszek M, Pilecki T, Krawczyk M, et al. Rehabilitation and 6-minute walk test after liver transplantation. Transplant Proc 2011; 43: 3021-4.

  4. Pessoa BV, Arcuri JF, Labadessa IG, Costa JNF, Sentanin AC, Di Lorenzo VAP. Validity of the six-minute step test of free cadence in patients with chronic obstructive pulmonary disease. Braz J Phys Ther 2014; 18: 228-36.

  5. Dal Corso S, Duarte SR, Neder JA, Malaguti C, Fuccio MB, Castro Pereira CA, Nery LE. A step test to assess exerciserelated oxygen desaturation in interstitial lung disease. Eur Respir J 2007; 29: 330-6.

  6. Feltracco P, Carollo C, Barbieri S, Pettenuzzo T, Ori C. Postliver transplant pulmonary complications. World J Gastroenterol 2013; 19: 9271-81.

  7. Moreno R, Berenguer M. Post-liver transplantation medical complications. Ann Hepatol 2006; 5: 77-85.

  8. Tessari P. Protein metabolism in liver cirrhosis: from albumin to muscle myofibrils. Curr Opin Clin Nutr Metab Care 2003; 6: 79-85.

  9. van den Berg-Emons R, van Ginneken B, Wijffels M, Tilanus H, Metselaar H, Stam H, Kazemier G. Fatigue is a major prob lem after liver transplantation. Liver Transpl 2006; 12: 928- 33.

  10. Benzing C, Krezdorn N, Hinz A, Glaesmer H, Brähler E, Förster J, Wiltberger G, et al. Mental Status in Patients Before and After Liver Transplantation. Ann Transplant 2015; 17: 683-93.

  11. American Thoracic Society Statement: 312 guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002; 166: 111-7.

  12. Arcuri JF, Borghi-Silva A, Labadessa IG, Sentanin AC, Candolo C, Pires Di Lorenzo VA. Validity and Reliability of the 6- Minute Step Test in Healthy Individuals: A Cross-sectional Study. Clin J Sport Med 2015; Epub 2015, Feb 10.

  13. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, et al. Standardisation of spirometry. Eur Respir J 2005; 26: 319-38.

  14. Pereira CAC, Sato T, Rodrigues SC. New reference values for forced spirometry in White adults in Brazil. J Bras Pneumol 2007; 33: 397-406.

  15. Green M, Road J, Sieck GC, Similowski T. Tests of Respiratory Muscle Strength. Am J Respir Crit Care Med 2002; 166: 528-47.

  16. Botega NJ, Bio MR, Zomignani MA, Garcia C, Jr., Pereira WA. Mood disorders among inpatients in ambulatory and validation of the anxiety and depression scale HAD. Rev Saúde Pública 1995; 29: 355-63.

  17. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica 1983; 67 : 361-70.

  18. Iwama AM, Andrade GN, Shima P, Tanni SE, Godoy I, Dourado VZ. The six-minute walk test and body weight-walk distance product in healthy Brazilian subjects. Braz J Med Biol Res 2009; 42: 1080-5.

  19. Arcuri JF, Borghi-Silva A, Labadessa IG, Sentanin AC, Candolo C, Pires Di Lorenzo VA. Validity and Reliability of the 6- Minute Step Test in Healthy Individuals: A Cross-sectional Study. Clin J Sport Med 2016; 26 :69-75.

  20. Mancuzo E, Pereira R, Sanches M, Mancuzo A. Pre-transplant aerobic capacity and prolonged hospitalization after liver transplantation. GE Port J Gastroenterol 2015; 22: 83-4.

  21. Bernal W, Martin-Mateos R, Lipcsey M, Tallis C, Woodsford K, McPhail MJ, Willars C, et al. Aerobic capacity cardiopulmonary exercise testing and survival without liver transplantation for patients with chronic liver disease. Liver Transplant 2014; 20: 54-62.

  22. Montano-Loza AJ, Meza-Junco J, Prado CM, Lieffers JR, Baracos VE, Bain VG, Sawyer MB. Muscle wasting is associated with mortality in patients with cirrhosis. Clin Gastroenterol Hepatol 2012; 10: 166-73.

  23. van den Berg-Emons R, Kazemier G, van Ginneken B, Nieuwenhuijsen C, Tilanus H, Stam H. Fatigue, level of everyday physical activity, and quality of life after liver transplantation. J Rehab Med 2006; 38: 124-9.

  24. VanWagner LB, Sarah Uttal S, Lapin B, Lee J, Jichlinski A, Subramanian T, Heldman M, et al. The 6-Minute Walk Test to Measure Functional Capacity After Liver Transplantation. Phys Ther 2016; 96: 1456-67.

  25. Costa D, Gonçalves HA, de Lima LP, Ike D, Cancelliero KM, Montebelo MIL. New reference values for maximal respiratory pressures in the Brazilian population. J Bras Pneumol 2010; 36: 306-12.

  26. Galant LH, Forgiarini Junior LA, Dias AS, Marroni CA. Functional status, respiratory muscle strength, and quality of life in patients with cirrhosis. Rev Bras Fisioter 2012; 16: 30-4.

  27. Paisani DM, Chiavegato LD, Faresin SM. Lung volumes, lung capacities and respiratory muscle strength following gastroplasty. J Bras Pneumol 2005; 31: 125-32.

  28. da Silva MMC, Corcha RA, Oliveira da Silva AM, Franco FJBZ, Jr., de Souza JRA, Boin IFSF. Respiratory Profile in Patients After Liver Transplantation. Transplantation Proceedings 2016; 48: 2352-5.

  29. Zhang M, Kim JC, Li Y, Shapiro BB, Porszasz J, Bross R, Feroze U. Relation between anxiety, depression, and physical activity and performance in maintenance hemodialysis patients. J Ren Nutr 2014; 24: 252-60.




2020     |     www.medigraphic.com