P813 A scoping review on the assessment and improvement of health-related physical fitness in patients with Inflammatory Bowel Disease

Abstract

Abstract Background Reaching the STRIDE-II therapeutic targets for inflammatory bowel disease (IBD) requires an interdisciplinary approach. Lifestyle interventions focusing on enhancing and preserving health-related physical fitness (HRPF) may aid in improving subjective health, decreasing disability, or even controlling inflammation. However, ambiguity remains about the status and impact of HRPF (body composition, cardiorespiratory fitness [CRF], muscular strength [MS], muscular endurance [ME], and flexibility) in IBD patients, hindering the development of physical activity and exercise guidelines. The aim of this scoping review was to provide an overview of the literature assessing HRPF components of interest (i.e., CRF, MS, ME, and flexibility) in IBD patients, as well as how HRPF is affected by physical activity and physical exercise training interventions. Methods A systematic search was performed in multiple databases up to 5 Nov 2022. Eligible studies included IBD patients and assessed HRPF components of interest or evaluated physical activity or physical exercise training interventions. Results The search yielded 7323 articles, of which 68 were included (Figure 1), with a median sample size of 42 (IQR 24–77). Of these studies, 53 were conducted in adults and 15 in children or adolescents. Most studies (n=32) focused on patients with Crohn's disease (CD), followed by studies that included both CD and ulcerative colitis (UC) patients (n=30) and studies that included only UC patients (n=6). A total of 56 studies assessed HRPF components, including CRF, MS, and ME (n=2); CRF and MS (n=5); MS and ME (n=7); CRF (n=13); MS (n=28); and ME (n=1) (Figure 2). Great heterogeneity existed in assessment methods, with frequent use of non-validated field tests (Table 1). According to limited studies that used gold-standard tests, CRF appears to be reduced in IBD patients, but controversial findings emerged regarding MS and ME. Physical activity or physical exercise training interventions in patients with IBD were evaluated in 22 studies, with only ten reporting effects on HRPF, overall indicating a favorable impact. However, most studies included only patients in remission or with mild disease activity, lacked proper patient selection based on HRPF, and the type and intensity of interventions varied across studies. Conclusion This review highlights a lack of literature on the accurate assessment of HRPF in patients with IBD, leading to a scarcity of evidence on the effect of physical activity and physical exercise training interventions. Future research should focus on validating practical field tests, elucidating the association between HRPF and patient-reported and clinical outcomes, and determining the optimal physical training paradigm for IBD patients.