Progression 1 (P1)

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This exercise program is not medical advice

Talk to your healthcare team about starting an exercise program before you begin.

This website should not be relied upon or serve as a replacement for medical advice from your healthcare team. Do not disregard or delay or discontinue your ongoing medical treatment because of your use of this website. Your continued treatment by your qualified medical practitioners is important to your health. If you have any concerns, address these with your medical team.

Any medical guidelines or recommendations from your medical practitioner regarding exercise in liver disease supersedes any information on this website. The information on the website is provided on an “as is” basis without any representations or warranties.

Can done while seated, good for those who may have balance issues, with or without equipment.


Include 5 days of aerobic activity each week, for a total time of 150 minutes per week.

As in INTRO, take short 1 minute rests as needed and work toward continuously exercising for the entire session.

The goal is to reach and maintain between 3 to 5 on the Borg Scale – breathing stronger but can carry on a conversation.

Muscle strengthening 

Aim to complete 2 to 3 sessions each week.

Alternate between the different exercises for the upper and lower body. At P1, include 4 to 5 exercises each session.

For each exercise, start with 2 sets of 10 repetitions each. Gradually increase to 3 sets of 15 repetitions.

While completing these exercises, aim to reach and maintain between 3 to 5 on the Borg Scale – breathing moderately but can still talk.

Lateral Arm Raises with Banding

(upper body)

Arm Curls with Banding

(upper body)

Over-head Triceps Extension with Banding

(upper body)

Leg Extensions with a Pause

(lower body)

Hamstring Curl with a Towel

Can use a scarf, belt, or a plastic bags knotted together instead of a towel. (lower body)

Standing Calf Raises

(lower body)

Squat (chair assisted)

Stand with your back almost touching a wall. Slowly move down to a squatting position and then return to a standing position. Keep your back straight and head up. This “squat” is similar to the Intro level’s Chair Sit-to-Stand exercise.


Complete 1 set of 3 repetitions held for 20 to 30 seconds each. Hold the stretch until there is a slight discomfort. Avoid overstretching.

Perform at least two Flexibility sessions each week. These can be part of the cool down after a Muscle Strengthening session, combined with a Balance session, or completed on its own..

Include stretches from the Intro level but do these while standing.

Seated Hamstring Stretch

To get a better stretch of the muscles, do this while standing. Use a chair for balance as necessary.


Complete 1 set of 3 repetitions at least twice a week.

If confident of your stability and balance, can try this without holding onto a support. Make sure to have it within easy reach though in case of loss of balance!

A Balance session can be used as the cool down following a Muscle Strengthening session, can be combined with a Flexibility session, or completed on its own depending upon your schedule.


Single Leg Raises with eyes closed

Make sure to have a chair nearby!

Example of a Weekly P1 Exercise Program

Aerobic: Over 5 different days, complete 150 minutes of aerobic exercise. Remember to take rests as needed!

Muscle strengthening: On 2 or 3 days each week, do 2 sets of 10 repetitions of each of the following exercises:

  • Lateral arm raises with banding
  • Arm curls with banding
  • Leg extension with a pause
  • Hamstring curl with towel
  • Squat

Flexibility: On 2 different days, perform all stretches 2-3 times lasting 20-30 seconds on each side.

Balance: On 2 different days, perform 3 repetitions of 10 steps each.

Lateral Arm Raises with Banding

Arm Curls with Banding

Leg Extensions with a Pause

Hamstring Curl with a Towel


Move the body the same as this video but do not sit on the chair! Alternatively, can do this with your back near to a wall without a chair.


The information on this page was developed by the Cirrhosis Care Alberta project team (physicians, nurse practitioners, registered nurses, registered dietitians, physiotherapists, pharmacists, and patient advisors).

This information is not intended to replace advice from your healthcare team. They know your medical situation best. Always follow your healthcare team’s advice.


Last reviewed March 15, 2021
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