Abstract

BackgroundThis study assessed the feasibility and acceptability of two common types of exercise training—high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT)—in adults with Crohn’s disease (CD).MethodsIn this mixed-methods pilot trial, participants with quiescent or mildly-active CD were randomly assigned 1:1:1 to HIIT, MICT or usual care control, and followed up for 6 months. The HIIT and MICT groups were offered three exercise sessions per week for the first 12 weeks. Feasibility outcomes included rates of recruitment, retention, outcome completion, and exercise attendance. Data were collected on cardiorespiratory fitness (e.g., peak oxygen uptake), disease activity, fatigue, quality of life, adverse events, and intervention acceptability (via interviews).ResultsOver 17 months, 53 patients were assessed for eligibility and 36 (68%) were randomised (47% male; mean age 36.9 [SD 11.2] years); 13 to HIIT, 12 to MICT, and 11 to control. The exercise session attendance rate was 62% for HIIT (288/465) and 75% for MICT (320/429), with 62% of HIIT participants (8/13) and 67% of MICT participants (8/12) completing at least 24 of 36 sessions. One participant was lost to follow-up. Outcome completion rates ranged from 89 to 97%. The mean increase in peak oxygen uptake, relative to control, was greater following HIIT than MICT (2.4 vs. 0.7 mL/kg/min). There were three non-serious exercise-related adverse events, and two exercise participants experienced disease relapse during follow-up.ConclusionsThe findings support the feasibility and acceptability of the exercise programmes and trial procedures. A definitive trial is warranted. Physical exercise remains a potentially useful adjunct therapy in CD. [ID: ISRCTN13021107].

Highlights

  • This study assessed the feasibility and acceptability of two common types of exercise training—highintensity interval training (HIIT) and moderate-intensity continuous training (MICT)—in adults with Crohn’s disease (CD)

  • Regular exercise training has been recommended as an adjunct therapy for people with Crohn’s disease (CD) [1,2,3] because of its potential beneficial effects on physical fitness, mental health, and disease-related factors such as fatigue, bone mineral loss and inflammation [4,5,6]

  • There has only been one published study investigating high-intensity interval training (HIIT) in CD patients to date [17], which showed that a single session of cycle-based HIIT was well tolerated and did not markedly increase pro-inflammatory cytokines (e.g., TNF-α) in a group of 15 teenagers

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Summary

Introduction

This study assessed the feasibility and acceptability of two common types of exercise training—highintensity interval training (HIIT) and moderate-intensity continuous training (MICT)—in adults with Crohn’s disease (CD). A greater understanding of the feasibility, acceptability and effects of different types of exercise training is needed to support the development evidence-based exercise guidelines and promotion strategies that are specific to CD. We hypothesised that supervised endurance exercise training (either as HIIT or MICT) is a safe and effective strategy for improving cardiorespiratory fitness, fatigue, quality of life and mental health in people with CD. The main aims of the Exercise for Adults with Crohn’s disease Trial (EXACT) study were to determine the acceptability and potential benefits and harms of HIIT and MICT in adults with quiescent or mildly-active CD, and the feasibility of conducting a full-scale trial

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