Physical fitness and physical activity in fatigued and non-fatigued inflammatory bowel disease patients

Vogelaar, Lauran; Berg-Emons, Rita van den; Bussmann, Hans; Rozenberg, Robert; Timman, Reinier; Woude, C. Janneke van der

doi:10.3109/00365521.2015.1046135

Cited by 37 publications

(43 citation statements)

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“…Evidence to date suggests that individuals with IBD should benefit from increased exercise [15,22,23,53,54], and in particular, that low-moderate intensity PA is safe [19,55]. The results from our study support these findings: no serious adverse effects related to exercise were reported.…”

Section: Discussionsupporting

confidence: 82%

“…Low intensity exercise (cycling) was tolerated in patients with CD [17]; improvements in HRQOL and psychological benefits were reported in CD patients (with no/mild-moderate disease activity) undergoing low-moderate intensity PA programmes [16,18,19,20,21]. Greater impairments in physical fitness (assessed by cardiorespiratory fitness, 6-minute walk distance, and isokinetic muscle strength) and PA levels were reported in fatigued compared with non-fatigued IBD patients, and these were ameliorated by exercise [22]. Self-reported fatigue and skeletal muscle fatigue were significantly correlated in CD patients and non-IBD controls [23].…”

Section: Introductionmentioning

confidence: 99%

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The effect of increasing physical activity and/or omega-3 supplementation on fatigue in inflammatory bowel disease

McNelly

Nathan

et al. 2016

Gastrointestinal Nursing

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Objective: Fatigue is frequently reported by patients with inflammatory bowel disease (IBD), irrespective of disease activity; however, evidence regarding fatigue management is limited. This study tested the effect of individualised advice to increase physical activity and/or omega-3 fatty acids supplementation on fatigue in inactive IBD. Methods:Patients in remission were recruited to a pilot study utilising a randomised Results: From n=656 screened patients, n=74 who met the eligibility criteria (designed to remove confounding factors) were randomised, n=60 commenced, and n=52 completed the study. The primary outcome, fatigue measured with FACIT-F score, was worse with omega-3 supplementation (95%CI:-8.6-(-0.7);p=0.02), and unchanged with exercise advice (p=0.38). Fatigue, measured by IBD-F score, was reduced with exercise 2 advice (95%CI:-3.8-(-0.2);p=0.03). One treatment-related adverse event (musculoskeletal pain) was reported with exercise. Conclusions:Advice to increase physical activity and omega-3 supplementation, singly or in combination, were shown to be well-tolerated in IBD patients in remission. There was no evidence of exercise-related adverse effects on gut symptoms. Fatigue (IBD-F score) was reduced with exercise advice, but fatigue (FACIT-F score) was unchanged.Increasing fatigue with omega-3 supplementation is unexplained. Regular exercise may be a self-management option in IBD-related fatigue.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

The effect of increasing physical activity and/or omega-3 supplementation on fatigue in inflammatory bowel disease

McNelly

Nathan

et al. 2016

Gastrointestinal Nursing

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“…As known from research of other chronically ill people, PA can effectively address the symptoms of fatigue [65–67]. Fatigue contributes to a loss in muscle mass due to the lack of PA [23, 24, 68] especially in a population with an existing muscular disadvantaged [16]. Hitherto, the etiology of fatigue cannot be explained [65], though, an assessment of Cancer Related Fatigue (CRF) shows, that the amount of circulating pro-inflammatory blood cytokines are strongly associated with the severity of CRF [69–71].…”

