Effectiveness of Home-Based Exercise Therapy on Quality of Life and Depression in Orthotopic Liver Transplantation Recipients
-
Mohammad Javaherian
,
Ali Parouhan
,
Mohsen Nasiri Toosi
,
Ali Jafarian
,
Seyede Zahra Emami-Razavi
,
Mohaddeseh Azadvari
,
Sedighe Hosseini Shabanan
,
Mohammad Eghbal Heidari
Abstract
Background: Liver transplantation can change the quality of life, physical activity, mood, and psychological symptoms in patients. As exercise capacity is correlated to the level of depression and quality of life among patients.
Objective: This study aimed to investigate the effect of exercise therapy on the quality of life and depression in Orthotopic liver transplantation recipients (LTRs).
Methods: This study was a single-blinded, randomized controlled trial parallel groups, and thirty LTRs were randomly assigned in a 1:1 ratio. The experimental group underwent a three-month home-based exercise therapy, while the control group received no exercise therapy. Assessments included Short Form-36 (SF-36) and Beck Depression questionnaires, along with the 6-Minute Walk Test (6MWT).
Results: There was no significant difference between groups in demographic characteristics. Before the intervention, the mean score of depression in the intervention and control groups were 27.87 (8.68) and 25.77 (6.77), respectively. After the intervention, t-test revealed a significant difference between the two groups (p = 0.001). The results of t-test indicated that the average quality of life dimensions improved post-intervention compared to the control group, with significant differences in the scores of these dimensions. After the intervention, the t-test showed a significant difference between the two groups in terms of 6MWT (p = 0.001).
Conclusion: According to the findings of this study, rehabilitation through prescribed exercise can improve quality of life and physical activity, and alleviate depression symptoms in LTRs. As a result, incorporating physiotherapy into the post-transplantation care of transplant recipients holds potential benefits.
1. Younossi ZM, Marchesini G, Pinto-Cortez H, Petta S. Epidemiology of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis: implications for liver transplantation. Transplantation. 2019;103(1):22-7.
2. Stiavetti E, Ghinolfi D, Pasetti P, Bocchi F, Filipponi F, editors. Analysis of patients' needs after liver transplantation in Tuscany: a prevalence study. Transplantation Proceedings; 2013: Elsevier.
3. Wang S, Toy M, Hang Pham TT, So S. Causes and trends in liver disease and hepatocellular carcinoma among men and women who received liver transplants in the US, 2010-2019. PloS one. 2020;15(9):e0239393.
4. Goosmann L, Buchholz A, Bangert K, Fuhrmann V, Kluge S, Lohse AW, et al. Liver transplantation for acute‐on‐chronic liver failure predicts post‐transplant mortality and impaired long‐term quality of life. Liver International. 2021;41(3):574-84.
5. Sundaram V, Jalan R, Wu T, Volk ML, Asrani SK, Klein AS, et al. Factors associated with survival of patients with severe acute-on-chronic liver failure before and after liver transplantation. Gastroenterology. 2019;156(5):1381-91. e3.
6. Weiss N, Thabut D. Neurological complications occurring after liver transplantation: role of risk factors, hepatic encephalopathy, and acute (on chronic) brain injury. Liver Transplantation. 2019;25(3):469-87.
7. Moy BT, Birk JW. A review on the management of biliary complications after orthotopic liver transplantation. Journal of clinical and translational hepatology. 2019;7(1):61.
8. Abd El Naby SY, Mahmoud BH, Raouf AAE, Ramadan SS. Health Related Quality of Life for Patients with Liver Transplantation. Journal of Survey in Fisheries Sciences. 2023;10(3S):2350-61.
9. Ghelichi-Ghojogh M, Javanian M, Amiri S, Vali M, Sedighi S, Rajabi A, et al. The survival rate of liver transplantation in children: a systematic review and meta-analysis. Pediatric Surgery International. 2022;38(9):1177-86.
10. Åberg F. Quality of life after liver transplantation. Best Practice & Research Clinical Gastroenterology. 2020;46:101684.
11. Dunn MA, Rogal SS, Duarte‐Rojo A, Lai JC. Physical function, physical activity, and quality of life after liver transplantation. Liver Transplantation. 2020;26(5):702-8.
12. Masala D, Mannocci A, Unim B, Del Cimmuto A, Turchetta F, Gatto G, et al., editors. Quality of life and physical activity in liver transplantation patients: results of a case-control study in Italy. Transplantation proceedings; 2012: Elsevier.
