Advanced exercise intervention for liver cirrhosis and sarcopenia: A development and feasibility study

Sarcopenia is a risk factor for poor survival outcomes in patients with liver cirrhosis. This study aimed to construct an advanced exercise program for patients with liver cirrhosis and sarcopenia and verify its preliminary application effect. A preliminary draft of the advanced exercise program was developed through literature review. The Delphi method was employed to obtain inputs from 10 experts, yielding the final draft. A convenience sample of patients with liver cirrhosis and sarcopenia admitted to the Interventional Department of our hospital was enrolled (September-December 2022). The control group received standard nursing care during hospitalization and maintained their preexisting lifestyle post-discharge. The experimental group implemented the advanced exercise program. The safety, feasibility, and effectiveness of the intervention program were evaluated. Following 2 rounds of inquiry, the opinions of the 10 experts tended to be consistent (expert authority coefficient: 0.895). The coefficients of variation for the first and second rounds of expert inquiry items were 0.10 to 0.27 and 0.06 to 0.16, respectively. The final intervention plan included 5 primary, 16 secondary, and 35 tertiary items. Thirty-two patients completed the 12-week trial. Experimental group showed significant improvements in muscle mass, muscle strength, physical function, and quality of life compared to the control group. No adverse events were reported in either group. The advanced exercise program for patients with liver cirrhosis and sarcopenia demonstrated safety, ease of implementation, and high operational feasibility. Preliminary validation demonstrated its effectiveness in improving muscle mass, strength, physical function, and quality of life.