{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:07:20Z","timestamp":1790021240828,"version":"4.0.1"},"reference-count":45,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP24K18908"],"award-info":[{"award-number":["JP24K18908"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP23fk0210128"],"award-info":[{"award-number":["JP23fk0210128"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","clinicalnutritionespen.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Clinical Nutrition ESPEN"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.clnesp.2026.105073","type":"journal-article","created":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T15:32:18Z","timestamp":1788017538000},"page":"105073","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["A 12-week home-based exercise program with nutritional guidance is associated with improved functional capacity in chronic liver disease"],"prefix":"10.1016","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6185-4796","authenticated-orcid":false,"given":"Shinji","family":"Unome","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takao","family":"Miwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiko","family":"Atago","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satomi","family":"Nakashima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayoko","family":"Nishimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Hiraoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Aiba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Imai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohei","family":"Shirakami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Takai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takaaki","family":"Aoki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahito","family":"Shimizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.clnesp.2026.105073_bib1","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1016\/S0140-6736(21)01374-X","article-title":"Liver cirrhosis","volume":"398","author":"Gines","year":"2021","journal-title":"Lancet"},{"key":"10.1016\/j.clnesp.2026.105073_bib2","doi-asserted-by":"crossref","DOI":"10.1097\/HC9.0000000000000811","article-title":"The impact of sarcopenia and frailty on decompensation in compensated cirrhosis: a systematic review","volume":"9","author":"Becchetti","year":"2025","journal-title":"Hepatol Commun"},{"issue":"Suppl 1","key":"10.1016\/j.clnesp.2026.105073_bib3","doi-asserted-by":"crossref","first-page":"S147","DOI":"10.1016\/j.jhep.2021.01.025","article-title":"Sarcopenia and frailty in decompensated cirrhosis","volume":"75","author":"Tandon","year":"2021","journal-title":"J Hepatol"},{"key":"10.1016\/j.clnesp.2026.105073_bib4","doi-asserted-by":"crossref","first-page":"487","DOI":"10.3350\/cmh.2025.1126","article-title":"Burden of malnutrition and sarcopenia in patients with cirrhosis: pathophysiology, assessment, and management","volume":"32","author":"Miwa","year":"2025","journal-title":"Clin Mol Hepatol"},{"key":"10.1016\/j.clnesp.2026.105073_bib5","doi-asserted-by":"crossref","DOI":"10.1016\/j.redox.2020.101513","article-title":"Physical activity and exercise: strategies to manage frailty","volume":"35","author":"Angulo","year":"2020","journal-title":"Redox Biol"},{"key":"10.1016\/j.clnesp.2026.105073_bib6","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2024.102599","article-title":"Evidence for exercise-based interventions across 45 different long-term conditions: an overview of systematic reviews","volume":"72","author":"Dibben","year":"2024","journal-title":"EClinicalMedicine"},{"key":"10.1016\/j.clnesp.2026.105073_bib7","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1097\/HEP.0000000000000941","article-title":"Physical exercise in liver diseases","volume":"83","author":"Zhang","year":"2026","journal-title":"Hepatology"},{"key":"10.1016\/j.clnesp.2026.105073_bib8","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1007\/s00535-023-02060-0","article-title":"Resistance exercise in combination with aerobic exercise reduces the incidence of serious events in patients with liver cirrhosis: a meta-analysis of randomized controlled trials","volume":"59","author":"Kawaguchi","year":"2023","journal-title":"J Gastroenterol"},{"key":"10.1016\/j.clnesp.2026.105073_bib9","doi-asserted-by":"crossref","first-page":"33","DOI":"10.21037\/hbsn-23-639","article-title":"Effects