Kronik Karaciğer Hastalarında Ev Temelli Aerobik Egzersiz ve Dirençli Egzersiz Eğitimi Kombinasyonunun Oksijen Tüketimi, Periferik Kas Fonksiyonu, Kırılganlık, Yaşam Kalitesi ve Sağlıkla İlişkili Yaşam Biçimine Etkilerinin Araştırılması

Abstract

Chronic Liver Disease (CLD) is a condition characterized by complications such as sarcopenia, malnutrition, impaired liver function tests, and cirrhosis. Exercise training can be considered an additional method in managing the complications caused by CLD on body systems. In our study, it was aimed to examine the effects of an eight-week exercise training on oxygen consumption, muscle strength, lean body mass, muscle oxygenation, physical frailty, liver function tests, fatigue, quality of life, and health-related lifestyle behaviors among home-based aerobic exercise (AE), aerobic and resistance exercise (ARE), and control groups. Patients were randomly divided into home-based AE (n=13), ARE (n=13), and control groups (n=13). Oxygen consumption (cardiopulmonary exercise test), muscle strength (hand dynamometer), respiratory muscle strength (mouth pressure measurement device), lean body mass (Bioelectrical Impedance Analysis [BIA], skinfold thickness measurement), quadriceps thickness and cross-sectional area (muscle ultrasound) muscle oxygenation, physical frailty (Liver Frailty Index, LFI), fatigue (Fatigue Severity Scale), physical activity (International Physical Activity Questionnaire-Short form, IPAQ), quality of life (Chronic Liver Disease Questionnaire [CLDQ], and health-related lifestyle behavior (Health-Promoting Lifestyle Profile II [HPLP II] were evaluated at the beginning and the end of eight weeks. After the exercise training, oxygen consumption and muscle oxygenation parameters in the ARE group showed greater improvement compared to other groups (p<0.05). Peripheral and respiratory muscle strengths were higher in the ARE group compared to the AE and control groups (p<0.05). The AE and ARE groups showed improvements in body composition parameters compared to the control group (p<0.05). The quadriceps thickness and cross-sectional area in the ARE group increased significantly compared to other groups (p<0.05). Significant improvements were observed in LFI scores and physical activity levels in both the ARE and AE groups; however, the ARE group showed improvement in all LFI parameters and moderate-intensity physical activity (p<0.05). Fatigue severity significantly decreased in the ARE and AE groups compared to the control group (p<0.05). While all groups showed improvement in CLDQ and HPLP II, the ARE group demonstrated greater increases in more parameters of these scales (p<0.05). According to our study, an eight-week home-based ARE training in patients with CLD led to more significant improvements in oxygen consumption, muscle strength, lean body mass, muscle oxygenation, physical frailty, fatigue, quality of life, and health-related lifestyle behaviors compared to other groups. It is recommended that combinations of home-based ARE training be included in physiotherapy and rehabilitation programs for the management of CLD.