Nutritional and functional rehabilitation in cirrhotic patients

Natália Perin Schmidt, Sabrina Alves Fernandes, Andresa Thomé Silveira, Roberta Goulart Rayn, Ana Cristhina Henz, Danusa Rossi, Lucas Homercher Galant, Cláudio Augusto Marroni

Abstract


Introduction: Cirrhotic people often have impaired nutritional and functional status. Objective: To evaluate the effect of multidisciplinary rehabilitation on cirrhotic patients. Method: Controlled clinical trial conducted at the Gastroenterology Ambulatory in southern Brazil, involving 33 patients with liver cirrhosis, through a multidisciplinary rehabilitation program, distributed into the groups: nutritional intervention (n=22) and functional and nutritional rehabilitation (n=11). Nutritional orientation according to European Society for Clinical Nutrition and Metabolism (ESPEN) Guideline. Functional intervention, during a period of 3 months, three weekly sessions of up to fifty minutes of exercise. Clinical and etiological characteristics, Child Pugh, nutritional, anthropometric and functional aspects were collected. Significant associations values were considered when p<0,05.Results: Mostly male patients (60,6%), average age 58 years (± 11,9 years), prevalence of cryptogenic etiology, Child-Pugh A, well-nourished subjective global assessment (SGA). Significant changes in the parameters abdominal circumference (ABC) (p<0,049), muscular arm circumference (MAC) (p <0,001),six-minute walk test (6mWT) (p<0,001) between the groups, with significant improvement in multidisciplinary rehabilitation. Significant improvement in the indirect parameters of sarcopenia, handshake strength (HS) (p<0,008) and 6mWT (p<0,001), especially in the group with functional and nutritional rehabilitation. Body composition revealed a significant change in multidisciplinary rehabilitation, in Weight (p<0,001), BMI (p<0,001), Phase Angle (PA) (p<0,036), ABC (p<0,002), MAC (p<0,001) and thumb adductor muscle (TAM) (p<0,030), which was not observed in the nutritional intervention group.Conclusion: The multidisciplinary intervention shows positive results, as observed, where the group with the functional and nutritional rehabilitation activity was superior to the group with the isolated nutritional intervention.


Keywords


Liver cirrhosis; Rehabilitation; Nutritional assessment; Sarcopenia

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