Evaluating Frailty and Exercise Capacity in Liver Cirrhosis: Comparative Insights from Field Tests

ABSTRACT

Purpose: Liver cirrhosis, a chronic disease marked by progressive liver dysfunction, leads to increased frailty and diminished physical performance. We aimed to assess frailty and exercise capacity in individuals with cirrhosis using field tests and evaluate their correlation with frailty.

Method: Participants’ demographic data and Model for End-stage Liver Disease (MELD) scores were recorded. Field tests included the Incremental Shuttle Walk Test (ISWT), 6-Minute Walk Test (6MWT), and 1-Minute Sit-to-Stand Test (1MSTST). Frailty was evaluated using the Liver Frailty Index (LFI), comprising chair stands, grip strength, and balance.

Results: Twenty-four patients were included in the study, with 85% identified as frail or pre-frail according to the LFI. A strong correlation was found between the 6MWT and ISWT (r=0.783; p<0.001), and a moderate correlation between the 6MWT and 1MSTST (r=0.604; p=0.004). The ISWT had a strong positive relationship with 1MSTST (r=0.713; p=0.001). Physical frailty scores were negatively correlated with the 6MWT (r=-0.474; p=0.035), ISWT (r=-0.582; p=0.009), and 1MSTST (r=-0.654; p=0.002). Principal component analysis (PCA) revealed component loadings in descending order: ISWT (0.956), 6MWT (0.859), and 1MSTST (0.818).

Discussion: This study identified a significant association between various field tests and frailty status in patients with liver cirrhosis. All field tests demonstrated a negative correlation with frailty. The strong correlation between the exercise tests and PCA results highlights ISWT as a key indicator of overall physical performance. These findings suggest that ISWT, along with the 6MWT and 1MSTST, can reliably assess physical frailty and exercise capacity in patients with liver cirrhosis.

Key Words: Liver cirrhosis, exercise test, frailty, physical fitness