13. Cannesson A, Boleslawski E, Declerck N, Mathurin P, Pruvot FR, Dharancy S. Daily life, pregnancy, and quality of life after liver transplantation. Presse Medicale (Paris, France: 1983). 2009;38(9):1319-24.
14. Bownik H, Saab S. Health-related quality of life after liver transplantation for adult recipients. Liver transplantation: official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 2009;15:S42-9.
15. Kober B, Küchler T, Broelsch C, Kremer B, Henne-Bruns D. A psychological support concept and quality of life research in a liver transplantation program: an interdisciplinary multicenter study. Psychotherapy and Psychosomatics. 1990;54(2-3):117-31.
16. Annema C, Roodbol PF, Stewart RE, Porte RJ, Ranchor AV. Prevalence of psychological problems and associated transplant‐related variables at different time periods after liver transplantation. Liver Transplantation. 2015;21(4):524-38.
17. Mullish BH, Kabir MS, Thursz MR, Dhar A. depression and the use of antidepressants in patients with chronic liver disease or liver transplantation. Alimentary pharmacology & therapeutics. 2014;40(8):880-92.
18. van den Berg-Emons RJ, van Ginneken BT, Nooijen CF, Metselaar HJ, Tilanus HW, Kazemier G, et al. Fatigue after liver transplantation: effects of a rehabilitation program including exercise training and physical activity counseling. Physical therapy. 2014;94(6):857-65.
19. Van Ginneken B, Van Den Berg-Emons H, Metselaar H, Tilanus H, Kazemier G, Stam H. Effects of a rehabilitation programme on daily functioning, participation, health-related quality of life, anxiety and depression in liver transplant recipients. Disability and rehabilitation. 2010;32(25):2107-12.
20. Jay CL, Butt Z, Ladner DP, Skaro AI, Abecassis MM. A review of quality of life instruments used in liver transplantation. Journal of hepatology. 2009;51(5):949-59.
21. Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The Short Form Health Survey (SF-36): translation and validation study of the Iranian version. Quality of life research. 2005;14:875-82.
22. Jackson-Koku G. Beck depression inventory. Occupational Medicine. 2016;66(2):174-5.
23. Foroncewicz B, Mucha K, Szparaga B, Raczyńska J, Ciszek M, Pilecki T, et al., editors. Rehabilitation and 6-minute walk test after liver transplantation. Transplantation proceedings; 2011: Elsevier.
24. Magalhães CBDA, Bezerra PC, Cardoso MEDS, Garcia JHP, Viana CF, Morano MTAP, et al., editors. The Effect of a Comprehensive Rehabilitation Program on Respiratory Function and Functional Capacity on Patients After 1 Month to Liver Transplantation. Transplantation Proceedings; 2023: Elsevier.
25. Totti V, Tamè M, Burra P, Mosconi G, Roi GS, Sella G, et al., editors. Physical condition, glycemia, liver function, and quality of life in liver transplant recipients after a 12-month supervised exercise program. Transplantation proceedings; 2019: Elsevier.
26. Ergene TY, Karadibak D, Dönmez R, Polat KY. Effects of Early Resistance Training After Liver Transplantation Procedures: A Randomized Controlled Pilot Trial. 2022.
27. Tome S, Wells JT, Said A, Lucey MR. Quality of life after liver transplantation. A systematic review. Journal of Hepatology. 2008;48(4):567-77.
28. Bravata DM, Olkin I, Barnato AE, Keeffe EB, Owens DK. Health‐related quality of life after liver transplantation: A meta‐analysis. Liver transplantation and surgery. 1999;5(4):318-31.
29. Onghena L, Develtere W, Poppe C, Geerts A, Troisi R, Vanlander A, et al. Quality of life after liver transplantation: State of the art. World journal of hepatology. 2016;8(18):749.
30. Estraviz B, Quintana JM, Valdivieso A, Bilbao A, Padierna A, De Urbina JO, et al. Factors influencing change in health‐related quality of life after liver transplantation. Clinical transplantation. 2007;21(4):481-99.
31. Wells A, Reeves D, Capobianco L, Heal C, Davies L, Heagerty A, et al. Improving the effectiveness of psychological interventions for depression and anxiety in cardiac rehabilitation: PATHWAY—a single-blind, parallel, randomized, controlled trial of group metacognitive therapy. Circulation. 2021;144(1):23-33.
