Table 1. Characteristics of included studies.
| Author/Year | Study Design | Participants | Interventions | Outcome-measures |
|---|---|---|---|---|
| Robinson et al (1998) [46] | RCT | 107 CD participants with mild to moderate disease activity [IG = 60, CG = 57]. 48 males. Mean age 40.7 | IG: 12-month twice-weekly home-based low-impact progressive resistance training programme | BMD (DEXA) at the femoral neck, greater trochanter and lumbar spine taken at baseline and 12 months |
| CG: Usual care | ||||
| Loudon et al (1999) [43] | Uncontrolled pilot study | 12 CD inactive or mildly active participants, no controls. 2 males. Mean age 38.5 | 12-week supervised (indoor track) and unsupervised (outdoors) walking programme 3 sessions (20 min per session, leading to 35 min) a week | Stress (IBBSI), HRQOL (IBDQ), disease activity (HBI), aerobic fitness (V̇O2 max), BMI at 1 and 3 months |
| Candow et al (2002) [44] | Conference abstract; Uncontrolled cohort study | 12 CD participants, no controls. 5 males. Age range 34–51 | Resistance training programme consisting of 3 sets, 8–10 repetitions, 12 exercises working at 60–70% of 1RM 3 times a week over 12 weeks | Disease activity (HBI), muscle strength (1-repetition maximum leg press and chest press) at 1 and 3 months |
| Ng et al (2007) [48] | RCT; Stratified randomisation | Inactive or mildly active 32 CD participants [IG = 16, CG = 16]. 14 males. Mean age 38.8 | IG: 3-month independent low intensity walking programme, working at 40% of aerobic capacity for 30 minutes, 3 times a week | HRQOL (IBDQ), stress (IBDSI), disease activity (HBI) at baseline, 1, 2 and 3 months. PA habits (IPAQ-Long) at baseline and 3 months |
| CG: Usual care and asked to maintain their habitual PA levels | ||||
| De Souza-Tajiri et al (2014) [45] | Letter to the editor; Uncontrolled pilot study | 19 women with IBD [CD = 10, UC = 9] and quadriceps weakness. No controls | 8-week progressive supervised resistance training programme twice a week lasting 20 minutes | HRQOL (IBDQ) and quadriceps strength (maximal isometric quadriceps strength and quadriceps 1-RM) at baseline and 8-weeks post exercise |
| Sharma et al (2015) [47] | RCT | 87 IBD [CD = 36, UC = 51] participants in clinical remission [IG = 50, CG = 50]. 54 males. Mean age 34.7 | IG: One supervised yoga session, followed by 7 weeks 1 hour daily home-based sessions | Cardiovascular autonomic functions (heart rate variability through ECG), immune markers (ECP, sIL-2R) and anxiety (STAI) at baseline and 2 months. Clinical symptoms (diary) were recorded |
| CG: Usual care | ||||
| Klare et al (2015) [52] | RCT | 30 IBD participants [CD = 19, UC = 11] with an inactive to moderate disease [IG = 15, CG = 15]. 8 males. Mean age 41.1 | IG: Supervised moderate intensity outdoor running, 3 times a week for 10 weeks | HRQOL (IBDQ), disease activity (CDAI and RI), BMI, inflammatory markers (CRP and FC) and immune parameters (LC) at baseline and 10-week follow-up |
| CG: Asked to maintain their current lifestyle behaviours and avoid PA exceeding two hours per week | ||||
| Cramer et al (2017) [49] | RCT | 77 UC participants [IG = 39, CG = 38] in clinical remission. 19 males. Mean age 45.8 | IG: 12-week traditional hatha yoga programme, 90 minutes per week | HRQOL (IBDQ) and disease activity (CAI) at week 1, 12 and 24 |
| CG: Received two evidence-based self-care books and were offered the same yoga classes at week 24 | ||||
| Cronin et al (2019) [27] | RCT partial cross-over trial | 17 IBD participants [CD = 7, UC = 13] in clinical remission. 15 males. Median age of IG = 33 and CG = 31 | IG: Combined progressive aerobic and resistance, 3 times a week for 8 weeks. | QOL (SF-36), disease activity (HBI and SCI), psychological well-being (HADS, STAI and BDI-II), body composition (DEXA), pro-inflammatory cytokines (IL6, IL8, IL10 and TNF-a), gut microbiome (α and b-diversity) at baseline and 8 weeks |
| CG: Usual care, followed by exercise phase after 8 weeks | ||||
| Tew et al (2019) [28] | Pilot RCT | Inactive or mildly active 36 CD participants [IG1 = 13, IG2 = 12, CG = 11]. 17 males. Mean age of IG1 = 37, IG2 = 38.5 and CG = 25 | IG1: HIIT of ten 1-minute bouts of cycling at 90% of Wpeak interspersed with 1-minute bouts of 15% of Wpeak 3 times a week for 12 weeks | Feasibility, acceptability, safety, HRQOL (IBDQ), QOL (EQ-5D), Fatigue (IBD-F), psychological well-being (HADS) and physical activity habits (IPAQ) at week 1, 13 and 26. Body mass, waist circumference, blood pressure, resting heart rate, cardiorespiratory fitness (Ventilatory threshold and peak oxygen uptake), disease status (CDAI) and inflammatory status (FC) at week 1 and week 13. |
| IG2: MICT of 30 minutes of cycling at 35% Wpeak. 3 times a week for 12 weeks | ||||
| CG: Usual care group, offered an exercise consultation following study completion | ||||
