Effects of Home-Based Aerobic and Resistance Exercise on Oxygen Consumption, Muscle Function, Frailty, Quality of Life, and Health-Related Lifestyle in Chronic Liver Disease

The goal of this clinical trial is to evaluate whether home-based exercise interventions, including aerobic exercise (AE) and a combination of aerobic and resistance exercise (ARE), can improve physical and health-related outcomes in patients with chronic liver disease (CLD). The primary population includes adult patients with CLD experiencing complications such as sarcopenia, malnutrition, and fatigue. The main questions it aims to answer are: Does home-based ARE improve oxygen consumption, muscle strength, and physical frailty more effectively than AE or no exercise? Can home-based exercise reduce fatigue and improve quality of life and health-related behaviors? Researchers will compare the outcomes of three groups: Home-based AE group Home-based ARE group Control group (physical activity counselling) Participants will: Perform an 8-week home-based exercise program based on their group allocation (either AE or ARE). Undergo evaluations before and after the intervention, including: Oxygen consumption (via cardiopulmonary exercise testing) Muscle strength (using a hand dynamometer and respiratory muscle strength tests) Body composition (via bioelectrical impedance analysis and skinfold thickness measurements) Quadriceps muscle thickness and cross-sectional area (using muscle ultrasound) Muscle oxygenation Fatigue levels (using the Fatigue Severity Scale) Physical frailty (using the Liver Frailty Index) Quality of life (using the Chronic Liver Disease Questionnaire) Health-related lifestyle behaviors (using the Health-Promoting Lifestyle Profile II)