Evaluación de actividad física como coadyuvante terapéutico para pacientes con enfermedad inflamatoria intestinal: una revisión.

Abstract

Inflammatory bowel disease (IBD) includes Crohn’s disease (CD) and ulcerative colitis (UC). Pharmacological treatment in IBD presents a loss of efficacy and side effects, inviting to consider alternative strategies, such as the practice of physical activity (PA), as a therapeutic adjuvant. The purpose of this review was to evaluate the effectiveness of PA interventions as a tool to in-crease physical fitness, and health-related quality of life (HRQoL) and improve the symptomatology in patients with CD and UC, identifying the optimal PA component. The review was performed, by searching the electronic databases Medline (PubMed), SciELO, and Cochrane Library Plus, including randomized controlled trials from the last 10 years that related to IBD and PA, until January 31, 2022. We found four studies with a total of 133 patients. The performance of PA in patients with IBD (UC and CD) increases (p>0.05) physical capacity, skeletal muscle mass, bone mineral density, and HRQoL, significantly (p<0.05) increasing mood. In addition, it significantly (p<0.05) decreases intestinal in-flammation and extraintestinal manifestations. A trend of reduction (p>0.05) of fatigue, blood pressure, and microbiota restoration was observed. Moderate PA and performed regularly for a minimum of eight weeks, favors the improve-ment of the IBD patient at the physical, psychological, HRQoL, and symptom-atology levels.

Efficacy of Therapeutic Exercise in Reversing Decreased Strength, Impaired Respiratory Function, Decreased Physical Fitness, and Decreased Quality of Life Caused by the Post-COVID-19 Syndrome

“…These were demonstrated by the different tests evaluated SPPB [42,45], Time-up and go [41,42], Balke [41], FAC [48], and 6MWT [40,42]. These improvements in physical condition would contribute to a decrease in fatigue [21].…”

“…Several studies [20][21][22] have described the effectiveness of therapeutic exercise (ThEx) as a non-pharmacological adjuvant therapy in breast cancer [22], chronic kidney disease [20], and inflammatory bowel disease [21]. For these patients, it has been observed that it not only improves the physical performance of patients, but also reduces the clinical signs of the diseases and induces psychological changes associated with both the disease and the treatment, leading to a better health-related QoL (HRQoL) [20][21][22]. In addition, other benefits associated with the practice of exercise have been described (Figure 2), such as a reduction in the risk of cardiovascular disease and better regulation of blood glucose…”

“…Several studies [20][21][22] have described the effectiveness of therapeutic exercise (ThEx) as a non-pharmacological adjuvant therapy in breast cancer [22], chronic kidney disease [20], and inflammatory bowel disease [21]. For these patients, it has been observed that it not only improves the physical performance of patients, but also reduces the clinical signs of the diseases and induces psychological changes associated with both the disease and the treatment, leading to a better health-related QoL (HRQoL) [20][21][22]. In addition, other benefits associated with the practice of exercise have been described (Figure 2), such as a reduction in the risk of cardiovascular disease and better regulation of blood glucose levels, reducing the risk of developing diabetes [23][24][25][26][27].…”

Is Probiotics Supplementation an Appropriate Strategy to Modulate Inflammation in Physically Active Healthy Adults or Athletes? A Systematic Review

“…Indeed, the behavior of the microbiota, which acts like an endocrine gland, inducing multifactorial changes in organ function, metabolism, immunity, and host behavior [12]. Regular physical activity and low/moderate-intensity exercise are beneficial adaptations and improve the long-term resistance of the intestinal barrier by reducing the response of heat shock proteins to heat stress by preventing the breakdown of tight junction proteins between the epithelial cells [12], such as those produced by therapeutic exercise in patients with inflammatory bowel disease [13]. However, high-intensity and long-duration exercise causes gastrointestinal disorders known as "exercise-induced gastrointestinal syndrome", by damaging epithelial cells in the gut [14].…”