Section: Discussionmentioning

confidence: 99%

Structured physical activity interventions as a complementary therapy for patients with inflammatory bowel disease – a scoping review and practical implications

et al. 2019

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Background Patients with Inflammatory Bowel Disease (IBD) also suffer from a wide range of additional disorders, which may be caused by the disease, the side effect of the medication, or a lack of physical activity (PA). This results in reduced physical and psychological wellbeing. However, as known from other chronic diseases exercise could be utilized as supportive therapy for IBD patients. Main goals of this article are (a) collecting data of the effects structured physical activity interventions have on validated clinical parameters of IBD and health related symptoms, (b) developing activity recommendations for this clientele. Methods A scoping review was conducted, searching for relevant articles published until May 2018, which investigated the effects of structured exercise interventions in IBD patients. The heterogeneity of the outcomes and the interventions did not support a quantitative synthesis thus, a qualitative discussion of the studies is provided. Results After reviewing 353 records, 13 eligible articles were identified. Five studies investigated aerobic exercise, three studies resistance exercise, three studies mind-body therapies and two studies yoga. The quality of the studies is mixed, and the duration is rather short for exercise interventions. Only few studies assessed validated IBD activity markers or inflammatory biomarkers. Nevertheless, the patients showed an increase in fitness, bone mineral density (BMD), quality of life and a decrease of IBD induced stress and anxiety. No severe adversial events were reported. Conclusion Even though the evidence is limited the application of exercise interventions in IBD patients can be assumed to be safe and beneficial for the patients‘ overall-health, and IBD specific physical and psychosocial symptoms. But there is still a high demand for more thoroughly conducted studies, focussing on important clinical outcome parameters.

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“…Abbreviations: IBDQ, Inflammatory Bowel Disease Questionnaire.intervention-based research on this topic 35. Observational studies have revealed fatigue to be negatively associated with physical activity, cardiorespiratory fitness and muscle strength;28,37 therefore, highlighting exercise as a candidate intervention. The current study provides support for a beneficial role of exercise by demonstrating that fatigue severity (IBD-F score) was an average of 2 points lower in the exercise group at 6 months (95% CI −4 to −1; P = 0.005).…”

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confidence: 99%

Randomised clinical trial: combined impact and resistance training in adults with stable Crohn's disease

Jones

Baker

Speight

et al. 2020

Aliment Pharmacol Ther

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Summary Background Crohn's disease (CD) is a predisposing factor for bone loss and muscle dysfunction, which could lead to osteoporotic fractures and physical disability, respectively. Aim To assess the effect of 6 months of combined impact and resistance training on bone mineral density (BMD) and muscle function in adults with CD. Methods In this randomised controlled trial, 47 adults with stable CD were assigned to exercise (n = 23) or control (n = 24) groups and followed up for 6 months. The exercise group received usual care plus a 6‐month combined impact and resistance training programme, involving three, 60‐minute sessions per week and a gradual tapering of supervision to self‐management. The control group received usual care alone. The primary outcomes were BMD (via dual energy X‐ray absorptiometry) and muscle function (measures of upper and lower limb strength and endurance) at 6 months. Results At 6 months, BMD values were superior in the exercise group with statistical significance at lumbar spine (adjusted mean difference 0.036 g/cm2, 95% CI 0.024‐0.048; P < 0.001), but not at femoral neck (0.018 g/cm2, 0.001‐0.035; P = 0.059) or greater trochanter (0.013 g/cm2, −0.019 to 0.045; P = 0.415) after correcting for multiple outcomes. The exercise group also had superior values for all muscle function outcomes (P < 0.001; unadjusted mean differences ranging 22.6‒48.2%), and lower fatigue severity (P = 0.005). Three exercise‐related adverse events were recorded: two instances of light‐headedness and one of nausea. Conclusions The intervention improved BMD and muscle function in adults with CD and appears as a suitable model of exercise for reducing future risk of osteoporotic fractures and disability. Trial registration: ISRCTN11470370.

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Physical fitness and physical activity in fatigued and non-fatigued inflammatory bowel disease patients

Cited by 37 publications

References 100 publications

The effect of increasing physical activity and/or omega-3 supplementation on fatigue in inflammatory bowel disease

The effect of increasing physical activity and/or omega-3 supplementation on fatigue in inflammatory bowel disease

Structured physical activity interventions as a complementary therapy for patients with inflammatory bowel disease – a scoping review and practical implications

Randomised clinical trial: combined impact and resistance training in adults with stable Crohn's disease

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