Maria Teresa Tomás

The impact of exercise training on liver transplanted familial amyloidotic polyneuropathy (FAP) patients.

Background Liver transplantation is nowadays the only effective answer to adjourn the outcome of functional limitations associated with familial amyloidotic polyneuropathy (FAP), a neurodegenerative disease characterized by sensory and motor polyneuropathies. Nevertheless, there is a detrimental impact associated with the after-surgery period on the fragile physical condition of these patients. Exercise training has been proven to be effective on reconditioning patients after transplantation. However, the effects of exercise training in liver transplanted FAP patients have not been scrutinized yet. Methods The study aimed to evaluate the effects of a 24-week exercise training program (supervised or home-based) on body composition, muscle strength, and walking capacity of liver transplanted FAP patients. To fulfill this goal, a sample corresponding to 33% of all FAP patients who undergone a liver transplantation in the area of Lisbon between January 2006 and December 2008 were followed over time. Three evaluation periods were accomplished: M1 (pre-exercise training period), M2 (immediate post-exercise training period), and M3 (24 weeks after M2). The former allowed an assessment of the impact of detraining in these patients. Results The exercise training program improved body composition (lean mass and total body skeletal muscle mass), weight, and walking capacity. The improvements were more pronounced within the patients with supervised exercise training compared with the patients on the home-based program. In general, the benefits of the exercise training perdure even after a 24-week detraining period. Conclusions Exercise training results in significant improvements on the physical condition of liver transplanted FAP patients.

Body composition, muscle strength, functional capacity, and physical disability risk in liver transplanted familial amyloidotic polyneuropathy patients

Tomás MT, Santa‐Clara MH, Monteiro E, Baynard T, Carnero EÁ, Bruno PM, Barroso E, Sardinha LB, Fernhall B. Body composition, muscle strength, functional capacity, and physical disability risk in liver transplanted familial amyloidotic polyneuropathy patients.
Clin Transplant 2011: 25: E406–E414.

Functional Capacity and Levels of Physical Activity in Aging: A 3-Year Follow-up

Over the last decades, the world elderly population has increased exponentially and this tendency will continue during the coming years; from 2000 to 2050, people over 60 will double and those over 80 will quadruple. Loss of independence occurs as people age due to mobility restrictions, frailty, and decreased functional fitness and cognitive abilities. Evidence has shown that appropriate programs and policies contribute to keep older adults healthy and independent over time. The purpose of this chapter is to report the results of our 3-year follow-up study designed to characterize functional physical fitness in a sample of Portuguese community-dwelling older adults to propose a set of functional parameters that decline the most. We studied a group of 43 elderly people, aged 60 and over. Variables assessed on the participants were anthropometric measurements, functional capacity with the Senior Fitness Test battery (muscle strength, aerobic endurance, flexibility, agility, and dynamic balance), handgrip strength, levels of physical activity, and balance. Three years after the first assessment, a second assessment of the same variables was conducted. We analyzed what were the variables that, for this group, were related with a healthier aging and the relation with different physical activity levels. Our study showed that the distance covered in 6-min walk test and handgrip strength seem to explain a great amount of variability on functional variables that have changed on this period (68% of balance, lower and upper functional strength, respectively) and the active participants showed less decrements with aging in anthropometric and functional variables than those inactive or insufficiently active (p < 0.05). Greater importance should be given to prescription of exercise targeting older adults and, specifically, walking and manual activities should be given more attention as components of a community exercise program.

A 5-Year Follow-Up of The Benefits of an Exercise Training Program in Liver Recipients Transplanted Due to Familial Amyloidotic Polyneuropathy

Background: Supervised (SE) and home-based exercise (HBE) training regimes are effective on reconditioning patients with familial amyloidotic polyneuropathy (FAP) after liver transplantation, but research of the long-term retention of the benefits attained in patients with FAP has not yet been conducted. Purpose: In this 5-year follow-up study, we aimed to determine whether the exercise training gains in body composition, physical activity, and function promoted by a 24-week SE or HBE training regimes are retained in patients with FAP who resume normal activity. Methodology: Sixteen liver-transplanted patients with FAP were reassessed for body composition (dual X-ray absorptiometry), physical activity (questionnaire), and function (handgrip strength and 6-minute walk test). Results: Total body fat increased with both exercise regimes during follow-up (P < .05; η2 = 0.432-0.625) as well as femoral neck bone density (P = .048; η2 = 0.119). However, gains in upper limbs muscle quality during follow-up (P < .001; η2 = 0.597) were only found in the SE group (P = .042; η2 = 0.245). Both exercise regimes showed retaining aptitudes in walking capacity (P < .05; η2 = 0.329-0.460) and muscle mass (P = .05; η2 = 0.245). Still, none could retain the physical activity levels. Conclusion: Long-term resumption of normal activity following a 24-week SE or HBE regime in patients with FAP resulted in loss of exercise induced increases in physical activity but counterweighted postoperative losses in bone mineral density and substantially retained the benefits in walking capacity, muscle mass, and quality, in particular, in the SE group.