Fatigue and Physical Activity Patterns in Children With Inflammatory Bowel Disease.

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.