Efficacy and safety of home-based exercise in patients with sarcopenia complicated by liver cirrhosis

Objectives Sarcopenia is a common complication in patients with liver cirrhosis and is associated with reduced quality of life and poor prognosis. Exercise and nutritional therapy are recommended; however, their efficacy in patients with cirrhosis-associated sarcopenia remains unclear. This study evaluated the efficacy and safety of a home-based exercise program in this population. Methods In this prospective, single-arm study, 20 patients with cirrhosis and sarcopenia underwent a 12-week home-based program combining elastic band resistance training, walking, and nutritional therapy. The primary outcome was a change in 6-m walking speed at a normal pace. Secondary outcomes included handgrip strength, skeletal muscle index, short physical performance battery (SPPB) score, adherence, and safety. Results Seventeen participants completed the intervention. In the overall cohort, no significant improvements were observed in the walking speed, handgrip strength, skeletal muscle index, or SPPB score. In an exploratory post-hoc analysis of participants with greater than or equal to 80% adherence ( n = 12), improvements were observed in handgrip strength ( P = 0.034) and SPPB score ( P = 0.016), with a trend toward improved walking speed ( P = 0.077). Factors associated with high adherence included better lower limb function and a lower prevalence of severe sarcopenia. No serious exercise-related adverse events were observed. Conclusion The 12-week home-based exercise and nutritional intervention did not demonstrate clinically meaningful improvements in the overall cohort. Exploratory post-hoc analyses suggest potential functional benefits among participants with high adherence.