32. Wells A, McNicol K, Reeves D, Salmon P, Davies L, Heagerty A, et al. Improving the effectiveness of psychological interventions for depression and anxiety in the cardiac rehabilitation pathway using group-based metacognitive therapy (PATHWAY Group MCT): study protocol for a randomised controlled trial. Trials. 2018;19(1):1-12.
33. Enright PL. The six-minute walk test. Respiratory care. 2003;48(8):783-5.
34. Debette-Gratien M, Tabouret T, Antonini M-T, Dalmay F, Carrier P, Legros R, et al. Personalized adapted physical activity before liver transplantation: acceptability and results. Transplantation. 2015;99(1):145-50.
2. Stiavetti E, Ghinolfi D, Pasetti P, Bocchi F, Filipponi F, editors. Analysis of patients' needs after liver transplantation in Tuscany: a prevalence study. Transplantation Proceedings; 2013: Elsevier.
3. Wang S, Toy M, Hang Pham TT, So S. Causes and trends in liver disease and hepatocellular carcinoma among men and women who received liver transplants in the US, 2010-2019. PloS one. 2020;15(9):e0239393.
4. Goosmann L, Buchholz A, Bangert K, Fuhrmann V, Kluge S, Lohse AW, et al. Liver transplantation for acute‐on‐chronic liver failure predicts post‐transplant mortality and impaired long‐term quality of life. Liver International. 2021;41(3):574-84.
5. Sundaram V, Jalan R, Wu T, Volk ML, Asrani SK, Klein AS, et al. Factors associated with survival of patients with severe acute-on-chronic liver failure before and after liver transplantation. Gastroenterology. 2019;156(5):1381-91. e3.
6. Weiss N, Thabut D. Neurological complications occurring after liver transplantation: role of risk factors, hepatic encephalopathy, and acute (on chronic) brain injury. Liver Transplantation. 2019;25(3):469-87.
7. Moy BT, Birk JW. A review on the management of biliary complications after orthotopic liver transplantation. Journal of clinical and translational hepatology. 2019;7(1):61.
8. Abd El Naby SY, Mahmoud BH, Raouf AAE, Ramadan SS. Health Related Quality of Life for Patients with Liver Transplantation. Journal of Survey in Fisheries Sciences. 2023;10(3S):2350-61.
9. Ghelichi-Ghojogh M, Javanian M, Amiri S, Vali M, Sedighi S, Rajabi A, et al. The survival rate of liver transplantation in children: a systematic review and meta-analysis. Pediatric Surgery International. 2022;38(9):1177-86.
10. Åberg F. Quality of life after liver transplantation. Best Practice & Research Clinical Gastroenterology. 2020;46:101684.
11. Dunn MA, Rogal SS, Duarte‐Rojo A, Lai JC. Physical function, physical activity, and quality of life after liver transplantation. Liver Transplantation. 2020;26(5):702-8.
12. Masala D, Mannocci A, Unim B, Del Cimmuto A, Turchetta F, Gatto G, et al., editors. Quality of life and physical activity in liver transplantation patients: results of a case-control study in Italy. Transplantation proceedings; 2012: Elsevier.
13. Cannesson A, Boleslawski E, Declerck N, Mathurin P, Pruvot FR, Dharancy S. Daily life, pregnancy, and quality of life after liver transplantation. Presse Medicale (Paris, France: 1983). 2009;38(9):1319-24.
14. Bownik H, Saab S. Health-related quality of life after liver transplantation for adult recipients. Liver transplantation: official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 2009;15:S42-9.
15. Kober B, Küchler T, Broelsch C, Kremer B, Henne-Bruns D. A psychological support concept and quality of life research in a liver transplantation program: an interdisciplinary multicenter study. Psychotherapy and Psychosomatics. 1990;54(2-3):117-31.
16. Annema C, Roodbol PF, Stewart RE, Porte RJ, Ranchor AV. Prevalence of psychological problems and associated transplant‐related variables at different time periods after liver transplantation. Liver Transplantation. 2015;21(4):524-38.
17. Mullish BH, Kabir MS, Thursz MR, Dhar A. depression and the use of antidepressants in patients with chronic liver disease or liver transplantation. Alimentary pharmacology & therapeutics. 2014;40(8):880-92.
