Management of the extrahepatic symptoms of chronic hepatitis C: feasibility of a randomized controlled trial of exercise

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 (F1,20 = 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.