Web-Based Exercise as an Effective Complementary Treatment for Patients With Nonalcoholic Fatty Liver Disease: Intervention Study

Publication type:
Journal article
Metadata:
Autoren
  • Daniel Pfirrmann
  • Yvonne Huber
  • Joern Markus Schattenberg
  • Perikles Simon
Autoren-URL
https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=fis-test-1&SrcAuth=WosAPI&KeyUT=WOS:000454977200001&DestLinkType=FullRecord&DestApp=WOS_CPL
DOI
10.2196/11250
Externe Identifier
  • Clarivate Analytics Document Solution ID: HG4XA
  • PubMed Identifier: 30602434
ISSN
1438-8871
Ausgabe der Veröffentlichung
1
Zeitschrift
JOURNAL OF MEDICAL INTERNET RESEARCH
Schlüsselwörter
  • exercise
  • fatty liver
  • lifestyle
  • NAFLD
  • treatment
  • Web-based
Artikelnummer
ARTN e11250
Datum der Veröffentlichung
2019
Status
Published
Titel
Web-Based Exercise as an Effective Complementary Treatment for Patients With Nonalcoholic Fatty Liver Disease: Intervention Study
Sub types
  • Article
Ausgabe der Zeitschrift
21

Data source: Web of Science (Lite)

Other metadata sources:
Autoren
  • Daniel Pfirrmann
  • Yvonne Huber
  • Jörn Markus Schattenberg
  • Perikles Simon
DOI
10.2196/11250
eISSN
1438-8871
Ausgabe der Veröffentlichung
1
Zeitschrift
Journal of Medical Internet Research
Sprache
en
Online publication date
2019
Paginierung
e11250 - e11250
Status
Published online
Herausgeber
JMIR Publications Inc.
Herausgeber URL
http://dx.doi.org/10.2196/11250
Datum der Datenerfassung
2023
Titel
Web-Based Exercise as an Effective Complementary Treatment for Patients With Nonalcoholic Fatty Liver Disease: Intervention Study
Ausgabe der Zeitschrift
21

