Table 2.
Studies investigating the association between exercise and course of inflammatory bowel diseases
| Study, Year | Patients | Intervention | Outcomes | Results |
|---|---|---|---|---|
| Robinson et al, 199863 | 117 CD patients | Randomized controlled trial of home-based low-impact exercise program with a minimum of 10 sessions a month focusing on lumbar and hip regions vs control | BMD by radiologic criteria of exercise group (60) vs controls (57) at zero and 12 months | Nonsignificant trend of increased bone density in all measured areas in exercise patients vs controls Significant increase in BMD at greater trochanter in exercise vs controls (differences of means 4.67; 95% CI: 0.86–8.48; p=0.02) Increased BMD at femoral neck related to the number of exercise sessions completed (r=0.28; 95% CI: 0.10–0.45) |
| D’Inca et al, 199960 | 6 CD patients in remission, matched with 6 healthy controls | One hour of exercise at 60% VO2 maximum values after a meal (in both populations) | Orocecal transit time by lactulose breath test, intestinal permeability, polymorpho leukocyte function, lipoperoxidation, and antioxidant trace elements | Exercise had no significant effect on any parameter other than increased neutrophil activity, which was similar in healthy controls |
| Loudon et al, 199962 | 10 sedentary women and 2 men with mildly active CD or CD in remission | Structured low-intensity walking program consisting of three sessions a week for 12 weeks of 20–35 minutes duration for all patients | IBD Stress Index, IBDQ, HBI, Aerobic Fitness VO2 Max, and BMI | All measures had statistically significant (p<0.05) decreases over the 12-week study period |
| Elensbruch et al, 200580 | 15 UC patients in remission or with mildly active disease matched with 15 controls with UC | 60-hour mind–body training program over 10 weeks that included moderate exercise as well as stress management training, Mediterranean diet, and behavioral/self-care techniques vs no intervention | Quality of life, disease activity, and perceived stress via standardized disease scores (IBDQ, SF-36, PSS, CAI), secondary analysis of hormome and leukocyte levels and TNF modulation in each group | Statistically significant improvement in intervention group in quality of life (SF-36) and disease-related quality-of-life (IBDQ) scores, no difference in perceived patient stress, TNF modulation, leukocytes, or hormone levels |
| Ng et al, 200761 | 32 sedentary patients with inactive or mildly active CD randomized to exercise or usual care | 30 minutes of walking at 40% of aerobic capacity 3 times a week for 3 months vs no intervention | IBDQ, HBI, and IBDSI scores | Improvement in scores in the intervention cohort HBI (p<0.01) IBDQ (p<0.05) IBDSI (p<0.05) |
| Ploeger et al, 201259 | 15 pediatric patients with CD compared to 15 healthy matched controls | Moderate-intensity exercise (30 minutes of cycling at 50% of peak mechanical power) vs high-intensity interrupted exercise (6 sessions of 4×15 seconds of cycling at peak mechanical power with a minute of rest in between) |
Changes in immune cells, inflammatory markers, and growth factors before and after different modes of exercise | Similar increases in inflammatory markers, immune cells, and growth factors in IBD and control groups Increases greater in moderate-intensity, noninterrupted exercise All markers returned to baseline within 30–60 minutes of exercise cessation |
| Klare et al, 201564 | 30 patients with moderate-to-mild CD | Randomized to moderate-intensity running 3× weekly for 10 weeks vs usual care | IBDQ scores and subscores, disease activity, inflammatory markers, body composition | No significant difference in total IBDQ scores, IBDQ social subscores did improve in intervention group (p=0.023) No disease exacerbation |
| Jones et al, 201582 | 1,308 CD patients, 549 UC patients in remission |
Low or high levels of exercise, measured by self-report index | Disease activity indices for CD and UC 6 months later | Reduced risk of CD exacerbation (RR: 0.72, 95% CI: 0.55–0.94), reduced risk of UC exacerbation (RR: 0.78, 95% CI: 0.54–1.13), with higher levels of exercise |
Abbreviations: BMD, bone mineral density; BMI, body mass index; CAI, clinical activity index; CD, Crohn’s disease; HBI, Harvey Bradshaw Index; IBD, inflammatory bowel disease; IBDQ, IBD questionnaire; IBD SI, IBD stress index; PSS, perceived stress scale; RR, reduced risk; TNF, tumor necrosis factor; UC, ulcerative colitis.