Impact of an exercise program in children with inflammatory bowel disease in remission

Abstract

Background The aim of our study was to investigate the impact of a structured exercise program on bone mineral density (BMD) and body composition parameters in children and adolescents with IBD in remission. Methods Patients were recruited to participate in a 6-month exercise program. Total body less head (TLBH) dual energy X-ray absorptiometry (DXA) was used to measure BMD. The same method was used to assess fat mass (FM) and lean body mass (LBM) at baseline and at the completion of the program. Results Based on the baseline and endpoint TBLH DXA measurements, a total of 42 study participants (25 boys; aged 15.3 ± 2.08 years) experienced an increase in BMD (from 0.959 ± 0.023 g/cm 2 to 0.988 ± 0.025 g/cm 2 , p < 0.001) and LBM (from 37.12 ± 1.43 kg to 38.75 ± 1.61 kg, p = 0.012). Age- and sex-based BMD Z-score increased significantly (from −0.35 ± 0.15 to −0.28 ± 0.17, p = 0.020), whilst LBM Z-score did not significantly change (from −1.78 ± 0.23 to −1.71 ± 1.49, p = 0.908). Conclusions There was a significant improvement in BMD, age- and sex-based BMD Z-score, and LBM amongst study participants. Subgroup analysis showed that patients with CD and male study participants experienced significant improvement in all parameters, whilst patients with UC and IBD-U and female patients experienced improvement solely in BMD. Impact statement: Children and adolescents with IBD, regardless of disease activity, are under increased risk of secondary osteoporosis and lean body mass deficits. A 6-month home-based structured exercise program leads to a significant improvement in bone mineral density and lean body mass. Exercise therapy should be explored as a potentially adjacent to standard treatment modalities.

Scoping review on health-related physical fitness in patients with inflammatory bowel disease: Assessment, interventions, and future directions

“…Two studies focused on pediatric patients with IBD, and both demonstrated beneficial effects of their intervention on HRPF components[ 53 , 54 ]. Mählmann et al [ 53 ] demonstrated that an 8-wk aerobic exercise training intervention with active video gameplay increased the distance reached on the 6-min walk test, a practical field test for assessing cardiorespiratory fitness, in children with IBD in remission and with active disease.…”

“…Mählmann et al [ 53 ] demonstrated that an 8-wk aerobic exercise training intervention with active video gameplay increased the distance reached on the 6-min walk test, a practical field test for assessing cardiorespiratory fitness, in children with IBD in remission and with active disease. The effects of a home-based resistance exercise training program for 6 mo on HRPF components in children and adolescents with IBD in remission were investigated by Trivić et al [ 54 ]. Lean body mass significantly improved, whereas lean body mass age-based and sex-based z-scores did not.…”

Physical activity, quality of diet and bone mineral density in patients with inflammatory bowel disease

“…Nevertheless, we did not find a significant correlation between PA and CRP. On the contrary, Trivić et al reported that a 6‐month home‐based structured exercise programme improved lean body mass 31 . However, vigorous PA may cause gut dysbiosis, 22 which may also be negative for IBD patients.…”

Magnetic Resonance Imaging Can Be Used to Assess Sarcopenia in Children with Newly Diagnosed Crohn’s Disease

“…As previously noted, malnutrition is one of the symptoms of CD in children. Moreover, in our previous study, in which we evaluated the body composition of CD patients who were in clinical remission, we showed reduced lean body mass using DXA [20]. There are a limited number of pediatric studies that evaluated muscle mass in children with CD [7][8][9][10][11][12][13][14][15][16].…”