Nutritional and functional rehabilitation in cirrhotic patients
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.
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