18. van den Berg-Emons RJ, van Ginneken BT, Nooijen CF, Metselaar HJ, Tilanus HW, Kazemier G, et al. Fatigue after liver transplantation: effects of a rehabilitation program including exercise training and physical activity counseling. Physical therapy. 2014;94(6):857-65.
19. Van Ginneken B, Van Den Berg-Emons H, Metselaar H, Tilanus H, Kazemier G, Stam H. Effects of a rehabilitation programme on daily functioning, participation, health-related quality of life, anxiety and depression in liver transplant recipients. Disability and rehabilitation. 2010;32(25):2107-12.
20. Jay CL, Butt Z, Ladner DP, Skaro AI, Abecassis MM. A review of quality of life instruments used in liver transplantation. Journal of hepatology. 2009;51(5):949-59.
21. Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The Short Form Health Survey (SF-36): translation and validation study of the Iranian version. Quality of life research. 2005;14:875-82.
22. Jackson-Koku G. Beck depression inventory. Occupational Medicine. 2016;66(2):174-5.
23. Foroncewicz B, Mucha K, Szparaga B, Raczyńska J, Ciszek M, Pilecki T, et al., editors. Rehabilitation and 6-minute walk test after liver transplantation. Transplantation proceedings; 2011: Elsevier.
24. Magalhães CBDA, Bezerra PC, Cardoso MEDS, Garcia JHP, Viana CF, Morano MTAP, et al., editors. The Effect of a Comprehensive Rehabilitation Program on Respiratory Function and Functional Capacity on Patients After 1 Month to Liver Transplantation. Transplantation Proceedings; 2023: Elsevier.
25. Totti V, Tamè M, Burra P, Mosconi G, Roi GS, Sella G, et al., editors. Physical condition, glycemia, liver function, and quality of life in liver transplant recipients after a 12-month supervised exercise program. Transplantation proceedings; 2019: Elsevier.
26. Ergene TY, Karadibak D, Dönmez R, Polat KY. Effects of Early Resistance Training After Liver Transplantation Procedures: A Randomized Controlled Pilot Trial. 2022.
27. Tome S, Wells JT, Said A, Lucey MR. Quality of life after liver transplantation. A systematic review. Journal of Hepatology. 2008;48(4):567-77.
28. Bravata DM, Olkin I, Barnato AE, Keeffe EB, Owens DK. Health‐related quality of life after liver transplantation: A meta‐analysis. Liver transplantation and surgery. 1999;5(4):318-31.
29. Onghena L, Develtere W, Poppe C, Geerts A, Troisi R, Vanlander A, et al. Quality of life after liver transplantation: State of the art. World journal of hepatology. 2016;8(18):749.
30. Estraviz B, Quintana JM, Valdivieso A, Bilbao A, Padierna A, De Urbina JO, et al. Factors influencing change in health‐related quality of life after liver transplantation. Clinical transplantation. 2007;21(4):481-99.
31. Wells A, Reeves D, Capobianco L, Heal C, Davies L, Heagerty A, et al. Improving the effectiveness of psychological interventions for depression and anxiety in cardiac rehabilitation: PATHWAY—a single-blind, parallel, randomized, controlled trial of group metacognitive therapy. Circulation. 2021;144(1):23-33.
32. Wells A, McNicol K, Reeves D, Salmon P, Davies L, Heagerty A, et al. Improving the effectiveness of psychological interventions for depression and anxiety in the cardiac rehabilitation pathway using group-based metacognitive therapy (PATHWAY Group MCT): study protocol for a randomised controlled trial. Trials. 2018;19(1):1-12.
33. Enright PL. The six-minute walk test. Respiratory care. 2003;48(8):783-5.
34. Debette-Gratien M, Tabouret T, Antonini M-T, Dalmay F, Carrier P, Legros R, et al. Personalized adapted physical activity before liver transplantation: acceptability and results. Transplantation. 2015;99(1):145-50.
| Issue | Articles in Press | |
| Section | Research Article(s) | |
| Keywords | ||
| Physical and Rehabilitation Medicine, quality of life, Depression, Orthotopic Liver transplantation | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Javaherian M, Parouhan A, Nasiri Toosi M, Jafarian A, Emami-Razavi SZ, Azadvari M, Hosseini Shabanan S, Heidari ME. Effectiveness of Home-Based Exercise Therapy on Quality of Life and Depression in Orthotopic Liver Transplantation Recipients. jmr. 2025;(-).
