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Review
. 2023 Feb 23;13(3):330.
doi: 10.3390/metabo13030330.

Therapeutic Physical Exercise Programs in the Context of NASH Cirrhosis and Liver Transplantation: A Systematic Review

Marwin A Farrugia  1 , Sebastien Le Garf  2 , Andrea Chierici  3 , Thierry Piche  4 , Philippe Gual  5 , Antonio Iannelli  6 , Rodolphe Anty  1
Affiliations
Review

Therapeutic Physical Exercise Programs in the Context of NASH Cirrhosis and Liver Transplantation: A Systematic Review

Marwin A Farrugia et al. Metabolites. .

Abstract

In recent years, various physical exercise interventions have been developed with a view to reducing comorbidity and morbidity rates among patients with chronic diseases. Regular physical exercise has been shown to reduce hypertension and mortality in patients with type 2 diabetes. Diabetes and obesity are often associated with the development of nonalcoholic fatty liver disease, which can lead to liver fibrosis and then (in some cases) nonalcoholic steatohepatitis cirrhosis. We searched the literature for publications on personalized physical exercise programs in cirrhotic patients before and after liver transplantation. Eleven studies in cirrhotic patients and one study in liver transplant recipients were included in the systematic review, the results of which were reported in compliance with the preferred reporting items for systematic reviews and meta-analyses guidelines. The personalized physical exercise programs lasted for 6 to 16 weeks. Our review evidenced improvements in peak oxygen consumption and six-minute walk test performance and a reduction in the hepatic venous pressure gradient. In cirrhotic patients, personalized physical exercise programs improve quality of life, are not associated with adverse effects, and (for transplant recipients) might reduce the 90-day hospital readmission rate. However, none of the literature data evidenced reductions in the mortality rates before and after transplantation. Further prospective studies are needed to evaluate the benefit of long-term physical exercise programs in cirrhotic patients before and after liver transplantation.

Keywords: NAFLD; NASH cirrhosis; liver transplant recipients; physical activity; type 2 diabetes.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Summary of the possible treatment effects of PA in overweight or obese individuals (particularly those with NASH cirrhosis). NAFLD: non-alcoholic fatty liver disease; NASH: nonalcoholic steatohepatitis; GIP: glucose-dependent insulinotropic polypeptide; GLP-1: glucagon-like peptide-1.
Figure 2
Figure 2
Flow diagram of the systematic review.
See this image and copyright information in PMC

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