Balance and related factors in patients with liver cirrhosis

Objective: To determine balance, lower extremity muscle strength, cognitive function, autonomic dysfunction, fatigue and sleep, investigate their relationships with fall risk and compare results to healthy controls. Method: 24 cirrhotics and 24 healthy volunteers were included. Computarized balance system was used for balance assessments. Falls Efficacy Scale (FES), Timed Up and Go Test (TUGT) and 5 Times Sit-to-Stand Test (STS) were used to determine fall risk. Cognitive function, lower extremity muscle strength, autonomic dysfunction, fatigue, somnolence were evaluated by Stroop Test, dynamometer, orthostatic hypotension measurement, Fatigue Severity Scale, Epworth Sleepiness Scale, respectively. Results: Sway velocities during unilateral stance in eyes closed conditions, reaction times in Limits of Stability (LOS) Test, FES score, fatigue severity, sleepiness score, TUGT and 5 Times STS times, Stroop task durations were higher in patient group (p<0,05). Movement velocity, endpoint and maximum excursions, directional control in LOS test, antero-posterior movement velocity in Rhythmic Weight Shift test, rising index in STS test and QF and TA strengths were lower in patient group (p<0,05). Statistically significant relationships were found between balance tests and lower extremity muscle strength, cognitive dysfunction and day somnolence (p<0,05). Conclusion: Static and dynamic balance, lower extremity muscle strength, cognitive function could be affected negatively in cirrhotics. Fear of falling, fatigue and somnolence could be increased. Our results support the idea that balance disorders, decreases in lower extremity muscle strength, cognitive dysfunction and somnolence may increase risk of falling in cirrhotics. Determination of effective strategies and exercise approaches for minimizing fall risk leads to a decrease in health care costs and improve patients? quality of life.