%0 Journal Article
%@ 2561-326X
%I JMIR Publications
%V 5
%N 8
%P e30239
%T Utilization of a Directly Supervised Telehealth-Based Exercise Training Program in Patients With Nonalcoholic Steatohepatitis: Feasibility Study
%A Motz,Victoria
%A Faust,Alison
%A Dahmus,Jessica
%A Stern,Benjamin
%A Soriano,Christopher
%A Stine,Jonathan G
%+ Penn State Milton S Hershey Medical Center, 500 University Dr, Hershey, PA, 17033, United States, 1 717 531 1017, jstine@pennstatehealth.psu.edu
%K physical activity
%K fatty liver
%K telemedicine
%K liver
%K nonalcoholic fatty liver disease
%K liver disease
%K fatty liver disease
%K aerobic training
%K telehealth
%K fitness
%K feasibility
%K steatohepatitis
%D 2021
%7 17.8.2021
%9 Original Paper
%J JMIR Form Res
%G English
%X Background: Most patients with nonalcoholic fatty liver disease (NAFLD) are physically inactive despite the well-known benefits of physical activity. Telehealth offers promise as a novel way to deliver an exercise training program and increase physical activity. However, the feasibility, safety, and efficacy of telehealth-based exercise programs is unknown in patients with NAFLD. Objective: The aim of this study was to determine the feasibility of a directly supervised exercise training program delivered exclusively with telehealth to patients with nonalcoholic steatohepatitis (NASH), the progressive form of NAFLD. Methods: In response to COVID-19 research restrictions, we adapted an existing clinical trial and delivered 20 weeks of moderate-intensity aerobic training 5 days a week under real-time direct supervision using an audio–visual telehealth platform. Aerobic training was completed by walking outdoors or using a home treadmill. Fitness activity trackers with heart rate monitors ensured exercise was completed at the prescribed intensity with real-time feedback from an exercise physiologist. Results: Three female patients with biopsy-proven NASH were enrolled with a mean age of 52 (SD 14) years. The mean body mass index was 31.9 (SD 5.1) kg/m2. All patients had metabolic syndrome. All patients completed over 80% of exercise sessions (mean 84% [SD 3%]) and no adverse events occurred. Body weight (mean –5.1% [SD 3.7%]), body fat (mean –4.4% [SD 2.3%]), and waist circumference (mean –1.3 in. [SD 1.6 in.]) all improved with exercise. The mean relative reduction in magnetic resonance imaging-proton density fat fraction (MRI-PDFF) was 35.1% (SD 8.8%). Mean reductions in hemoglobin A1c and Homeostatic Model Assessment for Insulin Resistance were also observed (–0.5% [SD 0.2%] and –4.0 [SD 1.2], respectively). The mean peak oxygen consumption (VO2peak) improved by 9.9 (SD 6.6) mL/kg/min. Conclusions: This proof-of-concept study found that supervised exercise training delivered via telehealth is feasible and safe in patients with NASH. Telehealth-based exercise training also appears to be highly efficacious in patients with NASH, but this will need to be confirmed by future large-scale trials. Trial Registration: ClinicalTrials.gov NCT03518294; https://clinicaltrials.gov/ct2/show/NCT03518294 
%M 34402795
%R 10.2196/30239
%U https://formative.jmir.org/2021/8/e30239
%U https://doi.org/10.2196/30239
%U http://www.ncbi.nlm.nih.gov/pubmed/34402795