Liver transplantation is the most effective treatment for end-stage liver disease. However, many recipients continue to experience problems such as reduced physical function, impaired balance, fatigue, and cognitive difficulties even after successful transplantation. Although physiotherapy is commonly provided during the early postoperative period, its long-term benefits are not well understood.

This observational cross-sectional study evaluated the long-term physical and cognitive outcomes of adult liver transplant recipients approximately one year after transplantation. A total of 106 participants were included and divided into two groups according to whether they had participated in a routine post-transplant physiotherapy and rehabilitation program. Physical performance, balance, functional exercise capacity, cognitive function, and fatigue were assessed using standardized clinical outcome measures.

The study aimed to determine whether participation in a routine physiotherapy program was associated with better long-term functional outcomes after liver transplantation. The findings may help improve long-term rehabilitation strategies and support the integration of physiotherapy into routine multidisciplinary follow-up care for liver transplant recipients.

Detailed Description

Liver transplantation is the standard treatment for end-stage liver disease and has substantially improved long-term survival. As survival has increased, greater attention has been directed toward long-term functional recovery, including the restoration of physical performance, cognitive function, and independence in daily living. Despite successful transplantation, many recipients continue to experience persistent impairments such as reduced mobility, balance deficits, fatigue, and cognitive dysfunction, which may negatively affect quality of life and long-term health outcomes.

Physiotherapy and rehabilitation are widely recommended during the postoperative period to promote recovery and prevent complications. Although previous studies have demonstrated the short-term benefits of rehabilitation after liver transplantation, evidence regarding its long-term effects remains limited. In particular, few studies have evaluated whether improvements achieved during the early postoperative period are maintained approximately one year after transplantation.

This observational cross-sectional study was conducted to evaluate the long-term physical and cognitive outcomes of liver transplant recipients who had participated in a routine post-transplant physiotherapy program compared with recipients who had not received postoperative physiotherapy. The study assessed functional mobility, balance, functional exercise capacity, cognitive performance, and fatigue using standardized clinical assessment tools.

The findings of this study are expected to provide further evidence regarding the long-term contribution of routine physiotherapy to functional recovery after liver transplantation and to support the development of multidisciplinary rehabilitation strategies for transplant recipients.

Inclusion Criteria:

• Adult liver transplant recipients aged 18 years or older.
• At least 1 year since liver transplantation.
• Spontaneous breathing.
• Hemodynamically stable.
• Able to read and write.
• Willing and able to provide written informed consent.

Exclusion Criteria:

• History of a neurological disorder.
• Presence of a neuropsychiatric disorder.
• Orthopedic or rheumatologic conditions that could interfere with the assessments.
• Advanced cardiopulmonary disease.
• Visual or hearing impairment that prevented completion of the assessments. Refusal to participate in the study.

Adult liver transplant recipients who underwent liver transplantation at Turgut Özal Medical Center, İnönü University, and were evaluated approximately one year after transplantation. Participants were classified according to whether they had participated in a routine post-transplant physiotherapy and rehabilitation program.