Aerobic Capacity Muscle Strength and Health Related Quality of Life in Children With Chronic Liver Disease

Cairo University18 enrolled

Overview

Physical therapy program for children with chronic liver disease consist of gait training, strengthening ex for UL\&ll, stretching exercise to improve physical fitness and quality of life

Intervention study for one group of children diagnosed with chronic liver disease ages more than 6ys, study include assessment and intervention, assessment of 6MWt, grip strength by hand held dynamometer, quadriceps strength by Lafayette, al children subjected to laboratory investigation pre and post of study completion, anthropometric measure, quality of life and fatigue assessment then all children will perform physical therapy program of gait training muscle strengthening for 8 week

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Chronic Liver Failure

Interventions

Physical therapy exerciseOTHER

Endurance, strength and stretching training in Chronic liver disease children

Eligibility

Sex: ALLMin age: 7 YearsMax age: 14 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Their age ranged from7 to14 years old. * Residence in Cairo to be able to attend the rehabilitation program. * Diagnosis of CLD as (Wilson disease, autoimmune hepatitis, chronic cholestasis , ….etc). * All children were medically stabled * All children had the same socioeconomic status Exclusion Criteria: * Complication that prevent children from performing maximal exercise test as fracture of both upper and lower limbs, cardiovascular instability and muscle disease in patient with glycogen storage disease(GSD) or abnormal creatine phosphokinase(CPK). * Patients with cognitive and motor disorders as in case of hepatic encephalopathy and or ascites. * Patients who underwent liver transplantation. * Patient with end stage liver disease. * History of variceal bleeding from one month ago or less. * No other system disease (chest, cardiac and nervous system). * Medical examination no hernia.

Locations (1)

Cairo university

Cairo, Egypt

Outcomes

Primary Outcomes

aerobic capacity

it was assessed by 6 minute walk test(6-MWT) in meter, The distance in meters was recorded at the end of the six minutes.

Time frame: 8week

grip strength

it was assessed by pneumatic hand held dynamometer ,was measured in pounds per square inch (PSI). The child was sitting on a chair with or without arm rest, back supported, and both feet rested on the floor. The right arm was beside the body, with adducted shoulder, elbow flexed 90°, forearm in neutral position, wrist from 0° to 30° extension, and 0° to 15° of ulnar deviation. Child was instructed to hold and compress the pneumatic handle of dynamometer as much strength as possible with the tested hand

Time frame: 8week

quadriceps strength

it was assessed by Lafayette hand held dynamometer(LHHD)Child position was sitting on chair with back straight, hip and knee were in 90-degree flexion. LHHD was fixed on distal third of anterior surface of child leg while his/her tested thigh was stabilizing and then the child was instructed to perform maximal isometric knee extension and hold for 6 sec against LHHD sensor pad.

Time frame: 8 week

health related quality of life

The Arabic version of child self-report Pediatric Quality of Life Inventory core scale version 4 (PedsQI) was used to assess HRQOL. PedsQI core scale designed to measure HRQOL in children and adolescents ages from 2 to18years. Each item of the questionnaire rated based on a rating scale from 0-4. Then, each item score was linearly converted on assessment scale from 0 to 100;0=100, 1=75, 2=50, 3=25, 4=0 then overall score calculated for all domains through dividing all answered items over whole number of items, with higher scores indicate a better HRQOL

Time frame: 8week

fatigue

It was assessed by the PedsQI multidimensional fatigue scale version 3. It is composed of 3 domains; general fatigue, sleep/rest fatigue and cognitive fatigue,Each item score converted on a scale from 0 to 100: 0=100, 1=75, 2=50, 3=25, 4=0 then overall score calculated for all domains through dividing all answered items over whole number of items, with higher scores indicate lower level of fatigue

Data from ClinicalTrials.gov

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Secondary Outcomes

hemoglobin

A blood sample was taken for complete blood count (CBC )hemoglobin

Time frame: 8week

liver enzymes

A blood sample was taken for liver enzymes (Total bilirubin ,Direct bilirubin ) unit of measure (mg/dl)

Time frame: 8week

minerals

A blood sample was taken for minerals concentration (sodium Na,potassium K, magnissium M, calciumCa, posphorus P and create) unit of measure (mmol/l)

Time frame: 8week

mid upper arm circumference in centimeter

assessed by tape measure,the tape was passed around the arm at the mid-point of the upper right arm halfway between the acromion process and the olecranon process

Time frame: 8 weeks

triceps skin fold thickness

it was assessed by holtain skinfold calipers in millimeter

Time frame: 8 weeks

height in meter (m)

assessed by stadiometre

Time frame: 8 weeks

weight in kilogrms (Kg)

assess by electronic scale

Time frame: 8 weeks

body mass index

height/weight kg/m2

Time frame: 8weeks

mid upper muscle circumference

assessed by calculators that substract triceps skin fold thickness from mid upper arm circumference

Time frame: 8weeks

mid upper leg circumference in centimetre

assessed by tape measure at mid -point between iliac crest and mid of patella

Time frame: 8 weeks