Sarcopenia in Children Post Liver Transplant: Development of a Home-Based Video Program to Support Muscle Strength and Function—A Pre–Post Controlled Pilot Study

IF 1.9 4区医学 Q2 SURGERY Clinical Transplantation Pub Date : 2024-09-10 DOI:10.1111/ctr.15455

Amber Hager, Normand Boule, Lesley Pritchard, Sandra Hodgetts, Michelle Noga, Yuxin Guo, Vera Mazurak, Justin Grenier, Richard Thompson, Susan M. Gilmour, Diana R. Mager

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Abstract

Introduction

Sarcopenia is common in children after liver transplantation (LTx). Resistance training (RT) may be effective in combating sarcopenia.

Objectives

The purpose of the study was to test the feasibility and impact of a 12-week RT program on skeletal muscle mass (SMM), muscle strength, physical performance (PP), and child–parent perspectives about RT.

Methods

Children (6–18 years) post-LTx and healthy controls (HC) underwent progressive RT using resistance bands. SMM and adipose tissue (MRI: abdomen and thigh), muscle strength (handgrip, push-ups, sit-to-stand), and PP (6-minute walk test [6MWT], timed-up-and-down-stair test [TUDS]) were measured before and after 12-weeks of RT.

Results

Ten children post-LTx (11.9 ± 3.5 years) and 13 HC (11.7 ± 3.9 years) participated. LTx children significantly increased abdominal SM-index (+4.6% LTx vs. a −2.7% HC; p = 0.01) and decreased visceral adipose tissue-index (−18% LTx vs. −0.8% HC; p = 0.04) compared to HC. No thigh SMI changes were noted. Significant increases in 6MWT distance (LTx; p = 0.04), number of push-ups (p = 0.04), and greater reduction times for TUDS (−10.6% vs. +1.7%; p = 0.05) occurred after 12 weeks. Higher thigh muscle-fat content was associated with worse physical performance. These results were impacted by adherence (≥75% vs. <75%) and family engagement.

Conclusions

RT in children post-LTx is feasible and effective. RT in children post-LTx may alleviate adverse outcomes associated with sarcopenia.

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肝移植后儿童的肌肉疏松症：开发支持肌肉力量和功能的家庭视频计划--一项术前对照试点研究

导言肝移植（LTx）术后的儿童常出现肌肉疏松症。阻力训练（RT）可有效防治肌肉疏松症。研究目的测试为期 12 周的阻力训练计划的可行性及其对骨骼肌质量（SMM）、肌肉力量、体能表现（PP）的影响，以及儿童和家长对阻力训练的看法。方法采用阻力带对长程肌肉锻炼后的儿童（6-18 岁）和健康对照组（HC）进行渐进式长程肌肉锻炼。在进行为期 12 周的 RT 之前和之后，测量了 SMM 和脂肪组织（核磁共振成像：腹部和大腿）、肌肉力量（握力、俯卧撑、坐立）和运动能力（6 分钟步行测试 [6MWT]、定时上下楼梯测试 [TUDS]）。结果 10 名接受长程肺结核治疗后的儿童（11.9±3.5 岁）和 13 名接受长程肺结核治疗的儿童（11.7±3.9 岁）参加了测量。与 HC 相比，LTx 儿童的腹部 SM 指数明显增加（LTx +4.6% vs. HC -2.7%；p = 0.01），内脏脂肪组织指数下降（LTx -18% vs. HC -0.8%；p = 0.04）。大腿 SMI 没有变化。12 周后，6MWT 距离（LTx；p = 0.04）、俯卧撑次数（p = 0.04）和 TUDS 缩短时间（-10.6% vs. +1.7%; p = 0.05）显著增加。大腿肌肉脂肪含量越高，体能表现越差。这些结果受到坚持率（≥75% vs. <75%）和家庭参与度的影响。结论 LTx 术后儿童进行 RT 治疗是可行且有效的。对长春新碱释放术后儿童进行 RT 可减轻与肌肉疏松症相关的不良后果。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.