Combined Effect of 12-week High-Intensity Interval Training (HIIT), Strength Training and Dietary Modification on Metabolic Profile, Liver Function and Exercise Tolerance in Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD): A Case Report

BACKGROUND: MAFLD is characterized by hepatic fat accumulation and is strongly associated with obesity, insulin resistance, and dyslipidemia It is known as hepatic manifestation of metabolic syndrome which can progress to fibrosis, cirrhosis, and carcinoma. We report a case of 47 years old male with MAFLD, referred to the physiotherapy department for exercise intervention. On evaluation, we found central/abdominal obesity, dyslipidemia, diabetes-mellitus, abnormal liver function tests-(SGPT/SGOT), liver-elastography/fibro-scan suggest grade-III fatty liver, and reduced functional capacity. PURPOSE: To study the combined effect of 12 weeks of HIIT, strength training, and dietary modification in MAFLD. METHOD: Physiotherapy was implemented as [1] HIIT: Frequency- 3days/week, Intensity- 75% to 85% HRmax/RPE-(15-17), Bouts/sessions- 6bouts/session, each bout equal to 1min, Active recovery-(low intensity 40% HRmax/RPE<14), Work: Rest of (1:2) to (2:2) after 6weeks. [2] Strength training: Frequency- 3 days/week, Intensity- 65% of 10RM to 75% of 10RM after 6 weeks. Each session consists of 40-min. Dietary modification was done by a dietician. RESULT: After 12 weeks of intervention, there is a significant improvement in fibro-scan (12.5 to 10kPa), liver function test (SGPT: 74U/L to 35U/L, SGOT: 40U/L to 28U/L), HbA1c (7.3% to 5.8%), dyslipidemia (S. Cholesterol: 193mg/dl to 147 mg/dl, S. Triglyceride: 254 mg/dl to 84 mg/dl, S.LDL: 111.60 mg/dl to 87.20 mg/dl, S.HDL: 34 mg/dl to 43 mg/dl, waist-circumference-103 cm to 94 cm, and physical and functional capacity. CONCLUSION: According to our findings, combined HIIT, strength training and dietary modification are crucial pillars in the treatment of metabolic profile, liver function, and exercise tolerance in MAFLD. Keywords: HIIT, strength training, MAFLD.