Moderate endurance and muscle training is beneficial and safe in patients with quiescent or mildly active Crohn’s disease

Abstract

Background and aims Physical activity is beneficial in several chronic disorders including Crohn′s disease, but the preferred type of exercise is unknown. Our study aimed to examine and compare the safety, feasibility and potential beneficial effects of individual moderate endurance and moderate muscle training in patients with Crohn’s disease. Methods Quiescent or mildly active (Crohn’s disease activity index <220) patients with Crohn’s disease were randomly allocated to either a control, endurance, or muscle training group. Participants exercised individually for 3 months three times per week. Endpoints included dropout rate, disease activity, inflammatory parameters including faecal calprotectin, anthropometric data, quality of life, physical activity and strength. Results A total of 45 patients with Crohn’s disease were randomly allocated. In the endurance group ( n = 17), the dropout rate was significantly higher (47% vs. 13%) compared with the muscle group ( n = 15). In both groups the maximal and average strength in the upper and lower extremities increased significantly (all P < 0.04). In the endurance group emotional function was significantly improved ( P = 0.03). Statistically significant changes of disease activity and other outcome parameters were not observed in this pilot cohort. Conclusion Both individual moderate endurance and muscle training can be safely performed in patients with mild or quiescent Crohn’s disease. Muscle training appears more feasible and may be favoured. Both forms of exercise have beneficial effects on strength. Quality of life increased in both intervention groups, although statistical significance was only reached in one subgroup.

Personalized exercise intervention in HPN patients - A feasibility study

“…This result is not only statistically significant, but also clinically important, as an improvement of only two repetitions has shown clinically important on several outcomes in various diagnosis [25,26]. An RCT with 45 Crohn's Disease participants, randomized to control group, moderate endurance, or muscle training, also showed a significant improvement in the lower extremities measured by leg press test (p < 0.04) [27], while we used squats and chair stand. In their pilot study with 9 participants after an extensive small bowel resection, Araújo et al (2008) found a significant increase in MM after a 14 weeks training intervention in patients with IBD [22].…”

The GLIM Criteria Represent a More Appropriate Tool for Nutritional Assessment in Patients With Crohn's Disease

“…Sarcopenia has been considered to be a meaningful marker of an adverse prognosis in patients with CD ( 48 – 50 ). Recent studies reported that moderate endurance and muscle training were beneficial for patients with quiescent or mildly active CD ( 51 , 52 ), which may imply the potential impact of improved muscle status on disease activity to some extent. This potential effect is somewhat related to the assessment of muscle mass by the GLIM criteria.…”

Inflammatory Bowel Disease and Sarcopenia: Its Mechanism and Clinical Importance

“…However, unlike healthy individuals, there are concerns about exercise intervention for patients with IBD. Although there are a number of studies that demonstrated the safety and efficacy of exercise interventions in patients with IBD, these studies have often been conducted in patients with IBD with mild disease status or in remission, and a thorough evaluation is required to determine whether exercise interventions in patients with active IBD are an aggravating factor for IBD [103][104][105][106][107][108][109]. The significance of exercise intervention for improving sarcopenia in patients with IBD with higher disease activity is unknown [104][105][106][107][108][109].…”