Relationship between Daily Physical Activity and Muscle Cramping in Elderly Liver Cirrhosis Patients: A Multicenter Study

Objective Sarcopenia is a common secondary muscle-related complication observed in patients with chronic liver disease (CLD), along with muscle cramping. The present study aimed to assess the daily activity levels to explore the relationship between the number of steps taken and muscle cramping in patients with liver cirrhosis (LC) in Japan. Methods Fifty patients were enrolled (male 25, Child-Pugh A, B=42:8). Daily steps were recorded over six months using a pedometer, and seasonal sub-analyses were performed. Sarcopenia was diagnosed in accordance with the guidelines of the Japan Society of Hepatology. Results The median number of steps per day was 3,881, with no significant seasonal differences. Muscle cramping, reduced handgrip strength and sarcopenia were noted in 66.0%, 34.0% and 23.9% of the patients, respectively. However, no significant relationships were found between muscle cramping, handgrip strength, and the average number of steps per day. Although no significant differences in daily steps were noted in the comparisons of patients with varying degrees of hepatic function or the sarcopenia status, those with muscle cramping had a worse modified ALBI grade (≥2b) than those without (42.4% vs. 5.9%, p=0.009). The median average number of steps per day was not significantly different between the patients with and without muscle cramping (3,673 vs. 4,775, p=0.292). Conclusion The present study revealed that the average number of steps per day in LC patients is low. Although no significant relationship between daily activity and muscle cramping was observed, the establishment of appropriate intervention strategies to maintain daily activity and prevent sarcopenia progression is urgently required.