of exercise and nutrition in improving sarcopenia in liver cirrhosis patients: a systematic review and meta-analysis","volume":"14","author":"Hsu","year":"2025","journal-title":"Hepatobiliary Surg Nutr"},{"key":"10.1016\/j.clnesp.2026.105073_bib10","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1002\/hep.32049","article-title":"Malnutrition, frailty, and sarcopenia in patients with cirrhosis: 2021 practice guidance by the American association for the study of liver diseases","volume":"74","author":"Lai","year":"2021","journal-title":"Hepatology"},{"key":"10.1016\/j.clnesp.2026.105073_bib11","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.jhep.2018.06.024","article-title":"EASL clinical practice guidelines on nutrition in chronic liver disease","volume":"70","year":"2019","journal-title":"J Hepatol"},{"key":"10.1016\/j.clnesp.2026.105073_bib12","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1111\/hepr.70132","article-title":"Guidance for liver rehabilitation in chronic liver disease","volume":"56","author":"Terai","year":"2026","journal-title":"Hepatol Res"},{"key":"10.1016\/j.clnesp.2026.105073_bib13","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s00535-023-02047-x","article-title":"A survey questionnaire evaluating physical activity patterns and determinants in patients with chronic liver disease","volume":"59","author":"Hanai","year":"2024","journal-title":"J Gastroenterol"},{"key":"10.1016\/j.clnesp.2026.105073_bib14","doi-asserted-by":"crossref","first-page":"717","DOI":"10.14309\/ajg.0000000000001113","article-title":"A multicenter pilot randomized clinical trial of a home-based exercise program for patients with cirrhosis: the strength training intervention (STRIVE)","volume":"116","author":"Lai","year":"2021","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.clnesp.2026.105073_bib15","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1186\/s12876-025-03881-4","article-title":"Mapping of rehabilitation interventions and assessment methods for patients with liver cirrhosis: a scoping review","volume":"25","author":"Hosoi","year":"2025","journal-title":"BMC Gastroenterol"},{"key":"10.1016\/j.clnesp.2026.105073_bib16","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1164\/ajrccm.166.1.at1102","article-title":"ATS statement: guidelines for the six-minute walk test","volume":"166","year":"2002","journal-title":"Am J Respir Crit Care Med"},{"key":"10.1016\/j.clnesp.2026.105073_bib17","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1002\/hep.29219","article-title":"Development of a novel frailty index to predict mortality in patients with end-stage liver disease","volume":"66","author":"Lai","year":"2017","journal-title":"Hepatology"},{"key":"10.1016\/j.clnesp.2026.105073_bib18","doi-asserted-by":"crossref","first-page":"M85","DOI":"10.1093\/geronj\/49.2.M85","article-title":"A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission","volume":"49","author":"Guralnik","year":"1994","journal-title":"J Gerontol"},{"key":"10.1016\/j.clnesp.2026.105073_bib19","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1111\/hepr.13678","article-title":"Evidence-based clinical practice guidelines for liver cirrhosis 2020","volume":"51","author":"Yoshiji","year":"2021","journal-title":"Hepatol Res"},{"key":"10.1016\/j.clnesp.2026.105073_bib20","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1007\/s00535-021-01788-x","article-title":"Evidence-based clinical practice guidelines for liver cirrhosis 2020","volume":"56","author":"Yoshiji","year":"2021","journal-title":"J Gastroenterol"},{"key":"10.1016\/j.clnesp.2026.105073_bib21","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1007\/s10620-014-3086-6","article-title":"Randomized pilot study: effects of an exercise programme and leucine supplementation in patients with cirrhosis","volume":"59","author":"Roman","year":"2014","journal-title":"Dig Dis Sci"},{"key":"10.1016\/j.clnesp.2026.105073_bib22","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1186\/s12877-025-05970-1","article-title":"The effect of 12-week long exercise intervention, and 2-weeks of detraining period on lower limbs strength parameters and postural stability in older adults: a linear mixed model analysis","volume":"25","author":"Svobodova","year":"2025","journal-title":"BMC