P840 Longitudinal bidirectional association of physical activity and disease activity in children with Inflammatory Bowel Disease: a cohort study

Abstract

Background Studies have shown that regular physical activity (PA) can contribute to lower inflammatory markers over time in pediatric patients with an inflammatory bowel disease (IBD). However, patients with active disease may be less prone to engage in PA and therefore, develop sedentary habits. No study so far, have investigated if clinical disease activity (CDA) can affect PA longitudinally and if PA may impact disease outcomes. The aim of this study was to investigate the bidirectional association between PA and CDA in a cohort of children and adolescents with IBD. Methods IBD patients of CHU Sainte-Justine pediatric hospital were prospectively surveyed using the Canadian Health Measures Survey Children’s Physical Activity Questionnaire during outpatient visits every three months for one year. PA levels were classified according to Canadian moderate-to-vigorous PA (MVPA) recommendations. Clinical data was collected retrospectively through patients’ files. CDA was determined at baseline and at each follow-up visit. Results A total of 247 IBD patients (median age [IQR], 15 years [13-17]; 55% male) were included. Among them, 167 (68%) were diagnosed with Crohn’s disease and 80 (32%) with ulcerative or indeterminate colitis. At the initial visit, 65% of patients were considered in clinical remission, 28% of patients were considered “sedentary”, 21% “moderately active”, 31% “extremely active” and 25% “vigorously active”. Patients classified as “extremely active” (34-74 minutes of daily MVPA) at initial visit were less likely to have active CDA at follow-up (odds ratio (OR) [95% CI]: 0.30 [0.09-0.96]). Inversely, CDA at baseline did not correlate with PA levels at follow-up. BMI, sex and age did not significantly affect PA level or CDA between follow-ups. Conclusion This study demonstrates a possible protective association between higher PA level and CDA over time in pediatric IBD. These findings stress the importance to engage children with IBD in regular physical activity.