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NCT Number: NCT07694245

Physical and Cognitive Outcomes After Post-Transplant Physiotherapy in Liver Transplant Recipients

Liver transplantation is the most effective treatment for end-stage liver disease. However, many recipients continue to experience problems such as reduced physical function, impaired balance, fatigue, and cognitive difficulties even after successful transplantation. Although physiotherapy is commonly provided during the early postoperative period, its long-term benefits are not well understood.

This observational cross-sectional study evaluated the long-term physical and cognitive outcomes of adult liver transplant recipients approximately one year after transplantation. A total of 106 participants were included and divided into two groups according to whether they had participated in a routine post-transplant physiotherapy and rehabilitation program. Physical performance, balance, functional exercise capacity, cognitive function, and fatigue were assessed using standardized clinical outcome measures.

The study aimed to determine whether participation in a routine physiotherapy program was associated with better long-term functional outcomes after liver transplantation. The findings may help improve long-term rehabilitation strategies and support the integration of physiotherapy into routine multidisciplinary follow-up care for liver transplant recipients.

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Key information

Conditions

Liver Transplantation (LT) Digestive System Diseases End Stage Liver Disease End-Stage Liver DIsease Fatigue Hepatic Insufficiency Liver Diseases Liver Failure Pathological Conditions, Signs and Symptoms Signs and Symptoms

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Liver Transplant Institute Hospital, Turgut Özal Medical Center, İnönü University

Malatya, 44280, Turkey (Türkiye)

About this study

Detailed Description

Liver transplantation is the standard treatment for end-stage liver disease and has substantially improved long-term survival. As survival has increased, greater attention has been directed toward long-term functional recovery, including the restoration of physical performance, cognitive function, and independence in daily living. Despite successful transplantation, many recipients continue to experience persistent impairments such as reduced mobility, balance deficits, fatigue, and cognitive dysfunction, which may negatively affect quality of life and long-term health outcomes.

Physiotherapy and rehabilitation are widely recommended during the postoperative period to promote recovery and prevent complications. Although previous studies have demonstrated the short-term benefits of rehabilitation after liver transplantation, evidence regarding its long-term effects remains limited. In particular, few studies have evaluated whether improvements achieved during the early postoperative period are maintained approximately one year after transplantation.

This observational cross-sectional study was conducted to evaluate the long-term physical and cognitive outcomes of liver transplant recipients who had participated in a routine post-transplant physiotherapy program compared with recipients who had not received postoperative physiotherapy. The study assessed functional mobility, balance, functional exercise capacity, cognitive performance, and fatigue using standardized clinical assessment tools.

The findings of this study are expected to provide further evidence regarding the long-term contribution of routine physiotherapy to functional recovery after liver transplantation and to support the development of multidisciplinary rehabilitation strategies for transplant recipients.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adult liver transplant recipients aged 18 years or older.
  • At least 1 year since liver transplantation.
  • Spontaneous breathing.
  • Hemodynamically stable.
  • Able to read and write.
  • Willing and able to provide written informed consent.

Exclusion criteria

  • History of a neurological disorder.
  • Presence of a neuropsychiatric disorder.
  • Orthopedic or rheumatologic conditions that could interfere with the assessments.
  • Advanced cardiopulmonary disease.
  • Visual or hearing impairment that prevented completion of the assessments. Refusal to participate in the study.

Treatment and study plan

Routine Post-Transplant Physiotherapy

Other

Participation in the routine postoperative physiotherapy and rehabilitation program provided after liver transplantation as part of standard clinical care. The program included breathing exercises, progressive mobilization, muscle strengthening, balance training, gait training, and functional exercises. Participants were not assigned to this intervention by the study protocol; the intervention had been completed before enrollment in this observational study.

Primary outcomes

  1. Functional Mobility

    Time frame: Approximately 1 year after liver transplantation

    Functional mobility assessed using the Timed Up and Go (TUG) Test. The outcome is recorded as the time required to complete the test, measured in seconds (minimum possible value: 0 seconds; no predefined maximum value). Lower completion times indicate better functional mobility.

  2. Static Balance

    Time frame: Approximately 1 year after liver transplantation

    Static balance assessed using the Single-Leg Stance Test. Participants were instructed to stand on their dominant leg for as long as possible while maintaining balance. The duration of single-leg stance was recorded in seconds (minimum possible value: 0 seconds; no predefined maximum value), and the best performance was used for analysis. Longer standing times indicate better static balance.

  3. Cognitive Function

    Time frame: Approximately 1 year after liver transplantation

    Cognitive function assessed using the Montreal Cognitive Assessment (MoCA). Scores range from 0 to 30, with higher scores indicating better cognitive performance.

Secondary outcomes

  1. Functional Exercise Capacity

    Time frame: Approximately 1 year after liver transplantation

    Functional exercise capacity assessed using the Six-Minute Walk Test (6MWT). Walking distance was measured in meters (minimum possible value: 0 meters; no predefined maximum value). Greater walking distances indicate better functional exercise capacity.

  2. Fatigue Severity

    Time frame: Approximately 1 year after liver transplantation

    Fatigue severity assessed using the Fatigue Severity Scale (FSS). Total scores range from 9 to 63, with higher scores indicating greater fatigue severity.

Sponsors and collaborators

Lead sponsor

Hasan Kalyoncu University

Other

Registry information

Official study title

Evaluation of Physical and Cognitive Outcomes in Liver Transplant Recipients Who Participated in a Post-Transplant Physiotherapy Program

Important dates

Study start
2024
Primary completion
2026
Study completion
2026
First posted
Jul 9, 2026
Registry last updated
Jul 10, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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