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Improvement of Fatigue and Quality of Life in Patients with Quiescent Inflammatory Bowel Disease Following a Personalized Exercise Program


Background and Aims

Fatigue significantly impacts the quality of life of patients with inflammatory bowel disease (IBD). This study aimed to assess the effect of a personalized, intensive exercise program on fatigue, health-related quality of life (HRQoL), and cardiorespiratory fitness in patients with quiescent IBD and severe fatigue.


A pilot study was performed including IBD patients in remission with severe fatigue. The 12-week exercise program consisted of three times per week 1-h sessions, including aerobic- and progressive-resistance training at personalized intensity based on a cardiopulmonary exercise test (CPET) and one-repetition maximum. CPET was repeated after 12 weeks. Fatigue and HRQoL were assessed using the checklist individual strength and 32-item IBD questionnaire.


Twenty-five IBD patients with mean age of 45 (± 2.6) years were included of which 22 (88%) completed the exercise program. Fatigue significantly improved from 105 (± 17) points on the checklist individual strength before, to 66 (± 20) after completion of exercise program (p < 0.001). Patients’ HRQoL significantly improved from 156 (± 21) to 176 (± 19) (p < 0.001). When looking at the subdomains of HRQoL, significant improvement was seen in emotional (58 ± 12 vs. 69 ± 9.1, p = 0.003), systemic (19 ± 3.9 vs. 24 ± 4.7, p < 0.001), and social function (25 ± 5.4 vs. 30 ± 3.9, p < 0.001). Bowel symptoms did not change (53 ± 7.7 vs. 55 ± 7.3, p = 0.208). Repeat CPET showed a significant improvement in maximum power patients were able to deliver (2.4 ± 0.5 vs. 2.7 ± 0.5 W/kg, p = 0.002).


A personalized, intensive exercise program can lead to significant improvement of fatigue, HRQoL, and cardiorespiratory fitness in patients with quiescent IBD and severe fatigue.

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Fig. 1
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One-repetition maximum


Crohn’s disease


Checklist individual strength


Checklist individual strength–fatigue


Cardiopulmonary exercise test




Inflammatory bowel diseases


Inflammatory bowel disease questionnaire


Inflammatory bowel disease unclassified


Ulcerative colitis


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The authors thank the participating patients for their great effort and enthusiasm during their performance in this study.


This work was supported by “Rijnstate Vriendenfonds.”

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Authors and Affiliations



BR, WHD, JW, CHTH, CL, RC, PW and MG contributed to the study concept and design. RC and PK were responsible for the effectuation of the cardiorespiratory fitness tests. CL was responsible for conducting the exercise program and guidance of patients during training sessions. LE, BR, WHD and JW contributed to acquisition of data. LE and BR contributed to the analysis and interpretation of data. All authors contributed to drafting the article and revised it critically for important intellectual content and statistical analysis. All authors provided final approval of the version to be submitted.

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Correspondence to Liselot W. van Erp.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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van Erp, L.W., Roosenboom, B., Komdeur, P. et al. Improvement of Fatigue and Quality of Life in Patients with Quiescent Inflammatory Bowel Disease Following a Personalized Exercise Program. Dig Dis Sci 66, 597–604 (2021).

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