LAUSR

Frailty, a state of decreased physiologic reserve and increased vulnerability to stressors, is known to negatively impact the prognosis of patients with cirrhosis.(1) Moderate-intensity exercise has been recommended by American College of Sports Medicine (ACSM) to promote physiologic adaptation in the general population,(2) however, its definition in end-stage liver disease (ESLD) has not been established. Cadence or per-minute steps has been proposed as a method to monitor exercise intensity and it can be obtained with personal activity trackers (PAT).(3) Although heart rate reserve (HRR) - percentage increase from resting to maximal heart rate (HR) - is recommended to identify moderate-intensity exercise,(2) it has not been evaluated in patients with ESLD, nor has it been compared with cadence. In this study, we aimed to test agreement between cadence, HRR, and a PAT-proprietary algorithm, and evaluate the optimal methods of measuring exercise intensity in ESLD patients as part of a home-based physical activity program (HB-PAP) randomized pilot trial.(4).