Hepatitis is an inflammation of liver tissues caused by viruses, chemical exposure, drug reaction, or alcohol abuse. Viral hepatitis presents and progresses in various forms. Acute hepatitis results initially in fatigue, nausea, mild fever, and right upper quadrant abdominal discomfort. Chronic hepatitis can lead to end-stage liver failure requiring an organ transplant. Clients with hepatitis may experience fatigue and arthralgia severe enough to limit their normal activities. Acute hepatitis requires the client to conserve energy, but even as the condition begins to resolve, the client may still have significant fatigue.
Comorbidities to Consider
Chronic hepatitis may produce complications that include neuropathy, arthralgias, and myalgias, with rare occurrences of rheumatic diseases.
Keys to Examination of Clients
Laboratory testing of blood serum identifies the type of viral hepatitis.
A liver biopsy determines the stage of the disease.
Assess for signs of dehydration, edema, fluid weight gain, or respiratory difficulties.
Recommended Baseline Testing of Fitness Levels
Clients who want to return to their usual exercise and recreational activities should be assessed for their exercise tolerance.
Screen for balance and coordination to determine if normal neuromuscular function is present.
Assess for joint mobility and muscle extensibility to determine a loss of mobility.
Type: Aerobic and fitness activities1
Intensity: Moderate intensities
Duration: 30 minutes or more
Frequency: Three to five times per week
Clients may choose a variety of individual and group activities for their exercise programs and should be encouraged to use a variety of activities. Exercise intensity can be monitored by heart rate and perceived exertion levels. Clients who have recovered from acute hepatitis may return to their previous activities or sports when they are medically cleared.2 Clients in the initial or acute phases of hepatitis need to conserve energy and are not able to continue with their normal recreational or athletic activities.2 Clients should begin slowly and progress as they tolerate longer durations and greater intensities of exercise. As their condition resolves, clients may increase their daily activities and begin a return to their exercise programs. Clients with chronic hepatitis should be encouraged to participate in low- to moderate-level activities, but they should avoid any strenuous or prolonged physical activities.1,2 A study of individuals receiving treatment for chronic hepatitis C virus found significant improvements in fitness levels and quality of life measures after an 8-month program of aerobic training of 5 days per week.1
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