Efficacy and safety of home-based exercise in patients with sarcopenia complicated by liver cirrhosis

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OBJECTIVES: Sarcopenia is a common complication in patients with liver cirrhosis and is associated with reduced quality of life and poor prognosis. Exercise and nutritional therapy are recommended; however, their efficacy in patients with cirrhosis-associated sarcopenia remains unclear. This study evaluated the efficacy and safety of a home-based exercise program in this population. METHODS: In this prospective, single-arm study, 20 patients with cirrhosis and sarcopenia underwent a 12-week home-based program combining elastic band resistance training, walking, and nutritional therapy. The primary outcome was a change in 6-m walking speed at a normal pace. Secondary outcomes included handgrip strength, skeletal muscle index, short physical performance battery (SPPB) score, adherence, and safety. RESULTS: Seventeen participants completed the intervention. In the overall cohort, no significant improvements were observed in the walking speed, handgrip strength, skeletal muscle index, or SPPB score. In an exploratory post-hoc analysis of participants with greater than or equal to 80% adherence ( n = 12), improvements were observed in handgrip strength ( P = 0.034) and SPPB score ( P = 0.016), with a trend toward improved walking speed ( P = 0.077). Factors associated with high adherence included better lower limb function and a lower prevalence of severe sarcopenia. No serious exercise-related adverse events were observed. CONCLUSION: The 12-week home-based exercise and nutritional intervention did not demonstrate clinically meaningful improvements in the overall cohort. Exploratory post-hoc analyses suggest potential functional benefits among participants with high adherence.

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