LiveSMART Trial to Prevent Falls in Patients with Cirrhosis

Inclusion Criteria:

• Clinical diagnosis of cirrhosis based on histology and/or imaging specified in theprotocol.

• Evidence of portal hypertension - must meet at least one of the following criteria:

• Ascites (present or within past 2 years)

• Varices (seen by Esophagogastroduodenoscopy or by Ultrasound(US) orcross-sectional imaging)

• Fibroscan Liver stiffness measurement (LSM) >25 kilopascals (kPa) (if no otherfactors present)

• Magnetic resonance elastography (MRE) LSM > 5 kPa (if no other factors present)

• Acoustic radiation force impulse LSM > 17kpa (if no other factors present)

• Hepatic vein pressure gradient > 10 millimetres of mercury (mmHg)

• Portal hypertensive gastropathy seen on Esophagogastroduodenoscopy

• Platelet count < 80/ units per liter (uL)

• Recanalized umbilical vein (by US or cross-sectional imaging)

• Access to Wireless Fidelity (Wi-Fi) at home

• Owns or access to a smartphone, tablet or computer

• English or Spanish speaking

• Willing to participate in exercise program

Exclusion Criteria:

• Overt hepatic encephalopathy (HE) within 6 months, requiring >28 days total oflactulose

• Took lactulose for non - HE reasons for >28 days total in last 6 months

• Took Rifaximin for > 28 days total in last 6 months

• Model for End Stage Liver Disease (MELD) > 25 (Exception: MELD > 25 with clinicallystable End-Stage Renal Disease (ESRD) for whom the bilirubin is < 5 g/dL)

• Barcelona Clinic Liver Cancer (BCLC) > C Hepatocellular Carcinoma (HCC)

• Currently taking Sorafenib, Atezolizumab/Bevacizumab, Regorafinib, or Cabozatinib

• Greater than (>) 3 paracentesis/month in last 2 months

• Active Metastatic solid malignancy or acute leukemia within last 3 years

• Severe cognitive, vision, or hearing impairment (without use of corrective lenses orhearing assist devices) or psychiatric illness precluding study participation

• Currently participates in Tai-Chi or performs >150 min/week vigorous physicalactivity

• Currently receiving lower body physical and/or occupational therapy

• Living in an assisted living facility

• Hemoglobin A1C > 12 (within past 12 months)

• Requires a low galactose diet

• Deemed unsuitable by the study investigator

Inclusion Criteria for the Caregivers of the participants:

• Adult > 18 years of age

• Informal caregiver of a participant enrolled in LIVE-SMART

• English speaking

Exclusion Criteria for the Caregivers of the participants:

• Non-English speaking