Assessment of gnostic and stereognostic functions in patients with liver cirrhosis: A comparative study with healthy controls

Article type: Research Article

Authors: Tapajčiková, Táňa^a | Líška, Dávid^{b; *} | Slapšinskaitė Dackevičienė, Agnė^c | Skladaný, L’ubomír^d

Affiliations: [a] Faculty of HealthCare, Slovak Medical University, Banská Bystrica, Slovakia | [b] Faculty of Sports Science and Health, Matej Bel University, Banská Bystrica, Slovakia | [c] Medical Academy, Department of Sports Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania | [d] 2nd Department of Internal Medicine of the Slovak Medical University Faculty of Medicine, HEGITO (Division Hepatology, Gastroenterology and Liver Transplant), F. D. Roosevelt Teaching Hospital, Banská Bystrica, Slovakia

Correspondence: [*] Corresponding author: Dávid Líška, Faculty of Sports Science and Health, Matej Bel University, Tajovského 40, 974 05 Banská Bystrica, Slovakia. E-mail: [email protected].

Abstract: BACKGROUND: Individuals diagnosed with liver cirrhosis typically experience a variety of symptoms. Decompensation, a critical stage in the disease’s progression, is characterized by the emergence of prominent clinical signs. These signs typically include ascites, bleeding tendencies, hepatic encephalopathy, and jaundice. Furthermore, it is noteworthy that regions in the sensorimotor cortex responsible for practical and gnostic functions are closely situated within the parieto-occipital part of the cortex. Liver cirrhosis may also have an impact on this aspect of human motor function. OBJECTIVES: The main objective of the study is to compare the gnostic function and stereognostic function in individuals with liver cirrhosis and those in a healthy population. METHODS: The patients included in our registry, known as RH7, were enrolled in our study. The first group consisted of 74 liver cirrhosis patients (including 25 women and 49 men). The control group consisted of a 63 healthy population (including 23 women and 40 and men). Both groups underwent both the Petrie and kinaesthesia tests. RESULTS: The results of the Petrie test, which compared healthy participants with those with liver cirrhosis, indicate that the healthy population achieved a significant difference in both right and left upper limb compared to those with liver cirrhosis patients (p< 0.05). The healthy population showed a significant difference compared to liver cirrhosis patients in the kinesthesia test (p< 0.05), except for the second attempt with the left upper limb (p= 0.267). According to the LFI, there was no significant difference in either upper limb during both the initial and second attempts of Petrie test (p> 0.05). CONCLUSION: Patients with liver cirrhosis exhibited significantly poorer gnostic functions compared to the healthy population. This condition also leads to notable impairments in motor functions, affecting both the precision and coordination of movements. Despite these deficits, frailty alone does not appear to be an indicator of worsened gnostic or stereognostic functions. Therefore, while liver cirrhosis has a clear negative impact on motor and cognitive abilities, the presence of frailty does not necessarily exacerbate these specific cognitive deficits. This distinction is crucial for clinical assessments and interventions targeting motor and cognitive rehabilitation in patients with liver cirrhosis.

Keywords: Liver cirrhosis, gnostic and stereognostic function, frailty, rehabilitation

DOI: 10.3233/BMR-240114

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1685-1694, 2024