Cirrhosis is associated with a reduction in muscle mass and exercise capacity. This has an impact on morbidity and mortality. Regular aerobic exercise training is a proven effective therapy to improve exercise capacity in healthy and clinical populations. The effect of this training has not yet been evaluated in the decompensated cirrhosis patient population. The safety of this intervention also requires further study. Using a randomized controlled design, the investigators aim to determine the safety and efficacy of eight weeks of aerobic exercise training on aerobic capacity, functional performance, and muscle mass in decompensated cirrhosis patients.

Inclusion Criteria:

• Age >18 and ≤ 70 years
• Cirrhosis
• Child Pugh class B or C
• If required, primary or secondary variceal prophylaxis in place

Exclusion Criteria:

• Post-liver transplantation
• Hepatocelluar carcinoma beyond transplant criteria
• Active non-hepatocelluar carcinoma malignancy
• Significant cardiac disease
• Hemoglobin (<80 g/L)
• Oxygen saturation at rest <95%
• Known myopathy
• Chronic renal failure on dialysis
• Physical impairment making it impossible to ride an exercise bike or treadmill
• Orthopedic abnormality preventing exercise training
• HIV infection
• Patient unwilling to consent to study