Impact of structured exercise-based regimen on frailty in pediatric cirrhosis: A randomized controlled trial.
Deepika Yadav, Jaya Benjamin, Rakesh Kumar et al.
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In 30 seconds
This randomized controlled pilot trial assessed a structured exercise regimen in children aged 9–18 years with cirrhotic liver disease and frailty, comparing exercise plus standard medical therapy (SMT) with SMT alone. The regimen combined aerobic and resistance exercise for at least 50 minutes per day, 3–5 days weekly, over 24 weeks. Frailty-score improvement was significantly greater with exercise at 12 and 24 weeks (p < 0.001); frailty scores below 5 were reached by 85% versus 37% at 24 weeks. Exercise was also associated with improved skeletal muscle mass and reduced myostatin at 12 weeks.
Key findings
- Frailty-score change favored exercise plus SMT over SMT alone at 12 and 24 weeks (p < 0.001).
- Frailty score <5 was achieved by 60% and 85% of the exercise group at 12 and 24 weeks, versus 32% and 37% with SMT alone.
- At 12 weeks, myostatin reduction was greater with exercise (p = 0.02), and skeletal muscle mass and phase angle improved significantly.
Why it matters
Frailty and reduced muscle mass are relevant functional concerns in children with cirrhotic liver disease. This trial suggests that a structured aerobic and resistance programme may improve frailty measures and body-composition outcomes alongside standard therapy. The findings provide preliminary evidence for studying exercise as part of supportive care, while the pilot design and need for larger trials limit conclusions about sustained benefit.
What to keep in mind
This was a pilot trial with 46 participants and 24 weeks of exercise follow-up; the authors state that larger trials are needed to assess long-term benefits.