Patient experiences with the role of physical activity in inflammatory bowel disease: results from a survey and interviews

Abstract

Background Physical activity may affect disease activity in patients with inflammatory bowel disease. We used a survey to investigate this association and performed interviews to get a better understanding of patient experiences, and therefore the nature of this association. Methods Patients with Crohn’s disease (CD, n = 176) and ulcerative colitis (UC, n = 162) completed the short Crohn’s Disease Activity (sCDAI) or Patient Simple Clinical Colitis Activity Index (P-SCCAI) and the Short Questionnaire to Assess Health-enhancing physical activity (SQUASH). Associations were investigated by multiple linear regression. Semi-structured interviews (7 CD, 7 UC) were conducted to assess patient experiences with the role of physical activity in their disease. Results The majority of survey participants were in remission (70%) and adhered to the Dutch physical activity guidelines (61%). In Crohn’s disease, the total physical activity score was inversely associated with disease activity, even after adjustment for confounders (β = − 0.375; p = 0.013). No association between physical activity and disease activity was found in ulcerative colitis. Of the interviewees, 86% experienced beneficial effects of physical activity, such as improved general fitness, quality of life and self-image. However, during periods of active disease they struggled to find the motivation and perseverance to be physically active due to physical barriers. Conclusions Crohn’s disease participants with a higher physical activity level had a lower disease activity. This inverse association was not found in ulcerative colitis. Interviews revealed that IBD patients generally experience beneficial effects from physical activity, although the barriers caused by active disease may put them off to be physically active.

Physical activity in inflammatory bowel disease: benefits, challenges and perspectives

“…However, there was no difference between patients in remission and those with active disease. Comparable results were found in a similar study, with only 60% of patients adhering to the WHO recommendations [9]. Finally, in a case-control study, Qalqili et al [10] evaluated the difference regarding some lifestyle parameters, including physical activity, among 185 newly-diagnosed IBD patients (100 UC and 85 CD) and 150 healthy controls.…”

“…Olive et al [28] showed that anxiety and depression were a limitation to physical activity in adult patients with chronic disease, including IBD. Other frequent obstacles to physical activity reported by patients with IBD included fatigue, pain and faecal urgency [9]. Stoma and repeated surgical procedures also appear to limit physical activity.…”

Understanding super engaged users in the 10,000 Steps online physical activity program: A qualitative study

“…However, as there was no clear distinction in how they responded to the questions in the interviews, they were all analysed as one group. Other studies using semi-structured interviews indicated to have achieved data adequacy with less than 20 participants [23][24][25][26]. Therefore, it was intended to recruit 20 participants (10 in each group) and then recruit additional participants until data adequacy was achieved.…”

Intensity-specific considerations for exercise for patients with inflammatory bowel disease

“…Using multiple linear regressions and survey data, Lamers et al . [ 118 ] reported that CD patients with higher physical activity levels had lower reported disease activity. It should only be cautiously assumed that these patients had higher physical activity levels due to more higher-intensity activities.…”

“…A multiple linear regression analysis by Lamers et al . [ 118 ] showed that when CD disease activity was increased, physical activity scores decreased ( P = 0.035). Brevinge et al .…”