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

Abstract

Objective. To assess physical fitness and physical activity in inflammatory bowel disease (IBD) patients and whether fatigue is associated with impaired physical fitness and impaired physical activity. Materials and methods. Ten patients with quiescent IBD and fatigue (fatigue group [FG]) based on the Checklist Individual Strength-Fatigue score of ≥35 were matched for age (±5 years) and sex with a non-fatigue group (NFG) with IBD. Physical fitness was measured with a cyclo-ergometric-based maximal exercise test, a submaximal 6-min walk test, and a dynamometer test to quantify the isokinetic muscle strength of the knee extensors and flexors. Level of physical activity was measured with an accelerometer-based activity monitor. Results. The patients in both groups did not differ in regard to medication use, clinical characteristics, and body composition. However, medium-to-large effect sizes for impaired physical fitness (both cardiorespiratory fitness and muscle strength) and physical activity were seen between the patients in the FG and the NFG. Especially, intensity of physical activity was significantly lower in the FG patients compared with the NFG patients (effect size: 1.02; p = 0.037). Similar results were seen when outcomes of the FG and NFG were compared with reference values of the normal population. Conclusion. Fatigued IBD patients show an impaired physical fitness and physical activity compared with non-fatigued IBD patients. This gives directions for a physical component in fatigue in IBD patients. Therefore, these new insights into fatigue indicate that these patients might benefit from an exercise program to improve physical fitness and physical activity.

Key Words:

• fatigue
• inflammatory bowel disease
• physical activity
• physical fitness

Acknowledgments

The authors thank Emiel Sneekes and Herwin Horemans for contributing to the study by data processing and for their assistance in data analyses, Badr Nouhaili and Sylvi-An de Schipper for practical assistance and data collection. Contributors: All authors have read and approved the final manuscript. LV participated in the conception and design, acquisition of data, analysis and interpretation of data, and drafting of the manuscript. RB participated in the conception and design of the study, and critical revision of the manuscript for important intellectual content. RT participated in the conception and design of the study, performed the statistical analysis and critical revision of the manuscript for important intellectual content. HB participated in critical revision of the manuscript for important intellectual content. RR participated in critical revision of the manuscript for important intellectual content. CW had full access to all data of the study and takes responsibility for the integrity of the data and the accuracy of the data analysis, study concept and design, acquisition of data, and critical revision of the manuscript for important intellectual content. Funding: No funding was obtained.

Declaration of interest: All authors state that there are no potential conflicts of interest during the work under consideration for publication.