Barriers to Exercise in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease: A Patient Survey

Kedar Deshpande; John Olynyk; Oyekoya Ayonrinde; Kazunori Nosaka

doi:10.14740/jocmr5113

Barriers to Exercise in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease: A Patient Survey

J Clin Med Res. 2024 Mar;16(2-3):94-105. doi: 10.14740/jocmr5113. Epub 2024 Mar 16.

Authors

Kedar Deshpande¹, John Olynyk^{2

3}, Oyekoya Ayonrinde^{2

3

4

5}, Kazunori Nosaka^{1

5}

Affiliations

¹ School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
² Curtin Medical School, Curtin University, Perth, Australia.
³ Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Perth, Australia.
⁴ Medical School, The University of Western Australia, Perth, Australia.
⁵ These authors contributed equally to this article.

Abstract

Background: Although adequate physical activity is an essential component of treatment for metabolic dysfunction-associated steatotic liver disease (MASLD), the majority of people with MASLD do not engage in regular exercise and lead sedentary lifestyles. We aimed to identify perceived barriers to exercise and to examine awareness about the role of exercise in the treatment of MASLD.

Methods: Individuals aged 18 years and above were recruited from a hepatology outpatient clinic. MASLD severity was assessed using controlled attenuation parameter (CAP) and transient elastography (TE) determined liver stiffness measurement (LSM) for the severity of hepatic steatosis and fibrosis, respectively. An online questionnaire was administered to record self-reported exercise patterns, barriers to exercise, and knowledge regarding effectiveness of different types of exercise for MASLD.

Results: Eighty-one participants (57% female) with a mean age of 55.3 ± 13.4 years and a mean body mass index (BMI) of 33.8 ± 6.4 answered the questionnaire. The mean CAP score was 335.7 ± 47.8 dB/m, and the median LSM was 12.45 kPa. While most patients (83%) considered MASLD to be a serious health concern, 73% did not achieve the recommended exercise levels of ≥ 150 min of moderate-intensity physical activity per week, and 54% were unsure about the role of exercise in the treatment of MASLD. Commonly reported barriers to exercise included physical and mental health issues (57%), lack of time (43%), lack of enjoyment in exercising (31%), fatigue caused by exercise (24%), and others (25%).

Conclusions: Most participants with MASLD were unaware of the role of exercise as a potential treatment option and were not achieving recommended exercise levels. Inadequate time, physical and mental health problems, lack of enjoyment in exercise, and fatigue were major barriers.

Keywords: Challenges; Lifestyle; Liver fibrosis; Liver steatosis; Physical activity.

Grants and funding

This work was supported by a PhD scholarship from Edith Cowan University. The university did not have any role in the study design, data collection, analysis or interpretation of the data; in writing this manuscript, or in the decision to submit the article for publication.