Liver disease is the third leading cause of premature death in the UK – yet 90 per cent of liver disease is preventable. Kate Hallsworth explains the important role physiotherapists play in the holistic management of patients affected by liver disease
When I started my career back in 2000, I never dreamt that I would end up working in hepatology. Traditionally, physiotherapists didn’t really have a role to play in managing liver disease (LD) and input was largely restricted to respiratory care and functional rehab ahead of discharge.
20 years later there are now growing numbers of physios specialising in hepatology. Physiotherapists treat children and adults with a variety of LDs ranging from the more commonly known alcohol-related LD to those who present with autoimmune-mediated LD, such as Primary Biliary Cholangitis.
The role of physio has become vitally important for those with LD due to the profound effect on the muscular system with up to 70 per cent of patients presenting with loss of muscle mass, strength and function (sarcopenia).
Patients may also suffer complications such as fatigue, fluid overload and episodes of acute confusion. In addition, psychosocial factors such as addiction and in many cases health inequalities due to a background of deprivation, have a huge impact on patients’ quality of life (QoL) and access to care.
My current role focusses on improving care for patients with non-alcoholic fatty LD (NAFLD). NAFLD represents a spectrum of disease spanning ‘simple’ fatty liver to cirrhosis and is a leading cause for liver transplant. NAFLD is largely lifestyle-related with weight loss through dietary change and increased physical activity being key to its management.
We recently set up a group for AHPs, called the British Association for Allied Health Professionals in Liver (BAAL), which aims to promote excellence through the provision of AHP-led care for patients with LD.
We are a research active group – I currently lead a trial to assess the feasibility of using a digital intervention to support lifestyle management in NAFLD, whilst physio colleagues are leading a large NIHR-funded randomised control trial investigating the impact of exercise and behavioural psychology on physical function and QoL pre- and post-liver transplant.
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