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Management of the Extrahepatic Symptoms of Chronic Hepatitis C: Feasibility of a Randomized Controlled Trial of Exercise

McKenna, Olivia BSc Physio, PhD; Cunningham, Caitriona BSc Physio, PhD; Gissane, Conor BSc Physio, PhD; Blake, Catherine BSc Physio, PhD

American Journal of Physical Medicine & Rehabilitation: June 2013 - Volume 92 - Issue 6 - p 504–512
doi: 10.1097/PHM.0b013e31828cd500
Original Research Articles

Objective The aim of this study was to explore the feasibility and the efficacy of a physiotherapy-led exercise program in changing the health status of a sample of patients with chronic hepatitis C.

Design A single-blind randomized controlled trial was conducted in a sample of patients with iatrogenically acquired hepatitis C in Ireland. Twenty-two participants were recruited and randomly assigned to exercise (n = 10) and control (n = 12) groups. Both groups received a generic exercise advice leaflet, and the exercise group attended 12 exercise sessions for 6 wks. A battery of physical performance measures and patient-reported outcome measures were assessed at baseline and 6 wks, with 1-yr follow-up of the self-reported measures.

Results Significant group by time interactions during the 6-wk period were found for pain (F1,20 = 5.15, P = 0.034), grip strength (F1,20 = 5.94, P = 0.024), aerobic capacity (F 1,20 = 5.73, P = 0.024), and depression (F1,20 = 6.16, P = 0.022), with the exercise group showing greater positive change. The exercise group also had superior gains in the 36-Item Short-Form Health Survey vitality and social function scores (P < 0.05). The short-term gains were not sustained at 1 yr.

Conclusions This pilot study shows the feasibility of exercise in hepatitis C management, improving physical fitness, psychologic function, and quality-of-life without worsening symptoms in the short term.

From the Department of Physiotherapy, Mid-Western Regional Hospitals, Limerick, Ireland (OM); School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield, Dublin, Ireland (OM, CC, CB); and Directorate of Sports Rehabilitation, St Mary’s University College, Twickenham, London, England (CG).

All correspondence and requests for reprints should be addressed to Olivia McKenna, Mid Western Regional Hospitals, Limerick, Ireland.

Supported, in full, by funds from the Primary Care Unit of the Health Service Executive Mid-West Area, Ireland.

Olivia McKenna contributed to the study conception and design; conducted the actual study, data analysis, and interpretation; wrote and critically revised the article’s intellectual content; and approved the final draft. Caitriona Cunningham contributed to data interpretation, wrote and critically revised the article, and approved the final draft. Conor Gissane helped develop the analytic strategy, conducted data analysis and interpretation, and approved the final draft. Catherine Blake supervised the research study, with the responsibility of developing the study concept and design, deciding on the analytic strategy, writing the article, and approving the final draft.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2013 by Lippincott Williams & Wilkins