Related Experiment Video
Updated: Jul 21, 2025
A TNBS-Induced Rodent Model to Study the Pathogenic Role of Mechanical Stress in Crohn's Disease
Published on: March 1, 2022
Fatigue and Physical Activity Patterns in Children With Inflammatory Bowel Disease
Nanja Bevers1, Els Van de Vijver2, Adrienne Hanssen3
1From the Department of Pediatrics, Zuyderland Medical Center, Sittard-Geleen, the Netherlands.
Insights
Children with inflammatory bowel disease (IBD) experiencing fatigue showed reduced moderate-to-vigorous physical activity. Standard biological markers did not differentiate fatigued from non-fatigued pediatric IBD patients.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Clinical Outcomes in Chronic Illness
Background:
- Fatigue is a prevalent symptom in pediatric patients diagnosed with inflammatory bowel disease (IBD).
- Current diagnostic approaches for fatigue in pediatric IBD primarily focus on biological markers like inflammation and hemoglobin levels.
- Functional parameters assessing physical activity and daily functioning remain understudied in this population.
Purpose of the Study:
- To compare fatigued and non-fatigued pediatric IBD patients using both biological and functional assessments.
- To identify key differences in biological markers and physical activity levels between fatigued and non-fatigued children with IBD.
- To explore potential new methods for distinguishing fatigued from non-fatigued pediatric IBD patients.
Main Methods:
- A cross-sectional study involving 104 pediatric IBD patients with mild to moderate disease activity.
- Fatigue was defined using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (z score <-2.0).
- Evaluated disease-specific quality of life (IMPACT-III), C-reactive protein (CRP), fecal calprotectin (FC), hemoglobin z score (Hb z score), 6-minute walking distance (6MWD z score), and triaxial accelerometry (TA).
Main Results:
- Fatigued children (n=24) reported significantly lower disease-specific quality of life (IMPACT-III) compared to non-fatigued children (n=80).
- No significant differences were observed in Hb z scores, CRP, FC, or 6MWD z scores between the groups.
- Triaxial accelerometry (TA) revealed that fatigued patients spent significantly less time in moderate-to-vigorous physical activity (18.3 min/day) compared to non-fatigued patients (37.3 min/day).
Conclusions:
- Standard biological markers are insufficient to differentiate fatigued from non-fatigued pediatric IBD patients.
- Triaxial accelerometry (TA) shows promise in distinguishing fatigued from non-fatigued individuals.
- Functional assessment of physical activity may offer a valuable target for interventions aimed at improving quality of life in pediatric IBD patients experiencing fatigue.
Objectives:
Fatigue is a common symptom in children with inflammatory bowel disease (IBD). Diagnostic tests to evaluate biological causes of fatigue commonly include markers of inflammation and hemoglobin (Hb), yet functional parameters have been inadequately studied in pediatric IBD. In this study, we compared fatigued and non-fatigued children with IBD from both a biological and functional point of view.
Methods:
A cross-sectional study of 104 pediatric IBD patients with mild to moderately active IBD was conducted. Fatigued children were defined as those with a Pediatric Quality of Life Inventory Multidimensional Fatigue Scale z score <-2.0. Non-fatigued children had a z score ≥-2.0. Disease-specific quality of life (measured with IMPACT-III score), C-reactive protein (CRP), fecal calprotectin (FC), hemoglobin z score (Hb z score), and physical activity tests including 6-minute walking distance z score (6MWD z score) and triaxial accelerometry (TA) were evaluated.
Results:
Fatigued children (n = 24) had a significant lower IMPACT-III score than non-fatigued children (n = 80). Hb z scores, CRP, FC, and 6MWD z scores were not significantly different between groups. TA was performed in 71 patients. Wear time validation requirements were met in only 31 patients. Fatigued patients spent significant shorter median time in moderate-to-vigorous activity than non-fatigued patients (18.3 vs 37.3 minutes per day, P = 0.008).
Conclusion:
Biological parameters did not discriminate fatigued from non-fatigued patients. TA possibly distinguishes fatigued from non-fatigued patients; the potential association may provide a target for interventions to combat fatigue and improve quality of life.
Related Concept Videos
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents