Issue 23-3, 2024

Original article

https://doi.org/10.38025/2078-1962-2024-23-3-14-20

Enhancing Sleep Quality in Non-Alcoholic Fatty Liver with Combined Accelerated Aerobic Training: a Randomized Control Study

View article (Download PDF file)



Download XML file

1 ORCIDLamiaa M. Fahmy., 1 ORCIDAzza A. Abd Elhady, 2 ORCIDAshraf A. Ali, 3 ORCIDAsmaa H. Ali, 1 ORCIDGehad A. Abd Elhaseeb

1Department of Physical Therapy for Cardiovascular, Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
2Department of Internal Medicine, Theodor Bilharz Research Institute , Cairo University, Giza, Egypt
3Department of Physical Therapy for Basic Science, Faculty of Physical Therapy ,Cairo University, Giza, Egypt


ABSTRACT

NTRODUCTION. Exercise constitutes a crucial and well-established component of changing lifestyle to control non-alcoholic fatty liver disease (NAFLD). Accelerating training (AT) involves activating skeletal muscles through heightened gravity acceleration using vibration, rendering it a recommended therapeutic intervention.

AIM. To determine the impact of incorporating AT with aerobic exercise on sleep quality and liver function in NAFLD.

MATERIALS AND METHODS. This randomized control trial recruited 60 female NAFLD patients aged 35–45 years from Al-Shrouk General Hospital in Cairo. The participants were equally allocated at random into two groups: A (control group) received aerobic exercise, and B (intervention group) received AT plus aerobic exercise and followed a three-month intervention program. Before and after the interventions, sleep quality was assessed through the Pittsburgh Sleep Quality Index (PSQI), and liver function was evaluated by measuring alanine transaminase (ALT) and aspartate transferase (AST) hepatic enzymes in the blood.

RESULTS. Both PSQI scores (p < 0.05) and ALT enzyme levels were significantly (p was 0.005 and 0.006, respectively) improved in groups A and B after the three-month intervention program. However, the AST levels exhibited a non-significant change in both groups (p was 0.569 and 0.027, respectively).

CONCLUSION. Combining aerobic exercise and AT may provide the best clinical benefits to NAFLD patients.


KEYWORDS: non-alcoholic fatty liver disease, accelerating training, aerobic exercise, whole-body vibration, sleep quality

FUNDING: This study was not supported by any external sources of funding.

CONFLICT OF INTEREST: The authors declare no apparent or potential conflicts of interest related to the publication of this article.

ДЛЯ ЦИТИРОВАНИЯ:

Fahmy L.M., Abd-al Hady A.A., Ali A.A, Ali A.H., Abd-Elhaseeb G.A. Enhancing Sleep Quality in Non-Alcoholic Fatty Liver with Combined Accelerated Aerobic Training: a Randomized Control Study. Bulletin of Rehabilitation Medicine. 2024; 23(3):14-20. https://doi.org/10.38025/2078-1962-2024-23-3-14-20

ДЛЯ КОРРЕСПОНДЕНЦИИ:

Gehad A. Abd-Elhaseeb, E-mail: dr.gpt111@cu.edu.eg


References:

  1. Thorp A., Stine J.G. Exercise as Medicine: The Impact of Exercise Training on Nonalcoholic Fatty Liver Disease. Current Hepatology Reports. 2020; 19(4): 402–411. https://doi.org/10.1007/s11901-020-00543-9
  2. Heidari Z., Gharebaghi A. Prevalence of Non Alcoholic Fatty Liver Disease and its Association with Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus. Journal of Clinical and Diagnostic Research. 2017; 11(5): OC04–OC07. https://doi.org/10.7860/jcdr/2017/25931.9823
  3. Yu J.H., Ahn J.H., Yoo H.J., et al. Obstructive sleep apnea with excessive daytime sleepiness is associated with non-alcoholic fatty liver disease regardless of visceral fat. The Korean Journal of Internal Medicine. 2015; 30(6): 846–855. https://doi.org/10.3904/kjim.2015.30.6.846
  4. Zarean E., Looha MA., Amini P., et al. Sleep characteristics of middle-aged adults with non-alcoholic fatty liver disease: findings from the Shahrekord PERSIAN cohort study. BMC Public Health. 2023; 23(1): 312. https://doi.org/10.1186/s12889-023-15251-4
  5. Houghton D., Thoma C., Hallsworth K., et al. Exercise Reduces Liver Lipids and Visceral Adiposity in Patients with Nonalcoholic Steatohepatitis in a Randomized Controlled Trial. Clinical Gastroenterology and Hepatology. 2017; 15(1): 96–102.e3. https://doi.org/10.1016/j.cgh.2016.07.031
  6. Chalasani N., Younossi Z., Lavine J.E., et al. The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. American Journal of Gastroenterology. 2012; 55(6): 2005–2023. https://doi.org/10.1038/ajg.2012.217
  7. Risikesan J., Heebøll S., Kumarathas I., et al. Exercise increases myocardial free fatty acid oxidation in subjects with metabolic dysfunction-associated fatty liver disease. Atherosclerosis. 2023; 372: 10–18. https://doi.org/10.1016/j.atherosclerosis.2023.03.015
  8. Huh J.Y., Mougios V., Skraparlis A., et al. Irisin in response to acute and chronic whole-body vibration exercise in humans. Metabolism. 2014; 63(7): 918–921. https://doi.org/10.1016/j.metabol.2014.04.001
  9. Patel H., Alkhawam H., Madanieh R., et al. Aerobic vs anaerobic exercise training effects on the cardiovascular system. World Journal of Cardiology. 2017; 9(2): 134–138. https://doi.org/10.4330/wjc.v9.i2.134
  10. Keating S.E., Sabag A., Hallsworth K., et al. Exercise in the Management of Metabolic-Associated Fatty Liver Disease (MAFLD) in Adults: A Position Statement from Exercise and Sport Science Australia. Sports Medicine. 2023; 53(12): 2347–2371. https://doi.org/10.1007/s40279-023-01918-w
  11. Johnson N.A., George J. Fitness versus fatness: moving beyond weight loss in nonalcoholic fatty liver disease. Hepatology. 2010; 52(1): 370–381. https://doi.org/10.1002/hep.23711
  12. Oh S., Shida T., Sawai A., et al. Acceleration training for managing nonalcoholic fatty liver disease: a pilot study. Therapeutics and Clinical Risk Management 2014; 10: 925–936. https://doi.org/10.2147/tcrm.s68322
  13. Ibrahim A.A., Abdelbasset W.K. The role of physical exercise in treating people with non- alcoholic fatty liver disease. Journal of Advanced Pharmacy Education and Research. 2020; 10(2): 64–70.
  14. Reis-Silva A., Coelho-Oliveira A.C., Martins-Anjos E., et al. Impact of Two Whole-Body Vibration Exercise Protocols on Body Composition of Patients with Metabolic Syndrome: A Randomized Controlled Trial. International Journal of Environmental Research and Public Health. 2022; 20(1): 436. https://doi.org/10.3390/ijerph20010436
  15. Oh S., Oshida N., Someya N., et al. Whole-body vibration for patients with nonalcoholic fatty liver disease: a 6-month prospective study. The Physiological Reports. 2019; 7(9): e14062. https://doi.org/10.14814/phy2.14062
  16. Dossoki M.A., Abd Alhady A.A., Amer K.A., et al. Effect of Moderate Aerobic Exercises on Liver Function in Non-Alcoholic Fatty Liver Disease in University Students. Egyptian Journal of Physical Therapy. 2020; 2(1): 1–8. https://doi.org/10.21608/ejpt.2020.25632.1004
  17. Colantonio E., Kiss MAPDM. Is the HRmax = 220 − age equation valid to prescribe exercise training in children? Journal of Exercise Physiology online. 2013; 16(1): 19–27.
  18. Zhang C., Zhang H., Zhao M., et al. Reliability, Validity, and Factor Structure of Pittsburgh Sleep Quality Index in Community-Based Centenarians. Frontiers in Psychiatry. 2020; 11: 573530. https://doi.org/10.3389/fpsyt.2020.573530
  19. Glass O.K., Radia A., Kraus W.E., et al. Exercise Training as Treatment of Nonalcoholic Fatty Liver Disease. Journal of Functional Morphology and Kinesiology. 2017; 2(4): 35. https://doi.org/10.3390/jfmk2040035
  20. Shamsoddini A., Sobhani V., Ghamar Chehreh M.E., et al. Effect of Aerobic and Resistance Exercise Training on Liver Enzymes and Hepatic Fat in Iranian Men With Nonalcoholic Fatty Liver Disease. Hepatitis Monthly. 2015; 15(10): e31434. https://doi.org/10.5812/hepatmon.31434
  21. Hoseini Z., Behpour N., Hoseini R. Co-treatment with Vitamin D Supplementation and Aerobic Training in Elderly Women with Vit D Deficiency and NAFLD: A Single-blind Controlled Trial. Hepatitis Monthly. 2020; 20(2): e96437. https://doi.org/10.5812/hepatmon.96437
  22. Banno M., Harada Y., Taniguchi M., et al. Exercise can improve sleep quality: a systematic review and meta-analysis. PeerJ. 2018; 6: e5172. https://doi.org/10.7717/peerj.5172
  23. Xie Y., Liu S., Chen X.J., et al. Effects of Exercise on Sleep Quality and Insomnia in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in Psychiatry. 2021; 12: 664499. https://doi.org/10.3389/fpsyt.2021.664499
  24. D’Aurea C.V.R., Frange C., Poyares D., et al. Physical exercise as a therapeutic approach for adults with insomnia: systematic review and meta-analysis. Einstein (Sao Paulo). 2022; 20: eAO8058. https://doi.org/10.31744/einstein_journal/2022ao8058
  25. Barrón-Cabrera E., Soria-Rodríguez R., Amador-Lara F., et al. Physical Activity Protocols in Non-Alcoholic Fatty Liver Disease Management: A Systematic Review of Randomized Clinical Trials and Animal Models. Healthcare. 2023; 11(14): 1992. https://doi.org/10.3390/healthcare11141992
  26. Torres-Nunes L., da Costa-Borges P.P., Paineiras-Domingos L.L., et al. Effects of the Whole-Body Vibration Exercise on Sleep Disorders, Body Temperature, Body Composition, Tone, and Clinical Parameters in a Child with Down Syndrome Who Underwent Total Atrioventricular Septal Defect Surgery: A Case-Report. Children (Basel). 2023; 10(2): 213. https://doi.org/10.3390/children10020213



Creative Commons License
The content is available under the Creative Commons Attribution 4.0 License.

©


This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.