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Clinical Relevance of a Balance Training Program on Liver Transplant Patients. A Randomized Controlled Trial

Moya-Nájera, Diego1; Moya-Herraiz, Ángel, PhD2; Gargallo, Pedro3; Calatayud, Joaquin, PhD1; Escrig-Sos, Javier, PhD4; Colado, Juan C., PhD1,3

doi: 10.1097/TP.0000000000002415
Original Clinical Science—Liver

Background. Although some studies have reported significant improvements in physical function and strength after training programs on liver transplant (LT) recipients, there is a lack of knowledge on how it affects in static and dynamic balance, being an important part of these participants’ tasks development. The aim of the study was to determine the effects of a 6-month multicomponent circuit training program on static and dynamic balance in LT participants.

Methods. Fifty-four participants were randomized at 6 months after LT into 2 groups: exercise (EXER) group and control (CONTROL) group, with repeat testing at 6 (baseline) and 12 months after LT. The intervention consisted of a multicomponent training, including balance, strength, endurance, and flexibility training, with exercises arranged in a circuit setup and a moderate intensity with high perceived exertion. Training sessions were performed in the hospital facilities with qualified trainers. To determine differences over time between EXER and CONTROL, mixed-regression linear models with subject variable as random factor and variables of treatment duration, type, and interaction as predictors were used.

Results. The EXER group showed significant differences (P < 0.05) compared with CONTROL in all variables of static and dynamic balance, hip strength (49% versus 13%), agility (−16% versus −1%), and flexibility (78% versus −26%). Adherence to the intervention was 94%, and 80% of the participants continued voluntarily training after the 6 months.

Conclusions. This study demonstrated that a multicomponent circuit training program at a moderate intensity with high perceived exertion could reduce the probability of injuries because it improves balance on LT recipients.

1 Research Unit in Sport and Health, University of Valencia, Valencia, Spain.

2 Hepatobiliopancreatic Surgery and Transplant Unit, University and Politechnic Hospital La Fe of Valencia, Valencia, Spain.

3 Research Group in Prevention and Health in Exercise and Sport, University of Valencia, Valencia, Spain.

4 Castellón de la Plana Hospital, Castellón, Spain.

Received 5 July 2018. Revision received 1 August 2018.

Accepted 7 August 2018.

The authors declare no funding or conflicts of interest.

D.M.-N. contributed to design and study preparation, participants’ recruitment, training instruction, data acquisition (or data collection) of physical tests, data interpretation, and drafting the article. Á.M.-H. contributed to the design and study preparation, participants’ recruitment, data interpretation, and revising the article. P.G. contributed to training instruction and data acquisition of physical tests and helped to draft and revise the article. J.C. contributed to design study, data acquisition of physical tests, and revising the article. J.E. performed the statistical analysis and data interpretation. J.C.C. contributed to design study, supervision of the project, data interpretation, and revising the article.

All authors read and approved the final article.

Correspondence: Juan C. Colado, PhD, Department of Physical Education and Sports, University of Valencia, C/Gascó Oliag 3, 46010 Valencia, Spain. (

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