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Physical Activity Improves Quality of Life in Patients With Inflammatory Bowel Disease: A Systematic Review and
Emese Kasznár1,2, Barbara Csendes2,3, Dorottya Gergő2,4
1Heim Pál National Pediatric Institute, Budapest, Hungary.
Background:
Patients with inflammatory bowel disease (IBD) are often less active physically and experience impaired bone mineral density (BMD) as well as sarcopenia, which are associated with a higher risk of poor disease outcomes. Physical exercise can improve BMD and sarcopenia and may also play a role in controlling inflammation via anti-inflammatory myokines. This study aimed to evaluate the effects of structured physical exercise on the disease activity and quality of life of patients with IBD by conducting a before-and-after analysis.
Methods:
We conducted a systematic search on 16 November 2023. Studies with structured exercise interventions in patients with IBD focusing on quality of life, disease activity, body composition, muscle strength, inflammatory markers, aerobic fitness and sedentary time were included. The mean difference (MD) or the standardized MD (SMD) of the differences between the before and after values was used to measure the effect size with a 95% confidence interval (CI). Risk of bias was assessed using the MINORS tool.
Results:
Twenty-one studies involving 498 patients with IBD were included. Quality of life improved significantly: SMD 0.55 (CI, 0.30-0.80), particularly in the systemic subscale. Disease activity scores showed a non-significant improvement: SMD -0.20 (CI, -0.47 to 0.07) in Crohn's disease and SMD -0.23 (CI, -0.46 to 0.00) in ulcerative colitis. Numbers of inflammatory markers and faecal calprotectin levels also improved, but not significantly. Muscle strength and aerobic fitness improved, with a significant increase in VO2 max: SMD 1.88 (CI, 1.34-2.43). Due to the lack of available data, we were unable to conduct a statistical analysis of body composition parameters and sedentary time.
Conclusion:
Regular physical activity improves quality of life and physical fitness of IBD patients, with potential benefits for disease activity and sarcopenia.
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