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

Abstract

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.

Methods

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.

Results

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).

Conclusions

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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Abbreviations

1RM:

One-repetition maximum

CD:

Crohn’s disease

CIS:

Checklist individual strength

CIS–F:

Checklist individual strength–fatigue

CPET:

Cardiopulmonary exercise test

Hb:

Hemoglobin

IBD:

Inflammatory bowel diseases

IBDQ:

Inflammatory bowel disease questionnaire

IBD-U:

Inflammatory bowel disease unclassified

UC:

Ulcerative colitis

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Acknowledgments

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

Funding

This work was supported by “Rijnstate Vriendenfonds.”

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Authors

Contributions

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.

Corresponding author

Correspondence to Liselot W. van Erp.

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The authors declare that they have no conflict of interest.

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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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Cite this article

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). https://doi.org/10.1007/s10620-020-06222-5

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Keywords

  • Inflammatory bowel disease
  • Fatigue
  • Quality of life
  • Exercise