Establishing Safe thresholds to Improve Exercise Capacity in Collegiate Athletes with Inflammatory Bowel Disease (IBD): A Critically Appraised Topic

Abstract

CLINICAL SCENARIO: Crohn’s Disease (CD), Ulcerative Colitis (UC), and Indeterminate Colitis (IC) are forms of Inflammatory Bowel Disease (IBD), a complex auto-immune disorder of the GI tract. IBD can present several challenges to athletic participation due to unpredictable disease activity and uncontrollable systemic symptoms that severely impact daily activities and limit exercise/sports participation. Limited studies and a lack of standard guidelines for physical activity (PA) and exercise are additional barriers for patients. The limitation of studies and absence of standard guidelines are a particular concern for Athletic Trainers who may encounter collegiate athletes with IBD and must navigate the return-to-play process following a disease flare-up or surgery. Limited sources have determined that exercise interventions (e.g., combined endurance and resistance training) of low-to-moderate intensity are safe and feasible for IBD patients, particularly those with inactive or mild-to-moderate disease activity.1 In theory, these types of interventions could promote improvements in exercise capacity in IBD patients. FOCUSED CLINICAL QUESTION: Is there evidence to suggest that established safe exercise-intensities promote improvements in exercise capacity in collegiate athletes (18-24 years of age) with IBD?