Geriatr"},{"key":"10.1016\/j.clnesp.2026.105073_bib23","author":"Todd"},{"key":"10.1016\/j.clnesp.2026.105073_bib24","doi-asserted-by":"crossref","DOI":"10.1097\/HC9.0000000000000443","article-title":"Home exercise, branched-chain amino acids, and probiotics improve frailty in cirrhosis: a randomized clinical trial","volume":"8","author":"Roman","year":"2024","journal-title":"Hepatol Commun"},{"key":"10.1016\/j.clnesp.2026.105073_bib25","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1016\/j.cgh.2019.07.058","article-title":"Resistance training increases muscle strength and muscle size in patients with liver cirrhosis","volume":"18","author":"Aamann","year":"2020","journal-title":"Clin Gastroenterol Hepatol"},{"key":"10.1016\/j.clnesp.2026.105073_bib26","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1590\/s0004-2803.202203000-73","article-title":"Exercise in the physical rehabilitation of cirrotics: a randomized pilot study","volume":"59","author":"Rossi","year":"2022","journal-title":"Arq Gastroenterol"},{"key":"10.1016\/j.clnesp.2026.105073_bib27","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1038\/s41598-017-18320-y","article-title":"Home exercise training improves exercise capacity in cirrhosis patients: role of exercise adherence","volume":"8","author":"Kruger","year":"2018","journal-title":"Sci Rep"},{"key":"10.1016\/j.clnesp.2026.105073_bib28","doi-asserted-by":"crossref","first-page":"3350","DOI":"10.1007\/s10620-019-06034-2","article-title":"Home-based physical activity and diet intervention to improve physical function in advanced liver disease: a randomized pilot trial","volume":"65","author":"Chen","year":"2020","journal-title":"Dig Dis Sci"},{"key":"10.1016\/j.clnesp.2026.105073_bib29","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1097\/LVT.0000000000000418","article-title":"Clinically relevant cut-points for changes in the liver frailty index are associated with waitlist mortality in patients with cirrhosis","volume":"30","author":"Wang","year":"2024","journal-title":"Liver Transplant"},{"key":"10.1016\/j.clnesp.2026.105073_bib30","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/jep.12629","article-title":"Minimal clinically important difference for change in 6-minute walk test distance of adults with pathology: a systematic review","volume":"23","author":"Bohannon","year":"2017","journal-title":"J Eval Clin Pract"},{"key":"10.1016\/j.clnesp.2026.105073_bib31","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1080\/09638288.2022.2052978","article-title":"Minimal clinically important difference of the short physical performance battery and comfortable walking speed in old-old adults with acute cardiovascular disease: a multicenter, prospective, observational study","volume":"45","author":"Tamura","year":"2023","journal-title":"Disabil Rehabil"},{"key":"10.1016\/j.clnesp.2026.105073_bib32","doi-asserted-by":"crossref","first-page":"2377","DOI":"10.1016\/j.apmr.2021.05.011","article-title":"Short physical performance battery: response to pulmonary rehabilitation and minimal important difference estimates in patients with chronic obstructive pulmonary disease","volume":"102","author":"Stoffels","year":"2021","journal-title":"Arch Phys Med Rehabil"},{"key":"10.1016\/j.clnesp.2026.105073_bib33","doi-asserted-by":"crossref","first-page":"863","DOI":"10.14336\/AD.2019.1012","article-title":"Exercise programs for muscle mass, muscle strength and physical performance in older adults with sarcopenia: a systematic review and meta-analysis","volume":"11","author":"Bao","year":"2020","journal-title":"Aging Dis"},{"key":"10.1016\/j.clnesp.2026.105073_bib34","doi-asserted-by":"crossref","first-page":"133","DOI":"10.2165\/00007256-200636020-00004","article-title":"Neural adaptations to resistive exercise: mechanisms and recommendations for training practices","volume":"36","author":"Gabriel","year":"2006","journal-title":"Sports Med"},{"key":"10.1016\/j.clnesp.2026.105073_bib35","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1002\/jpen.2222","article-title":"Handgrip strength stratifies the risk of covert and overt hepatic encephalopathy in patients with cirrhosis","volume":"46","author":"Miwa","year":"2022","journal-title":"JPEN - J Parenter Enter Nutr"},{"key":"10.1016\/j.clnesp.2026.105073_bib36","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1111\/hepr.13420","article-title":"Reduced