| Fagan et al (2019) [29] | Conference abstract; Uncontrolled prospective cohort study | 82 IBD participants with an inactive or mildly/moderately active disease. No controls | Home-based personalised exercise programme 5 times a week lasting 10 minutes per session for a total of 4 months | Fatigue (MFI), anxiety, depression and HRQOL (IBDQ), disease activity (HBI, SCI), physical activity (IPAQ) at baseline and 4 months. Blood and stool samples were also analysed. |
| van Erp et al (2021) [30] | Uncontrolled pilot study | 25 inactive IBD participants with severe fatigue (≥3 months) [CD = 21; UC = 3; IBDU = 1]. 15 males. Mean age 45 | Personalised aerobic and progressive-resistance training programme thrice a week for 12 weeks with each session lasting for 1 hour (30 minutes aerobic and 30 minutes resistance). The programme consisted of using an indoor bicycle/cross-trainer/treadmill at 65–80% of maximum HR and 8 resistance training machines performing 15–20 repetitions at a weight of 40–60% of 1RM. | Fatigue (CIS), HRQOL (IBDQ), cardiorespiratory fitness (CPET) with maximum power and maximum oxygen uptake (V̇O2 max), body composition (BMI, BF% [skinfolds], BP and resting heart rate [ECG]) at baseline and 12 weeks |
| Seeger et al (2020) [31] | Pilot RCT | Inactive or mildly active 45 IBD participants [IG 1 = 17, IG 2 = 15, CG = 13]. 17 males. Mean age IG1 = 39.6, IG2 = 42 and CG = 43.7 | IG1: Moderate endurance home-based exercise programme performed for 30 minutes, thrice weekly for 12 weeks | Disease activity (CDAI, PRO2), lower extremity strength (isometric measurement of the quadriceps), handgrip strength (dynamometer), laboratory parameters (FC, TBC) and anthropometric data (BP, pulse, BMI and respiratory rate) at baseline and 3 months. HRQOL (sIBDQ), physical activity levels (sIPAQ), and disease activity (PRO2) at baseline, 3 and 6 months. |
| IG2: Muscular training programme consisting of 2–3 sets, 12 exercises performed three times a week and lasting 30–40 minutes each for 12 weeks | ||||
| CG: Usual care | ||||
| Jones et al (2020) [32] | RCT | Inactive or mildly active 47 CD participants [IG = 23; CG = 24]. 15 males. Mean age IG = 46.1, CG = 52.3 | IG: 6-month progressive combined impact and resistance training programme consisting of skipping, 2–3 sets of 10–15 repetitions for 5 multidirectional jumps followed by 2–3 sets of 10–15 repetitions for 8–10 TheraBand® elastic band exercises, three times a week. Programme was primarily homebased with 12 supervised sessions gradually tapered over 6 months. | BMD (DEXA) at the femoral neck, greater trochanter and lumbar spine at baseline and 6 months. Upper body strength (handgrip dynamometer, isokinetic strength of elbow flexors), lower body strength (isokinetic strength of knee extensors). Lower-body muscular endurance (30 seconds chair stand test), upper-body muscular endurance (30 seconds bicep curl test). HRQOL (IBDQ), QOL (EQ-5D-5L), fatigue (IBD-F), physical activity levels (SPAQ), disease activity (CDAI, FC) and anthropometric data (BP and resting heart rate) at baseline, 3 and 6 months |
| CG: Usual care comprised of evidence‐based medical treatment and an exercise consultation offered to control participants following completion of the study | ||||
| Kaur et al (2022) [33] | Uncontrolled Pilot Study | 9 IBD participants with an active (n = 5) or inactive (n = 4) disease [CD = 6; UC = 3]. 1 male. Mean age 52.1 | 8-week combined supervised and home-based yoga intervention. Supervised sessions were delivered once a week lasting 30 minutes, the first session was delivered over two hours. Home-based sessions were completed daily. | Adherence, adverse events, salient beliefs, acceptability, and safety. Depression (PHQ-9), anxiety (GAD-7), perceived stress (PSS-10), HRQOL (SF-12), sleep quality (PSQI) and disease activity (HBI and Partial Mayo Score) at baseline and 8 weeks |
IG, Intervention Group; CG, Control Group; CD, Crohn’s Disease; UC, Ulcerative Colitis; HRQOL, Health-Related Quality of Life; BMI, Body Mass Index; IBD, Inflammatory Bowel Disease; IBDQ, Inflammatory Bowel Disease Questionnaire; HBI, Harvey Bradshaw Index; RCT, Randomised Controlled Trial; FC, Faecal Calprotectin; CRP, C-reactive Protein; RI, Rachmilewitz Index; DEXA, Dual-Energy X-Ray Absorptiometry; PA, Physical Activity; IPAQ, International Physical Activity Questionnaire; ECG, Electrocardiogram; CAI, Clinical Activity Index; SCI, Simple Colitis Index; STAI, State and Trait Anxiety Index; BDI-II, Beck Depression Inventory-II; SF-36, Short-Form 36; LC, Leucocytes; sIL-2R, Soluble Interleukin-2 Receptor; ECP, Eosinophilic Cationic Protein; HIIT, High-Intensity Interval Training; MICT, Moderate-Intensity Continuous Training; WPeak, Peak Power Output; MFI, Multidimensional Fatigue Inventory; sIBDQ, Short Inflammatory Bowel Disease Questionnaire; PRO2, Patient Reported Outcome Score 2; sIPAQ, Short International Physical Activity Questionnaire; BP, Blood Pressure; IBDU, Inflammatory Bowel Disease Unclassified; BF%, Body Fat Percentage; ECG, Electrocardiogram; PHQ, Patient Health Questionnaire; GAD, Generalised Anxiety Disorder Assessment; PSS, Perceived Stress Scale; SF-12, Short-Form 12; PSQI, Pittsburgh Sleep Quality Index