Resistance training increases muscle strength and muscle size in patients with liver cirrhosis
Abstract
Background & aims Cirrhosis is often complicated by reduced muscle mass and strength, which limits the ability to perform daily activities and affects quality of life. Resistance training can increase muscle strength and mass in elderly and chronically ill patients. We performed a randomized controlled trial to investigate whether resistance training increases muscle strength and size in patients with compensated cirrhosis.Methods We performed a prospective study of 39 patients with cirrhosis (Child-Pugh class A or B) seen at an outpatient clinic in Denmark from January 2015 through March 2017. Participants protein intake and activity levels were registered daily. Participants were randomly assigned (1:1) to a group that performed 36 1-hour sessions of physical exercise (supervised progressive resistance training for 1 hour, 3 times weekly for 12 weeks) or a control group (no change in daily activity level). Maximal muscle strength was measured as the peak torque in isokinetic knee extension and muscle size was measured as the cross-sectional area of the quadriceps muscle, assessed by magnetic resonance imaging of the thigh.Results The exercise group increased their muscle strength by 13% (from a mean 119 Nm to 134 Nm)-an 11 Nm greater gain in mean strength than that of the control group (P = .05). The exercise group increased their quadriceps cross-sectional area by 10% (from a mean 58.5 cm 2 to 64.6 cm 2)-a 4.4 cm 2 greater gain than that of the control group (P < .01). The exercise group had significant increases in whole-body lean mass and body cell mass, and significant increases in 6-minute walking distance and the mental component summary of the short form-36 questionnaire. Adverse events were minor and equal between groups.Conclusions In a randomized trial of patients with compensated cirrhosis, we found that 12 weeks of supervised progressive resistance training increased muscle strength and size and had beneficial effects on general performance measures, compared with patients who did not change their daily activity routine (control subjects). ClinicalTrials.gov no: NCT02343653.
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Consistent benefits of exercise demonstrated in RCTs include reversal of sarcopenia and improvements in aerobic capacity, muscle mass and strength, performance measures, health-related quality of life and hepatic venous pressure gradient.
“Consistent bene fi ts of exercise demonstrated in RCTs include reversal of sarcopenia and improvements in aerobic capacity, muscle mass and strength, performance measures, health-related quality of life and hepatic venous pressure gradient.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [460]
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- Authors
- Aamann, L., Dam, G., Borre, M., Drljevic-Nielsen, A., Overgaard, K., Andersen, H., Vilstrup, H., & Aagaard, N. K.
- Affiliations
- Aarhus University Hospital (DK)
- Aarhus University (DK)
- Corresponding author
- Aamann, Luise
- ORCID
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2020-05
- Volume
- 18
- Issue
- 5
- Pages
- 1179-1187.e6
- ISSN
- 1542-3565 (ISSN-L)
- OpenAlex
- W2964748829
- Cited by
- 108
- References
- 43
- Citations by year
- 2026: 17 · 2025: 14 · 2024: 21 · 2023: 15 · 2022: 14 · 2021: 14 · 2020: 12 · 2019: 1
- FWCI
- 7.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Helsefonden (200.000 DKK, 16-B-0133)
- TrygFonden (1.548.961 DKK, 108112)
- Aase og Ejnar Danielsens Fond (10-001650)
- Aarhus Universitet (433.000 DKK, 15921954)
- Beckett-Fonden (40552/40706, 100.000 DKK)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Keywords
- resistance training, liver cirrhosis, muscle strength, muscle mass, muscle cross-sectional area, quadriceps, isokinetic knee extension, lean body mass, body cell mass, physical activity, quality of life, functional capacity, compensated cirrhosis
- MeSH terms
- Aged, Humans, Liver Cirrhosis, Prospective Studies, Quality of Life, Quadriceps Muscle, Muscle Strength, Resistance Training
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