handgrip strength is predictive of poor survival among patients with liver cirrhosis: a sex-stratified analysis","volume":"49","author":"Hanai","year":"2019","journal-title":"Hepatol Res"},{"key":"10.1016\/j.clnesp.2026.105073_bib37","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.1097\/TP.0000000000001232","article-title":"A comparison of muscle function, mass, and quality in liver transplant candidates: results from the functional assessment in liver transplantation study","volume":"100","author":"Wang","year":"2016","journal-title":"Transplantation"},{"key":"10.1016\/j.clnesp.2026.105073_bib38","doi-asserted-by":"crossref","first-page":"122","DOI":"10.23736\/S1973-9087.23.08130-3","article-title":"The influence of prehabilitation in patients with liver cirrhosis before liver transplantation: a randomized clinical trial","volume":"60","author":"Skladany","year":"2024","journal-title":"Eur J Phys Rehabil Med"},{"key":"10.1016\/j.clnesp.2026.105073_bib39","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/s12876-022-02147-7","article-title":"Effect of a 12-week home-based exercise training program on aerobic capacity, muscle mass, liver and spleen stiffness, and quality of life in cirrhotic patients: a randomized controlled clinical trial","volume":"22","author":"Sirisunhirun","year":"2022","journal-title":"BMC Gastroenterol"},{"key":"10.1016\/j.clnesp.2026.105073_bib40","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.14309\/ajg.0000000000001301","article-title":"Adding branched-chain amino acids to an enhanced standard-of-care treatment improves muscle mass of cirrhotic patients with sarcopenia: a placebo-controlled trial","volume":"116","author":"Hernandez-Conde","year":"2021","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.clnesp.2026.105073_bib41","doi-asserted-by":"crossref","first-page":"3290","DOI":"10.1007\/s10620-018-5271-5","article-title":"Patient and caregiver attitudes and practices of exercise in candidates listed for liver transplantation","volume":"63","author":"Chascsa","year":"2018","journal-title":"Dig Dis Sci"},{"key":"10.1016\/j.clnesp.2026.105073_bib42","doi-asserted-by":"crossref","DOI":"10.3389\/ti.2022.10330","article-title":"Physical effects, safety and feasibility of prehabilitation in patients awaiting orthotopic liver transplantation, a systematic review","volume":"35","author":"Jetten","year":"2022","journal-title":"Transpl Int"},{"key":"10.1016\/j.clnesp.2026.105073_bib43","first-page":"CD012678","article-title":"Physical exercise for people with cirrhosis","volume":"12","author":"Aamann","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.clnesp.2026.105073_bib44","doi-asserted-by":"crossref","DOI":"10.1038\/ctg.2016.38","article-title":"Changes in hepatic venous pressure gradient induced by physical exercise in cirrhosis: results of a pilot randomized open clinical trial","volume":"7","author":"Macias-Rodriguez","year":"2016","journal-title":"Clin Transl Gastroenterol"},{"key":"10.1016\/j.clnesp.2026.105073_bib45","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1002\/hep.28992","article-title":"Effects of an intensive lifestyle intervention program on portal hypertension in patients with cirrhosis and obesity: the SportDiet study","volume":"65","author":"Berzigotti","year":"2017","journal-title":"Hepatology"}],"container-title":["Clinical Nutrition ESPEN"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2405457726021704?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2405457726021704?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T19:27:50Z","timestamp":1790018870000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2405457726021704"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":45,"alternative-id":["S2405457726021704"],"URL":"https:\/\/doi.org\/10.1016\/j.clnesp.2026.105073","relation":{},"ISSN":["2405-4577"],"issn-type":[{"value":"2405-4577","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"A 12-week home-based exercise program with nutritional guidance is associated with improved functional capacity in chronic liver disease","name":"articletitle","label":"Article Title"},{"value":"Clinical Nutrition ESPEN","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.clnesp.2026.105073","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism.","name":"copyright","label":"Copyright"}],"article-number":"105073"}}