Evaluation of Physical and Cognitive Outcomes in Liver Transplant Recipients Following Participation in a Post-Transplant Physiotherapy Program

Objectives: Although liver transplantation is the most effective treatment for end-stage liver disease, many recipients still ex-perience impairments in physical performance, balance, cognitive function and fatigue, even after a successful transplant. While physiotherapy has been shown to be effective during the early postoperative period, evidence regarding its longer-term benefits is limited. This study investigated the long-term effects of routine physiotherapy and rehabilitation on physical performance, bal-ance, functional capacity, cognitive function and fatigue in liver transplant recipients approximately one year after transplantation.
Methods: This cross-sectional comparative study enrolled 106 adult liver transplant recipients who had undergone transplanta-tion at least one year previously. Participants were divided into two groups: a control group of 53 participants who had not par-ticipated in a postoperative physiotherapy programme, and a routine physiotherapy group of 53 participants who had completed the routine postoperative physiotherapy programme. Functional mobility was evaluated using the Timed Up and Go Test (TUG), static balance using the Single-Leg Stance Test (SLST), functional exercise capacity using the Six-Minute Walk Test (6MWT), cogni-tive function using the Montreal Cognitive Assessment (MoCA) and fatigue using the Fatigue Severity Scale (FSS). Between-group comparisons were performed using independent samples t-tests and chi-square tests, with statistical significance set at p<0.05.
Results: Baseline demographic and clinical characteristics were comparable between the groups (all p > 0.05). Recipients who had completed the routine physiotherapy programme demonstrated significantly better functional mobility (TUG, p=0.001), static balance (SLST, p=0.003), cognitive performance (MoCA, p=0.003) and lower fatigue levels (FSS, p=0.006) than the control group. No significant difference between the groups was observed in functional exercise capacity, as measured by the 6MWT (p=0.454).
Conclusion: Routine physiotherapy after liver transplantation was associated with improved functional mobility, balance, cognitive performance and reduced fatigue approximately one year after transplantation. While no significant improvement in functional exercise capacity was observed, these results suggest that the benefits of physiotherapy extend beyond the immediate postopera-tive period. Incorporating structured physiotherapy into long-term, multidisciplinary follow-up programmes could help to optimise functional recovery and improve overall patient outcomes after liver transplantation.

Keywords: Liver transplantation, physiotherapy, rehabilitation, functional mobility, cognitive function, fatigue