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A Multicenter Pilot Randomized Clinical Trial of a Home-Based Exercise Program for Patients With Cirrhosis: The Strength Training Intervention (STRIVE).

Publication ,  Journal Article
Lai, JC; Dodge, JL; Kappus, MR; Wong, R; Mohamad, Y; Segev, DL; McAdams-DeMarco, M
Published in: Am J Gastroenterol
April 2021

INTRODUCTION: We developed the strength training intervention (STRIVE), a home-based exercise program targeting physical function in patients with cirrhosis. In this pilot study, we aimed to evaluate the safety and efficacy of STRIVE. METHODS: Eligible were adult patients with cirrhosis at 3 sites. Patients were randomized 2:1-12 weeks of STRIVE, a 30-minute strength training video plus a health coach or standard of care (SOC). Physical function and quality of life were assessed using the Liver Frailty Index (LFI) and Chronic Liver Disease Questionnaire (CLDQ), respectively. RESULTS: Fifty-eight and 25 were randomized to STRIVE and SOC arms, respectively: 43% women, median age was 61 years, MELDNa, Model for End-Stage Liver Disease Sodium was 14, and 54% were Child-Pugh B/C. Baseline characteristics were similar in the STRIVE vs SOC arms except for rates of hepatic encephalopathy (19 vs 36%). LFI @ 12 weeks was available in 43 STRIVE and 20 SOC participants. After 12 weeks, the median LFI improved from 3.8 to 3.6 (ΔLFI -0.1) in the STRIVE arm and 3.7 to 3.6 (ΔLFI -0.1) in the SOC arm (P = 0.65 for ΔLFI difference). CLDQ scores improved from 4.6 to 5.2 in STRIVE participants (ΔCLDQ 0.38) and did not change in SOC participants (4.2-4.2; ΔCLDQ -0.03) (P = 0.09 for ΔCLDQ difference). One patient died (SOC arm) of bleeding. Only 14% of STRIVE participants adhered to the strength training video for 10-12 weeks. No adverse events were reported by STRIVE participants. DISCUSSION: STRIVE, a home-based structured exercise program for patients with cirrhosis, was safely administered at 3 sites, but adherence was low. Although all participants showed minimal improvement in the LFI, STRIVE was associated with a substantial improvement in quality of life.

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Published In

Am J Gastroenterol

DOI

EISSN

1572-0241

Publication Date

April 2021

Volume

116

Issue

4

Start / End Page

717 / 722

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surveys and Questionnaires
  • Severity of Illness Index
  • Resistance Training
  • Quality of Life
  • Pilot Projects
  • Middle Aged
  • Male
  • Liver Cirrhosis
  • Humans
 

Citation

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Chicago
ICMJE
MLA
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Lai, J. C., Dodge, J. L., Kappus, M. R., Wong, R., Mohamad, Y., Segev, D. L., & McAdams-DeMarco, M. (2021). A Multicenter Pilot Randomized Clinical Trial of a Home-Based Exercise Program for Patients With Cirrhosis: The Strength Training Intervention (STRIVE). Am J Gastroenterol, 116(4), 717–722. https://doi.org/10.14309/ajg.0000000000001113
Lai, Jennifer C., Jennifer L. Dodge, Matthew R. Kappus, Randi Wong, Yara Mohamad, Dorry L. Segev, and Mara McAdams-DeMarco. “A Multicenter Pilot Randomized Clinical Trial of a Home-Based Exercise Program for Patients With Cirrhosis: The Strength Training Intervention (STRIVE).Am J Gastroenterol 116, no. 4 (April 2021): 717–22. https://doi.org/10.14309/ajg.0000000000001113.
Lai JC, Dodge JL, Kappus MR, Wong R, Mohamad Y, Segev DL, et al. A Multicenter Pilot Randomized Clinical Trial of a Home-Based Exercise Program for Patients With Cirrhosis: The Strength Training Intervention (STRIVE). Am J Gastroenterol. 2021 Apr;116(4):717–22.
Lai, Jennifer C., et al. “A Multicenter Pilot Randomized Clinical Trial of a Home-Based Exercise Program for Patients With Cirrhosis: The Strength Training Intervention (STRIVE).Am J Gastroenterol, vol. 116, no. 4, Apr. 2021, pp. 717–22. Pubmed, doi:10.14309/ajg.0000000000001113.
Lai JC, Dodge JL, Kappus MR, Wong R, Mohamad Y, Segev DL, McAdams-DeMarco M. A Multicenter Pilot Randomized Clinical Trial of a Home-Based Exercise Program for Patients With Cirrhosis: The Strength Training Intervention (STRIVE). Am J Gastroenterol. 2021 Apr;116(4):717–722.

Published In

Am J Gastroenterol

DOI

EISSN

1572-0241

Publication Date

April 2021

Volume

116

Issue

4

Start / End Page

717 / 722

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surveys and Questionnaires
  • Severity of Illness Index
  • Resistance Training
  • Quality of Life
  • Pilot Projects
  • Middle Aged
  • Male
  • Liver Cirrhosis
  • Humans