Patient and Caregiver Attitudes and Practices of Exercise in Candidates Listed for Liver Transplantation

Abstract

Background: Impaired physical capacity increases peri-liver transplant complications. Patient perceptions regarding exercise prior to transplantation are not known.

Aims: This study aimed to assess patient and caregiver activity levels, perceptions of willingness to exercise, and of provider advice.

Methods: Consecutive patients listed for liver transplant and caregivers presenting for routine outpatient visits were evaluated over a 3-month interval. Anonymous surveys adapted to patients and caregivers addressed the importance and safety of exercise, type and duration of exercise performed, barriers, willingness to wear a monitoring device, and perceived provider recommendations. Responses were logged on a Likert scale from 1 to 5.

Results: Three hundred and sixty-eight responses were received. Most participants perceived exercise as important. Patients exercised three times per week for 30 min. Eighty percent endorsed walking (median response: 2-agree; IQR 1-2). Most did not jog, swim, cycle, or strength train. Fatigue, reported by 70%, was the major barrier (2, IQR 1-3). Over 90% of caregivers endorsed exercise as important (1-strongly agree, IQR 1-2) and encouraged exercise (median response 2, IQR 1-2). Over 60% of patients (median response 2, IQR 1-3) and caregivers (median response 2, IQR 2-3) felt providers encouraged exercise.

Conclusions: Patients and caregivers are willing to exercise to optimize physical fitness prior to liver transplantation.

Keywords: Caregiver; Exercise; Liver transplantation; Patient; Physical capacity.

Figure 1.

Patient and caregiver perceptions of exercise. The chart displays patient perceptions of the importance of exercise, caregiver beliefs of the importance of exercise in cirrhotic patients, patient perceptions as to whether it is reasonable for a cirrhotic patient to exercise, whether the patient self-reports regular exercise, whether the patient is willing to exercise, whether the caregiver is willing to encourage exercise, and whether the patient is willing to wear and the caregiver willing to suggest the use of an exercise monitoring device.

Figure 2.

Pooled patient and caregiver perceptions of provider recommendations regarding exercise. The chart shows the percentage of respondents’ impressions of whether their provider encouraged or discouraged exercise, and whether the respondent felt provider recommendation against exercise was a barrier.