Data source: Crossref

Abstract
<h4>Background</h4>Physical inactivity is a major risk factor for nonalcoholic fatty liver disease (NAFLD). Exercise-based prevention interventions for improving cardiorespiratory fitness are a recommended complementary treatment for NAFLD. Achievement of minimally effective physical activity to improve cardiorespiratory fitness among patients typically involves high personal and financial expenses in face-to-face settings. We designed an eHealth approach for patients with NAFLD to improve the cardiorespiratory fitness and report the first results of the HELP (Hepatic Inflammation and Physical Performance in Patients With NASH [nonalcoholic steatohepatitis]) study.<h4>Objective</h4>We aimed to assess the effectiveness of an 8-week, tailored, Web-based exercise intervention for cardiorespiratory fitness improvement, expressed as peak oxygen uptake (peak volume of oxygen [VO<sub>2peak</sub>]), in patients with histologically confirmed NAFLD.<h4>Methods</h4>In a 24-month period, 44 patients were enrolled into an 8-week, prospective, single-arm study with 12 weeks of follow-up. After a medical examination and performance diagnostics, a sports therapist introduced the patients to a Web-based platform for individualized training support. Regular individual patient feedback was provided to systematically adapt the weekly exercise schedule, which allowed us to monitor and ensure patient adherence to strength and endurance training and optimize the step-wise progressive exercise load. Exercise progression was based on an a priori algorithm that considered the subjective rate for both perceived exhaustion and general physical discomfort. The VO<sub>2peak</sub> was assessed at baseline and at the end of the study by spiroergometry.<h4>Results</h4>A total of 43 patients completed the intervention with no adverse events. The VO<sub>2peak</sub> increased significantly by 2.4 mL/kg/min (8.8%; 95% confidence interval [CI]: 1.48-3.27; P<.001) accompanied by a reduction of 1.0 kg in a body weight (95% CI: 0.33-1.58; P=.004) and 1.3 kg in body fat mass (95% CI: 0.27-2.27; P=.01). In an exploratory analysis, step-wise logistic regression analysis revealed low body fat and VO<sub>2peak</sub> at baseline and the total minutes of endurance training during the intervention as main contributors to a positive change in VO<sub>2peak</sub>. Our predictive model indicated that the average patient with NAFLD needed 223 min for stabilization of VO<sub>2peak</sub> and 628 min for average improvement in VO<sub>2peak</sub>. However, in patients with a VO<sub>2peak</sub> approximately 20% higher than the average VO<sub>2peak</sub>, 628 min were only sufficient to stabilize the VO<sub>2peak</sub> and >40% reduction in the average fat mass would be required to achieve an average outcome.<h4>Conclusions</h4>This is the first study to show that patients with NAFLD can be effectively supported by a Web-based approach, which can increase the VO<sub>2peak</sub> to a similar extent as face-to-face interventions. Patients with low body fat and low VO<sub>2peak</sub> benefited the most from our intervention. In terms of future treatment strategies, NAFLD patients with high body fat may particularly benefit from body-fat reduction through a strict nutritional intervention, subsequently enabling a more effective exercise intervention.<h4>Trial registration</h4>ClinicalTrials.gov NCT02526732; https://clinicaltrials.gov/ct2/show/NCT02526732 (Archived by WebCite at http://www.webcitation.org/74pXhXXfq).<h4>International registered report identifier (irrid)</h4>RR2-10.2196/resprot.8607.
Addresses
  • Department of Sports Medicine, Disease Prevention and Rehabilitation, Institute of Sports Science, Johannes Gutenberg University, Mainz, Germany.
Autoren
  • Daniel Pfirrmann
  • Yvonne Huber
  • Jörn Markus Schattenberg
  • Perikles Simon
DOI
10.2196/11250
eISSN
1438-8871
Externe Identifier
  • PubMed Identifier: 30602434
  • PubMed Central ID: PMC6746083
Open access
true
ISSN
1439-4456
Ausgabe der Veröffentlichung
1
Zeitschrift
Journal of medical Internet research
Schlüsselwörter
  • Humans
  • Treatment Outcome
  • Exercise
  • Exercise Therapy
  • Risk Factors
  • Prospective Studies
  • Internet
  • Adult
  • Middle Aged
  • Female
  • Male
  • Non-alcoholic Fatty Liver Disease
Sprache
eng
Medium
Electronic
Online publication date
2019
Open access status
Open Access
Paginierung
e11250
Datum der Veröffentlichung
2019
Status
Published
Publisher licence
CC BY
Datum der Datenerfassung
2019
Titel
Web-Based Exercise as an Effective Complementary Treatment for Patients With Nonalcoholic Fatty Liver Disease: Intervention Study.
Sub types
  • research-article
  • Journal Article
Ausgabe der Zeitschrift
21

Data source: Europe PubMed Central

Abstract
BACKGROUND: Physical inactivity is a major risk factor for nonalcoholic fatty liver disease (NAFLD). Exercise-based prevention interventions for improving cardiorespiratory fitness are a recommended complementary treatment for NAFLD. Achievement of minimally effective physical activity to improve cardiorespiratory fitness among patients typically involves high personal and financial expenses in face-to-face settings. We designed an eHealth approach for patients with NAFLD to improve the cardiorespiratory fitness and report the first results of the HELP (Hepatic Inflammation and Physical Performance in Patients With NASH [nonalcoholic steatohepatitis]) study. OBJECTIVE: We aimed to assess the effectiveness of an 8-week, tailored, Web-based exercise intervention for cardiorespiratory fitness improvement, expressed as peak oxygen uptake (peak volume of oxygen [VO2peak]), in patients with histologically confirmed NAFLD. METHODS: In a 24-month period, 44 patients were enrolled into an 8-week, prospective, single-arm study with 12 weeks of follow-up. After a medical examination and performance diagnostics, a sports therapist introduced the patients to a Web-based platform for individualized training support. Regular individual patient feedback was provided to systematically adapt the weekly exercise schedule, which allowed us to monitor and ensure patient adherence to strength and endurance training and optimize the step-wise progressive exercise load. Exercise progression was based on an a priori algorithm that considered the subjective rate for both perceived exhaustion and general physical discomfort. The VO2peak was assessed at baseline and at the end of the study by spiroergometry. RESULTS: A total of 43 patients completed the intervention with no adverse events. The VO2peak increased significantly by 2.4 mL/kg/min (8.8%; 95% confidence interval [CI]: 1.48-3.27; P<.001) accompanied by a reduction of 1.0 kg in a body weight (95% CI: 0.33-1.58; P=.004) and 1.3 kg in body fat mass (95% CI: 0.27-2.27; P=.01). In an exploratory analysis, step-wise logistic regression analysis revealed low body fat and VO2peak at baseline and the total minutes of endurance training during the intervention as main contributors to a positive change in VO2peak. Our predictive model indicated that the average patient with NAFLD needed 223 min for stabilization of VO2peak and 628 min for average improvement in VO2peak. However, in patients with a VO2peak approximately 20% higher than the average VO2peak, 628 min were only sufficient to stabilize the VO2peak and >40% reduction in the average fat mass would be required to achieve an average outcome. CONCLUSIONS: This is the first study to show that patients with NAFLD can be effectively supported by a Web-based approach, which can increase the VO2peak to a similar extent as face-to-face interventions. Patients with low body fat and low VO2peak benefited the most from our intervention. In terms of future treatment strategies, NAFLD patients with high body fat may particularly benefit from body-fat reduction through a strict nutritional intervention, subsequently enabling a more effective exercise intervention. TRIAL REGISTRATION: ClinicalTrials.gov NCT02526732; https://clinicaltrials.gov/ct2/show/NCT02526732 (Archived by WebCite at http://www.webcitation.org/74pXhXXfq). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/resprot.8607.
Date of acceptance
2018
Autoren
  • Daniel Pfirrmann
  • Yvonne Huber
  • Jörn Markus Schattenberg
  • Perikles Simon
Autoren-URL
https://www.ncbi.nlm.nih.gov/pubmed/30602434
DOI
10.2196/11250
eISSN
1438-8871
Externe Identifier
  • PubMed Central ID: PMC6746083
Ausgabe der Veröffentlichung
1
Zeitschrift
J Med Internet Res
Schlüsselwörter
  • NAFLD
  • Web-based
  • exercise
  • fatty liver
  • lifestyle
  • treatment
  • Adult
  • Exercise
  • Exercise Therapy
  • Female
  • Humans
  • Internet
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease
  • Prospective Studies
  • Risk Factors
  • Treatment Outcome
Sprache
eng
Country
Canada
Paginierung
e11250
PII
v21i1e11250
Datum der Veröffentlichung
2019
Status
Published online
Datum, an dem der Datensatz öffentlich gemacht wurde
2020
Titel
Web-Based Exercise as an Effective Complementary Treatment for Patients With Nonalcoholic Fatty Liver Disease: Intervention Study.
Sub types
  • Journal Article
Ausgabe der Zeitschrift
21

Data source: PubMed

Author's licence
CC-BY
Autoren
  • Daniel Pfirrmann
  • Yvonne Huber
  • Jörn Schattenberg
  • Perikles Simon
Hosting institution
Universitätsbibliothek Mainz
Sammlungen
  • JGU-Publikationen
Resource version
Published version
URN
urn:nbn:de:hebis:77-publ-588033
DOI
10.2196/11250
Funding acknowledgements
  • DFG, Open Access-Publizieren Universität Mainz / Universitätsmedizin
File(s) embargoed
false
Open access
true
ISSN
1438-8871
Ausgabe der Veröffentlichung
1
Zeitschrift
Journal of medical internet research
Schlüsselwörter
  • 796 Sport
  • 796 Athletic and outdoor sports and games
Sprache
eng
Open access status
Open Access
Paginierung
e11250
Datum der Veröffentlichung
2019
Public URL
https://openscience.ub.uni-mainz.de/handle/20.500.12030/710
Herausgeber
Healthcare World
Herausgeber URL
http://dx.doi.org/10.2196/11250
Datum der Datenerfassung
2019
Datum, an dem der Datensatz öffentlich gemacht wurde
2019
Zugang
Public
Titel
Web-based exercise as an effective complementary treatment for patients with nonalcoholic fatty liver disease : intervention study
Ausgabe der Zeitschrift
21

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58803.pdf

Data source: OPENSCIENCE.UB

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